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Manager Optum Utilization Review Jobs in Minnesota

ISHE

SSBV Medical Director - Remote

Plymouth, MN · On-site

$249 - $373/hr

Optum is a global organization that delivers care, aided by technology to help millions of people ... MCG) in utilization review or payment integrity settings * Experience with short-stay billing ...

Tnafp

SSBV Medical Director - Remote

Plymouth, MN · On-site

$249 - $373/hr

Optum is a global organization that delivers care, aided by technology to help millions of people ... MCG) in utilization review or payment integrity settings * Experience with short-stay billing ...

NHSHP

SSBV Medical Director - Remote

Plymouth, MN · On-site

$249 - $373/hr

Optum is a global organization that delivers care, aided by technology to help millions of people ... MCG) in utilization review or payment integrity settings * Experience with short-stay billing ...

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Manager Optum Utilization Review information

What does a manager Optum Utilization Review do?

A Manager of Optum Utilization Review oversees a team responsible for evaluating the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They ensure that all reviews comply with regulatory standards, company policies, and clinical guidelines. Managers also collaborate with healthcare providers, monitor team performance, and help implement process improvements to optimize patient outcomes and resource use. Their role is vital in balancing quality patient care with cost-effective service delivery.

How does a manager Optum Utilization Review typically collaborate with clinical and non-clinical teams to ensure effective case management?

As a Manager in Optum Utilization Review, you will regularly coordinate with clinical teams such as nurses, physicians, and case managers to review patient cases for medical necessity and compliance with policies. You’ll also work closely with non-clinical staff, including data analysts and administrative professionals, to streamline workflows and support accurate documentation. Effective collaboration ensures timely decision-making, helps resolve escalated cases, and supports continuous quality improvement initiatives. This role often requires strong communication and leadership skills to align multidisciplinary teams and achieve organizational goals.

What are the key skills and qualifications needed to thrive as a manager Optum Utilization Review, and why are they important?

To thrive as a Manager, Optum Utilization Review, you need a background in healthcare management, clinical expertise (often as an RN or related field), and experience with utilization management processes. Familiarity with utilization review software, electronic health records (EHRs), and relevant certifications such as CCM (Certified Case Manager) or URAC accreditation is typically required. Strong leadership, analytical thinking, and effective communication skills help you guide teams and collaborate with providers and payers. These competencies are crucial for ensuring compliance, optimizing patient care, and achieving organizational goals in a complex healthcare environment.

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

AspectManager Optum Utilization ReviewUtilization Review Nurse
CredentialsTypically requires a nursing license, certifications in case management or utilization reviewRegistered Nurse (RN) license, certifications in case management or utilization review
Work EnvironmentSupervises teams, manages review processes, collaborates with healthcare providersConducts patient reviews, assesses medical necessity, documents findings
Employer & Industry UsageCommon in health insurance companies, managed care organizations, healthcare providersPrimarily in hospitals, insurance companies, healthcare organizations

The main difference is that the Manager Optum Utilization Review oversees the review process and team management, while the Utilization Review Nurse focuses on conducting individual patient assessments and reviews. Both roles require nursing credentials and knowledge of healthcare policies, but the manager has additional responsibilities in leadership and process oversight.

What are the most commonly searched types of Optum Utilization Review jobs in Minnesota?

The most popular types of Optum Utilization Review jobs in Minnesota are:

What are popular job titles related to Manager Optum Utilization Review jobs in Minnesota?

For Manager Optum Utilization Review jobs in Minnesota, the most frequently searched job titles are:

What job categories do people searching Manager Optum Utilization Review jobs in Minnesota look for?

The top searched job categories for Manager Optum Utilization Review jobs in Minnesota are:

What cities in Minnesota are hiring for Manager Optum Utilization Review jobs?

Cities in Minnesota with the most Manager Optum Utilization Review job openings:

Manager Optum Utilization Review jobs near you
Infographic showing various Manager Optum Utilization Review job openings in Minnesota as of August 2026, with employment types broken down into 2% As Needed, 87% Full Time, 3% Part Time, 2% Temporary, and 6% Contract. Highlights an 89% In-person, 2% Hybrid, and 9% Remote job distribution.

Director, Optum Wallet

UnitedHealth Group

Eden Prairie, MN • On-site

Full-time

Retirement

This job post has expired 1 day ago. Applications are no longer accepted.

UnitedHealth Group rating

7.6

Company rating: 7.6 out of 10

Based on 146 frontline employees who took The Breakroom Quiz

192nd of 898 rated healthcare providers

Job description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
Optum Financial, as one of UHG's five Growth Pillars, continues to present significant opportunities within the enterprise, in existing markets, and for developing products and markets that do not yet exist. Optum Wallet is a next-generation strategic initiative focused on transforming how consumers pay for healthcare by unifying healthcare funds, modern payment capabilities, and embedded financial experiences across the care journey. As Optum Wallet moves from strategy to launch, there is a critical need for a solid execution leader to support business stand-up and early market traction.
The Director, Optum Wallet - Business Operations & GTM will serve as the right-hand to the Optum Wallet GM, acting as a high-impact operator responsible for driving execution across go-to-market, partnerships, and business operations. This role will work closely with cross-functional leaders across Product, Payments, Strategy, and Distribution to ensure successful pilot launches and scalable GTM pathways.
Primary Responsibilities:
  • Drive execution of Optum Wallet's early go-to-market strategy, including pilot launches with providers, platforms, and partners
  • Support the Optum Wallet GM in translating strategy into detailed execution plans, milestones, and deliverables
  • Coordinate cross-functional teams (Product, Engineering, Payments, Legal, Sales) to ensure launch readiness and alignment
  • Lead day-to-day management of pilot partners, including onboarding, integration coordination, and issue resolution
  • Support development and refinement of distribution strategy, including provider channels, platform integrations, and partner pathways
  • Assist in structuring early commercial models and partner economics, including tradeoffs across integration and payment models
  • Identify and proactively resolve key risks and dependencies (e.g., integration constraints, operational processes, regulatory considerations)
  • Synthesize learnings from pilots and partner interactions to inform product roadmap and GTM evolution
  • Prepare executive materials and provide clear, data-driven recommendations to support decision-making and prioritization
  • Serve as a key execution partner to the GM, ensuring consistent operating cadence, progress tracking, and momentum

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
  • 6+ years of experience in consulting, business operations, corporate strategy, product strategy, or go-to-market execution
  • 5+ years of experience leading cross-functional initiatives that delivered measurable business outcomes such as revenue growth, cost reduction, operational efficiency, or customer adoption
  • 4+ years of experience using data analysis, financial modeling, forecasting, or KPI management to drive business decisions and quantify impact
  • 3+ years of experience managing complex programs spanning multiple business functions from strategy through execution
  • 3+ years of experience supporting executive-level decision making through business case development, strategic planning, performance reporting, or operating reviews
  • Demonstrated experience delivering multiple concurrent initiatives on schedule and within defined business objectives
  • Advanced proficiency in Microsoft Excel, including financial modeling, scenario analysis, forecasting, and dashboard development
  • Advanced proficiency in Microsoft PowerPoint, including development of executive-level presentations and strategic recommendations

Preferred Qualifications:
  • 3+ years of experience in fintech, payments, healthcare, digital platform, or technology-enabled businesses
  • 2+ years of experience supporting payment products, payment operations, processors, payment flows, or integration models
  • Experience leading or supporting 0-to-1 product launches, new business ventures, or market expansion initiatives
  • Knowledge of Optum, UnitedHealthcare (UHC), or the broader healthcare ecosystem
  • Experience managing external partners, strategic alliances, or commercial relationships
  • Experience supporting partnership negotiations, business development, or commercial deal execution
  • Solid written and verbal communication skills, including preparation of executive communications and leadership presentations

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $134,600 to $230,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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