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Full Time Utilization Management Jobs (NOW HIRING)

Acadia Healthcare

Utilization Specialist

Battle Creek, MI · On-site

$35 - $42/hr

Bronson Behavioral Health Hospital is hiring a full-time Utilization Specialist. The Utilization Specialist will act as a liasion between managed care organizations and the professional clinical ...

Humana

Utilization Management Registered Nurse

As a Utilization Management Registered Nurse: * You will use clinical nursing skills to interpret ... full time (40 hours per week) employment at the time of posting. The pay range may be higher or ...

Humana

Utilization Management Registered Nurse

As a Utilization Management Registered Nurse: * You will use clinical nursing skills to interpret ... full time (40 hours per week) employment at the time of posting. The pay range may be higher or ...

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Full Time Utilization Management information

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$39K

$89.5K

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How much do full time utilization management jobs pay per year?

As of Sep 13, 2026, the average yearly pay for full time utilization management in the United States is $89,483.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,500.00 and $104,500.00 per year, depending on experience, location, and employer.

What is utilization management?

Utilization Management (UM) in a full-time role involves evaluating the necessity, appropriateness, and efficiency of the use of healthcare services, procedures, and facilities. Professionals in this field, often nurses or healthcare administrators, review patient cases, coordinate with healthcare providers, and ensure that care meets established guidelines while controlling costs. Their goal is to optimize patient outcomes by ensuring the right level of care is provided at the right time, while also helping organizations comply with regulations and insurance requirements.

How does a full time utilization management role typically interact with clinical and administrative teams?

In a Full Time Utilization Management position, you will regularly collaborate with both clinical staff, such as physicians and nurses, and administrative teams, like case managers and billing specialists. Your main responsibility is to review patient care requests, ensure services are medically necessary, and coordinate approvals or denials based on established guidelines. Effective communication and teamwork are essential, as you’ll often facilitate discussions between departments to optimize patient outcomes and resource use. This collaborative environment helps you build a broad understanding of healthcare processes and strengthens your problem-solving skills.

What are the key skills and qualifications needed to thrive as a full time utilization management professional?

To thrive in Full Time Utilization Management, you need a background in healthcare (often as an RN or other clinical license), strong knowledge of medical necessity criteria, and familiarity with insurance guidelines. Expertise in case management software, electronic health records (EHRs), and certifications such as Certified Case Manager (CCM) or Accredited Case Manager (ACM) are typically required. Attention to detail, critical thinking, effective communication, and negotiation skills help you advocate for appropriate patient care while managing costs. These skills ensure efficient resource allocation, compliance with regulations, and optimal patient outcomes within healthcare organizations.

What is the difference between Full Time Utilization Management vs Utilization Review Nurse?

AspectFull Time Utilization ManagementUtilization Review Nurse
CredentialsRN license, certifications in case management or utilization reviewRN license, certifications in utilization review or case management
Work EnvironmentTypically full-time, office-based, healthcare organizationsOften part-time or per review, hospital or insurance settings
Employer & IndustryHealth insurance companies, healthcare providersHospitals, insurance companies, third-party review organizations

Full Time Utilization Management professionals oversee the entire utilization review process, often in a full-time capacity, focusing on managing patient care and resource utilization. Utilization Review Nurses perform specific review tasks, usually on a case-by-case basis, and may work part-time or per review. Both roles require RN licensure and related certifications, but Full Time Utilization Management roles involve broader responsibilities and continuous oversight.

What cities are hiring for Full Time Utilization Management jobs?

Cities with the most Full Time Utilization Management job openings:

What are the most commonly searched types of Utilization Management jobs?

The most popular types of Utilization Management jobs are:

What states have the most Full Time Utilization Management jobs?

States with the most job openings for Full Time Utilization Management jobs include:

What are popular job titles related to Full Time Utilization Management jobs?

For Full Time Utilization Management jobs, the most frequently searched job titles are:

Full Time Utilization Management jobs near you

Utilization Specialist

Battle Creek, MI • On-site

Acadia Healthcare
Hospitals • 10K+ employees
Learn more about Acadia Healthcareexternal

$35 - $42/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 5 days ago

Acadia Healthcare rating

6.3

Company rating: 6.3 out of 10

Based on 192 frontline employees who took The Breakroom Quiz

Job description

Overview
Join a compassionate team where your creativity and therapeutic skills truly make a meaningful impact on the lives of our patients.
Bronson Behavioral Health Hospital is hiring a full-time Utilization Specialist. The Utilization Specialist will act as a liasion between managed care organizations and the professional clinical staff at the hospitial.
The hourly pay range for this position is $35.00 -$42.00. Bronson offers competitive wages along with a comprehensive benefits package and many additional perks.
  • Three Medical Plan Levels, Dental and Vision Insurance
  • HSA with a Company Contribution
  • FSA Dependent Care Flexible Spending Account
  • Basic Life/AD&D and Supplemental Life Insurance
  • Short-Term and Long-Term Disability Insurance
  • 401k with a Company Match
  • EAP (Employee Assistance Program)
  • Employee Discount Program
  • Vacation, Sick Time, Personal Days, and 8 Paid Holidays
  • Tuition Reimbursement
  • Access to continuing education credits at no cost to you
  • Paid training and professional development

Proactively monitor utilization of services for patients to optimize reimbursement for the facility.
Responsibilities
ESSENTIAL FUNCTIONS:
  • Act as liaison between managed care organizations and the facility professional clinical staff.
  • Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
  • Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.
  • Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
  • Conduct quality reviews for medical necessity and services provided.
  • Facilitate peer review calls between facility and external organizations.
  • Initiate and complete the formal appeal process for denied admissions or continued stay.
  • Assist the admissions department with pre-certifications of care.
  • Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.

OTHER FUNCTIONS:
  • Perform other functions and tasks as assigned.

Qualifications
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
  • Required Education: High school diploma or equivalent.
  • Preferred Education: Associate's, Bachelor's, or Master's degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field.
  • Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred

LICENSES/DESIGNATIONS/CERTIFICATIONS:
  • Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
  • CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.
  • First aid may be required based on state or facility requirements.

ADDITIONAL REGULATORY REQUIREMENTS:
While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances
(e.g. emergencies, changes in workload, rush jobs or technological developments) dictate.
We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.
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About Acadia Healthcare

Sourced by ZipRecruiter

Acadia Healthcare is a leading provider in the healthcare and hospital industry, based in Franklin, Tennessee, United States. The company is recognised for its commitment to creating a behavioural health network that provides accessible, high-quality treatment options for individuals suffering from mental health issues, addiction, eating disorders, and PTSD. Acadia Healthcare was founded in 2005, with the mission to create a world-class organization that sets the standard of excellence in the treatment of specialty behavioural health and addiction disorders.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Franklin, TN, US

Year founded

2005

Social media

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