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Manager Utilization Management Jobs in California

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Manager Utilization Management information

See California salary details

$38.5K

$89.8K

$165.3K

How much do manager utilization management jobs pay per year?

As of Jul 13, 2026, the average yearly pay for manager utilization management in California is $89,819.00, according to ZipRecruiter salary data. Most workers in this role earn between $58,700.00 and $108,100.00 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?

AspectManager Utilization ManagementUtilization Review Nurse
CredentialsRN, often with management or utilization review certificationsRN, with certifications in utilization review or case management
Work EnvironmentSupervises teams, manages policies, oversees utilization review processesPerforms patient chart reviews, assesses medical necessity, collaborates with providers
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, insurance companies, healthcare organizations
Search & Comparison IntentYesYes

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.
What are the most commonly searched types of Utilization Management jobs in California? The most popular types of Utilization Management jobs in California are:
What cities in California are hiring for Manager Utilization Management jobs? Cities in California with the most Manager Utilization Management job openings:
Infographic showing various Manager Utilization Management job openings in California as of July 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 2% Temporary, and 2% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $89,819 per year, or $43.2 per hour.

Manager, Utilization Management Nurse Management

Blue Shield of CA

Woodland Hills, CA โ€ข On-site

Other

Re-posted 18 days ago


Job description

Your Role

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-Cal and Medicare populations. The Utilization Management 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 advanced clinical knowledge and proven management skills to organize work, coach staff, and manage risk. Your leadership helps drive consistent, high-quality utilization management outcomes.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Knowledge and Experience

  • Requires maintaining an active, unrestricted RN license in assigned states or the ability to obtain required state (in addition to primary state license) RN license within 90 days of hire
  • Requires 7 years of prior relevant experience including 3 years of management experience gained as a team leader, supervisor or project/program manager
  • Requires knowledge of regulatory requirements for government lines of business (Medi-Cal and Medicare)
  • Bachelor of Science in Nursing or advanced degree preferred
  • Demonstrated experience with basic management approaches such as work scheduling, prioritizing, coaching, process execution, work organization, inventory management, risk management and delegation
  • Strong emotional intelligence skills
  • Strong communication and computer navigation skills
  • Strong teamwork and collaboration skills
  • Strong critical thinking skills
  • Independent motivation and strong work ethic

Hybrid Virtual Work

This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.