In Utilization Management at Main Campus Lee Building Work schedule will be Full-time on the Day Shift, Monday - Friday 8:00am - 4:30pm. Summary: Responsible for the day to day functions of the ...
In Utilization Management at Main Campus Lee Building Work schedule will be Full-time on the Day Shift, Monday - Friday 8:00am - 4:30pm. Summary: Responsible for the day to day functions of the ...
... Utilization Management (UM) programs including prior authorization, concurrent inpatient and continued stay reviews including authorization and management of selected post inpatient care. This ...
... Utilization Management (UM) programs including prior authorization, concurrent inpatient and continued stay reviews including authorization and management of selected post inpatient care. This ...
Accountable for the functions of the Utilization Management department. * Develops and oversees policies and procedures, regulatory reporting and clinical practice guidelines. * Integrates quality ...
Accountable for the functions of the Utilization Management department. * Develops and oversees policies and procedures, regulatory reporting and clinical practice guidelines. * Integrates quality ...
As the Regional Manager of Utilization Management for Cleveland Clinic Florida, including Indian River, Martin Health, and Weston Hospitals, you will oversee the daily operations of Utilization ...
As the Regional Manager of Utilization Management for Cleveland Clinic Florida, including Indian River, Martin Health, and Weston Hospitals, you will oversee the daily operations of Utilization ...
Accountable for the functions of the Utilization Management department. * Develops and oversees policies and procedures, regulatory reporting and clinical practice guidelines. * Integrates quality ...
Accountable for the functions of the Utilization Management department. * Develops and oversees policies and procedures, regulatory reporting and clinical practice guidelines. * Integrates quality ...
Accountable for the functions of the Utilization Management department. * Develops and oversees policies and procedures, regulatory reporting and clinical practice guidelines. * Integrates quality ...
Accountable for the functions of the Utilization Management department. * Develops and oversees policies and procedures, regulatory reporting and clinical practice guidelines. * Integrates quality ...
Accountable for the functions of the Utilization Management department. * Develops and oversees policies and procedures, regulatory reporting and clinical practice guidelines. * Integrates quality ...
Accountable for the functions of the Utilization Management department. * Develops and oversees policies and procedures, regulatory reporting and clinical practice guidelines. * Integrates quality ...
Oversee the management of patient care utilization, ensuring appropriate healthcare services are provided while optimizing resource use. This individual will be responsible for leading a team of ...
Oversee the management of patient care utilization, ensuring appropriate healthcare services are provided while optimizing resource use. This individual will be responsible for leading a team of ...
Oversee the management of patient care utilization, ensuring appropriate healthcare services are provided while optimizing resource use. This individual will be responsible for leading a team of ...
Oversee the management of patient care utilization, ensuring appropriate healthcare services are provided while optimizing resource use. This individual will be responsible for leading a team of ...
... Manager will report to the Director of Utilization Management. In this role you will lead and support a team of clinicians to ensure safe, timely, and appropriate care for members. You will apply ...
... Manager will report to the Director of Utilization Management. In this role you will lead and support a team of clinicians to ensure safe, timely, and appropriate care for members. You will apply ...
... Manager will report to the Director of Utilization Management. In this role you will lead and support a team of clinicians to ensure safe, timely, and appropriate care for members. You will apply ...
... Manager will report to the Director of Utilization Management. In this role you will lead and support a team of clinicians to ensure safe, timely, and appropriate care for members. You will apply ...
... Manager will report to the Director of Utilization Management. In this role you will lead and support a team of clinicians to ensure safe, timely, and appropriate care for members. You will apply ...
... Manager will report to the Director of Utilization Management. In this role you will lead and support a team of clinicians to ensure safe, timely, and appropriate care for members. You will apply ...
Manager, Utilization Management Nurse Management
El Dorado Hills, CA · On-site
$111K - $167K/yr
... Manager will report to the Director of Utilization Management. In this role you will lead and support a team of clinicians to ensure safe, timely, and appropriate care for members. You will apply ...
Manager, Utilization Management Nurse Management
El Dorado Hills, CA · On-site
$111K - $167K/yr
... Manager will report to the Director of Utilization Management. In this role you will lead and support a team of clinicians to ensure safe, timely, and appropriate care for members. You will apply ...
... Manager The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of care for both our Medi ...
... Manager The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of care for both our Medi ...
... Manager The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of care for both our Medi ...
... Manager The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of care for both our Medi ...
... Manager will report to the Director of Utilization Management. In this role you will lead and support a team of clinicians to ensure safe, timely, and appropriate care for members. You will apply ...
... Manager will report to the Director of Utilization Management. In this role you will lead and support a team of clinicians to ensure safe, timely, and appropriate care for members. You will apply ...
... Manager The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of care for both our Medi ...
... Manager The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies the guidelines for nationally recognized levels of care for both our Medi ...
Nurse Manager - Utilization Management
Phoenix, AZ · On-site
$108K - $162K/yr
The RN Manager effectively resolves utilization review and denial management issues, provides leadership in resolving psychosocial issues, and removes barriers and complexities for case managers and ...
Nurse Manager - Utilization Management
Phoenix, AZ · On-site
$108K - $162K/yr
The RN Manager effectively resolves utilization review and denial management issues, provides leadership in resolving psychosocial issues, and removes barriers and complexities for case managers and ...
Continuously monitors regulatory requirements for Utilization Management. * Attends Mandatory Education programs required by the organization. * Keeps current on both department and organizational ...
Continuously monitors regulatory requirements for Utilization Management. * Attends Mandatory Education programs required by the organization. * Keeps current on both department and organizational ...
The RN Manager effectively resolves utilization review and denial management issues, provides leadership in resolving psychosocial issues, and removes barriers and complexities for case managers and ...
The RN Manager effectively resolves utilization review and denial management issues, provides leadership in resolving psychosocial issues, and removes barriers and complexities for case managers and ...
Manager Utilization Management information
See salary details
$39K - $50.7K
9% of jobs
$59.3K is the 25th percentile. Wages below this are outliers.
$50.7K - $62.4K
22% of jobs
$62.4K - $74K
11% of jobs
The median wage is $81.2K / yr.
$74K - $85.7K
14% of jobs
$85.7K - $97.4K
12% of jobs
$104.7K is the 75th percentile. Wages above this are outliers.
$97.4K - $109.1K
13% of jobs
$109.1K - $120.8K
13% of jobs
$120.8K - $132.5K
5% of jobs
$132.5K - $144.1K
2% of jobs
$144.1K - $155.8K
0% of jobs
$155.8K - $167.5K
0% of jobs
$39K
$91K
$167.5K
How much do manager utilization management jobs pay per year?
As of Jul 11, 2026, the average yearly pay for manager utilization management 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 are the key skills and qualifications needed to thrive as a Manager Utilization Management, and why are they important?
To thrive as a Manager Utilization Management, you need a thorough understanding of healthcare regulations, utilization review processes, and case management, often supported by a clinical degree (such as RN) and relevant experience. Familiarity with utilization management software, claims processing systems, and potentially certifications like CCM (Certified Case Manager) or ACM (Accredited Case Manager) is important. Strong leadership, analytical thinking, and effective communication help you guide teams and collaborate with providers and payers. These skills ensure efficient resource use, compliance, and quality patient care within managed care organizations.
What is the difference between Manager Utilization Management vs Utilization Review Nurse?
| Aspect | Manager Utilization Management | Utilization Review Nurse |
|---|---|---|
| Credentials | RN, often with management or utilization review certifications | RN, with certifications in utilization review or case management |
| Work Environment | Supervises teams, manages policies, oversees utilization review processes | Performs patient chart reviews, assesses medical necessity, collaborates with providers |
| Employer & Industry | Hospitals, insurance companies, healthcare organizations | Hospitals, insurance companies, healthcare organizations |
| Search & Comparison Intent | Yes | Yes |
While both roles focus on utilization review, the Manager Utilization Management oversees teams and policies, ensuring efficient resource use, whereas the Utilization Review Nurse conducts patient-specific reviews to determine medical necessity. The manager role involves leadership and strategic planning, while the nurse role is more clinical and review-focused.
What are some common challenges faced by a Manager in Utilization Management, and how can they effectively address them?
Managers in Utilization Management often encounter challenges such as balancing quality patient care with cost containment, navigating evolving healthcare regulations, and managing diverse teams. To effectively address these issues, successful managers develop strong communication skills, stay updated on industry standards, and foster collaboration between clinical and administrative staff. Implementing robust training programs and utilizing data-driven decision-making can also help ensure compliance and improve overall team performance.
What does a Manager of Utilization Management do?
A Manager of Utilization Management oversees the process of evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. They lead a team that reviews medical claims and care plans to ensure compliance with clinical guidelines and regulatory requirements. Their role often involves collaborating with physicians, nurses, insurance companies, and other stakeholders to optimize patient outcomes while managing healthcare costs. Additionally, they are responsible for implementing policies, training staff, and ensuring that utilization management activities align with organizational goals.
More about Manager Utilization Management jobs
What cities are hiring for Manager Utilization Management jobs? Cities with the most Manager 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 Manager Utilization Management jobs? States with the most job openings for Manager Utilization Management jobs include:
What job categories do people searching Manager Utilization Management jobs look for? The top searched job categories for Manager Utilization Management jobs are:
Full-time
Re-posted 5 days ago
Children's Of Alabama rating
6.4
Based on 40 frontline employees who took The Breakroom Quiz
726th of 1,018 rated hospitals
Job description
In Utilization Management at Main Campus Lee Building
Work schedule will be Full-time on the Day Shift, Monday - Friday 8:00am - 4:30pm.
Summary:
Responsible for the day to day functions of the Utilization Management department inclusive of supervising Nurse Reviewers, and collaborating with Revenue Cycle and Business Office.
Credentials with Equivalent Qualifications:
Essential:
* Registered Nurse AL Single State or any of the following equivalent qualifications below:
- Registered Nurse AL NLC Multi State
- Registered Nurse Non-AL NLC Multi State
Education with Equivalent Qualifications:
Essential:
* Bachelor of Science Nursing in Nursing
Experience with Equivalent Qualifications:
Essential:
* 5 Years Staff Level
Work schedule will be Full-time on the Day Shift, Monday - Friday 8:00am - 4:30pm.
Summary:
Responsible for the day to day functions of the Utilization Management department inclusive of supervising Nurse Reviewers, and collaborating with Revenue Cycle and Business Office.
Credentials with Equivalent Qualifications:
Essential:
* Registered Nurse AL Single State or any of the following equivalent qualifications below:
- Registered Nurse AL NLC Multi State
- Registered Nurse Non-AL NLC Multi State
Education with Equivalent Qualifications:
Essential:
* Bachelor of Science Nursing in Nursing
Experience with Equivalent Qualifications:
Essential:
* 5 Years Staff Level
What Children's Of Alabama employees say
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Get the full story on Breakroom
About Children's of Alabama
Sourced by ZipRecruiter
Since 1911, Children’s of Alabama has provided specialized medical care for ill and injured children. Ranked among the best children’s hospitals in the nation by U.S. News & World Report, Children’s serves patients from every county in Alabama and nearly every state. With more than 3.5 million square feet, it is one of the largest pediatric medical facilities in the United States. Children’s offers inpatient and outpatient services at its Russell Campus on Birmingham’s historic Southside with additional specialty services provided at Children’s South, Children’s on 3rd and in Huntsville and Montgomery. Primary medical care is provided in more than a dozen communities across central Alabama. Children’s is the only health system in Alabama dedicated solely to the care and treatment of children. It is a private, not-for-profit medical center that serves as the teaching hospital for the University of Alabama at Birmingham (UAB) pediatric medicine, surgery, psychiatry, research and residency programs. The medical staff consists of UAB faculty and Children’s full-time physicians as well as private practicing community physicians. Our staff is committed to providing the finest pediatric healthcare to all children. We built our legacy on our core values of trust, teamwork, compassion, innovation and commitment. We know that every time we come through these doors we will live up to our high standards as we work to make a difference in children's lives. You've chosen a career that’s all about care. If you want to make a difference the life of children and their families, if you want to advance in your profession, if you appreciate good benefits, and want to work with outstanding medical professionals in a variety of areas, then Children’s of Alabama is where you belong.
Industry
Health care and social assistance
Company size
5,001 - 10,000 Employees
Headquarters location
Birmingham, AL, US
Year founded
1911