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Manager Aetna Utilization Review Jobs (NOW HIRING)

Cobalt Benefits Group LLC

Director, Utilization Review

Exeter, NH · On-site

$135K - $155K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Director of Utilization Review is responsible for the strategic leadership, operational ... The position also advances technology-enabled utilization management, interoperability, and ...

Washington Hospital

Utilization Review Liaison

Fremont, CA · On-site

$32.35 - $43.63/hr

Description Salary Range: $32.35 - $43.63 + applicable differentials Under the general supervision of the Director of Case Management, the Utilization Review (UR) Liaison is responsible for the ...

Washington Hospital

Utilization Review Liaison

Fremont, CA · On-site

$32.35 - $43.63/hr

Description Salary Range: $32.35 - $43.63 + applicable differentials Under the general supervision of the Director of Case Management, the Utilization Review (UR) Liaison is responsible for the ...

New

AMN Healthcare Revenue Cycle

Travel Utilization Review

Atlanta, GA · On-site

$1.8K - $2.7K/wk

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Industry experienced workforce management team * Licensure and certification reimbursement About ... Utilization Review (UR) About AMN Healthcare Revenue Cycle AMN Healthcare is a leading force in the ...

Banyan

Utilization Review Specialist

Pompano Beach, FL · On-site

$50K - $65K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Utilization Review Specialist | Remote | Full-Time $50,000 - $65,000 Annually | Weekdays (Weekend ... In this remote role, you'll manage a caseload of 50-75 patients, conducting admission and ...

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Manager Aetna Utilization Review information

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$39K

$91K

$167.5K

How much do manager aetna utilization review jobs pay per year?

As of Aug 17, 2026, the average yearly pay for manager aetna utilization review in the United States is $91,011.00, according to ZipRecruiter salary data. Most workers in this role earn between $59,500.00 and $109,500.00 per year, depending on experience, location, and employer.

What does a manager in Aetna Utilization Review do?

A Manager of Aetna Utilization Review oversees the process of evaluating medical necessity, appropriateness, and efficiency of healthcare services for Aetna-insured members. They manage a team of utilization review nurses or specialists who review patient records and coordinate with healthcare providers to ensure compliance with Aetna’s policies. Their main goal is to ensure patients receive necessary care while controlling costs and preventing unnecessary treatments. Additionally, they may handle appeals, train staff, and implement process improvements.

What key skills and qualifications are needed to thrive as a manager in Aetna Utilization Review?

To thrive as a Manager in Aetna Utilization Review, you need a strong background in healthcare management, clinical knowledge (often as an RN or similar licensure), and experience with utilization review processes. Familiarity with case management software, medical coding systems, and compliance with regulatory requirements such as NCQA or URAC is typically expected. Leadership, decision-making, and communication skills are crucial for effectively guiding teams and collaborating with providers. These competencies ensure efficient care coordination, regulatory compliance, and high-quality patient outcomes in a complex healthcare environment.

How does a manager in Aetna Utilization Review typically collaborate with clinical teams and other departments to ensure effective patient care?

A Manager of Aetna Utilization Review works closely with clinical teams, case managers, and other departments to coordinate care and ensure that medical services are necessary and meet established guidelines. This role often involves reviewing patient cases, providing guidance on coverage decisions, and facilitating clear communication between healthcare providers and insurance representatives. Regular meetings and case discussions help to resolve complex cases and optimize patient outcomes. Effective collaboration is key to balancing cost efficiency with quality care, and managers are expected to foster a supportive environment that encourages teamwork and continuous improvement.

What is the difference between Manager Aetna Utilization Review vs Utilization Review Nurse?

AspectManager Aetna Utilization ReviewUtilization Review Nurse
CredentialsTypically requires a nursing license, certifications like CCM or ANCC, and management experienceRegistered Nurse (RN) license, relevant certifications
Work EnvironmentSupervises utilization review teams, collaborates with healthcare providers, and manages case reviewsConducts patient case assessments, reviews medical records, and makes utilization decisions
Employer & Industry UsageCommonly employed by insurance companies like Aetna, healthcare organizations, and managed care firmsUsed within insurance companies, healthcare facilities, and third-party review organizations

The main difference is that the Manager Aetna Utilization Review oversees the review process and manages teams, while the Utilization Review Nurse focuses on conducting case assessments and medical reviews. Both roles require nursing credentials, but the manager position involves leadership and administrative responsibilities.

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Manager Aetna Utilization Review jobs near you
Infographic showing various Manager Aetna Utilization Review job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 86% Full Time, 12% Part Time, and 1% Contract. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution, with an average salary of $91,011 per year, or $43.8 per hour.

Utilization Review Liaison

Washington Hospital Healthcare System

Fremont, CA

$32.35 - $43.63/hr

Full-time

Posted 13 days ago

Job description

Salary Range: $32.35 - $43.63 + applicable differentials

Under the general supervision of the Director of Case Management, the Utilization Review (UR) Liaison is responsible for the assisting Utilization Review Case Managers. The UR Liaison is responsible for coordinating insurance reviews and issuance of authorization numbers through submission of required clinical information. The UR Liaison will work directly with all Case Management staff, Business Office, Patient Access, and along with the Hospital's Revenue Cycle to ensure quality and efficiency of certain elements of claims processing, denial prevention, and denial management.

Provides office and referral management support services; assists the Utilization Review Team in obtaining medical records, documenting case information in the system, performing data entry into appropriate databases for monitoring and tracking, and following up on phone calls as directed.

Continue to learn about clinical programs, processes, and changes

May also perform office support functions as required

In addition to performing the essential functions listed below, may also be assigned other duties as required.

Employment Type: Full Time (8-hr, 1.0 FTE)

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