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Manager Optum Utilization Review Jobs in Seattle, WA

Briljent

Clinical Domain Project Manager (PBM)

Seattle, WA · On-site

$110 - $140/hr

Assigned projects span drug coverage administration, Preferred Drug List (PDL) management, prior authorization, utilization management, drug utilization review, clinical criteria configuration, and ...

ProMed Healthcare PLLC

Case Management RN

Everett, WA · On-site

Accountabilities include assessment and planning, coordination of care, resource utilization management and/ or review, discharge planning, documentation of interventions, regulatory compliance and ...

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All JobsOptum Utilization Review JobsManager Optum Utilization Review JobsManager Optum Utilization Review Jobs in Seattle, WA

Manager Optum Utilization Review information

See Seattle, WA salary details

$44.4K

$103.6K

$190.6K

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

As of Aug 22, 2026, the average yearly pay for manager optum utilization review in Seattle, WA is $103,573.00, according to ZipRecruiter salary data. Most workers in this role earn between $67,700.00 and $124,600.00 per year, depending on experience, location, and employer.

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 Seattle, WA?

The most popular types of Optum Utilization Review jobs in Seattle, WA are:

What are popular job titles related to Manager Optum Utilization Review jobs in Seattle, WA?

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

What job categories do people searching Manager Optum Utilization Review jobs in Seattle, WA look for?

The top searched job categories for Manager Optum Utilization Review jobs in Seattle, WA are:

What cities near Seattle, WA are hiring for Manager Optum Utilization Review jobs?

Cities near Seattle, WA 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 Seattle, WA as of August 2026, with employment types broken down into 2% As Needed, 87% Full Time, 6% Part Time, 2% Temporary, and 3% Contract. Highlights an 86% In-person, 2% Hybrid, and 12% Remote job distribution, with an average salary of $103,573 per year, or $49.8 per hour.

RN - Care Manager Utilization Review

MLee Medical Employment

Vashon, WA • On-site

Other

Medical, Dental, Vision, Retirement

Re-posted 22 days ago

Job description

Join a dynamic healthcare team in the Pacific Northwest as a Registered Nurse Care Manager specializing in Utilization Review. This role involves coordinating care and managing the utilization of services for patients in acute and post-acute skilled care settings. You will collaborate closely with interdisciplinary teams both inside and outside the organization to enhance patient outcomes and ensure cost-effective care.
Job Summary
As a vital member of the care team, you will continuously assess the appropriateness and timeliness of care levels, ensuring resources are used efficiently. Your daily activities include rounding with patients, conducting assessments, and facilitating smooth transitions from hospital to home or other care facilities. You will also identify and resolve discharge barriers, provide clear documentation, and support peer-to-peer reviews for concurrent denials.
Education and Experience

  • Minimum of 2 years of Registered Nursing experience in acute care or care management/utilization review.
  • Current RN license valid in the region or multistate license.
  • BLS certification is required.
  • Bachelor's degree in Nursing and Care Manager Certification are preferred.
Skills and Abilities
  • Strong organizational and prioritization skills.
  • Excellent written and verbal communication tailored to diverse audiences.
  • Proficiency with technology and software, including intermediate to advanced Microsoft Office skills.
  • Ability to maintain confidentiality and accurate documentation.
  • Demonstrated teamwork, collaboration, and customer service skills in fast-paced environments.
  • Independent problem-solving and sound judgment to complete tasks effectively.

Work Environment and Benefits
This full-time exempt position offers a supportive work environment with opportunities for professional growth. Benefits include competitive compensation, comprehensive medical, dental, and vision coverage, retirement plans with employer contributions, tuition reimbursement, employee wellness programs, and more. The location provides access to numerous outdoor recreational activities such as hiking, kayaking, fishing, and cultural experiences in the Pacific Northwest region.
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About McCall and Lee

Sourced by ZipRecruiter

McCall and Lee is a well-known and reputable company, headquartered in Austin, Texas, United States. Operating in the healthcare industry, their primary services center around professional recruiting and executive search. They cater to the needs of various levels of medical practitioners and executive positions for healthcare establishments. McCall and Lee is founded on the premise of filling healthcare vacancies with the most suitable and competent professionals to ensure top-quality medical service delivery. Their core value revolves around integrity, excellence, commitment, and customer satisfaction.

Industry

Recruiting and staffing services and human resources consulting services

Company size

11 - 50 Employees

Headquarters location

Austin, TX, US

Social media

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