ZipRecruiter

Log In

1

Manager Utilization Management Jobs in California

previous page

Showing results 41-60

All JobsUtilization Management JobsManager Utilization Management JobsManager Utilization Management Jobs in California

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 Aug 7, 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?

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 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 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 are popular job titles related to Manager Utilization Management jobs in California? For Manager Utilization Management jobs in California, the most frequently searched job titles are:
What job categories do people searching Manager Utilization Management jobs in California look for? The top searched job categories for Manager 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:
Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in California as of August 2026, with employment types broken down into 73% Full Time, 22% Part Time, 3% 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.

Supervisor of Utilization Management

Partnership HealthPlan of California

Fairfield, CA • On-site

$141K - $183K/yr

Other

Re-posted 11 days ago

Job description

Overview
To provide daily supervision of utilization management staff. Provide departmental leadership, support, resources and direction to staff. Assists in developing and maintaining a cohesive team with a high level of productivity, accuracy and quality to achieve departmental goals and objectives.
Responsibilities
  • Provides daily leadership, direction, resources, training, evaluation, coverage and program support to assigned staff.
  • Performs supervisory functions such as timecard management, staff scheduling to meet business requirements and directing work activities.
  • Provides performance feedback to utilization management staff and conducting annual reviews.
  • Participates in the interviewing, hiring and on-boarding processes of new staff.
  • Maintains active participation with inbound and outbound provider reporting and other related duties, adjusting assignments as necessary to meet business needs and/or regulations.
  • Documents and maintains patient-specific records in the Partnership computer system, in databases and files as applicable.
  • Participates in committees, workgroups and/or multidisciplinary teams to support Partnership's strategic plan, organizational goals, and/or business needs.
  • Facilitates meetings with Partnership community provider partners as a part of utilization management process.
  • Develops and maintains positive working relationships with all business partners to ensure
  • optimum member care and provider satisfaction.
  • Reviews department desktops, policies and procedures, recommends changes for more efficient operations, and communicates changes and updates to staff when appropriate.
  • Researches and responds to provider issues or barriers ensuring successful outcomes and superb customer service.
  • Audits medical records as appropriate for accuracy, workflow evaluation, staff feedback and process improvement activities.
  • This position, in addition to his or her own case load, may be assigned cases in the area of oversight as deemed necessary to provide coverage.
  • Evaluates appropriateness of care through interpretation of benefits as outlined in Title 22, Medi-Cal Provider Manual, DMHC CMS regulatory requirements, Partnership Policies and Procedures, and medical necessity criteria for each product line.
  • Researches and responds to provider issues or barriers, ensuring successful outcomes and superb customer service.
  • Participates in special projects and assignments as required.

Qualifications
Education and Experience
Associate or Bachelor's degree in nursing. RN with 3-5 years'
experience to include staff supervision; one (1) year managed care (case
management) experience; or equivalent combination of education and
experience. General knowledge of managed care with emphasis in case
management preferred.
Special Skills, Licenses and Certifications
Current California RN license. RN Supervisor will be supervising both
RN and LVN staff. Case Management certification preferred. Strong
knowledge of nursing requirements in a clinical setting. Knowledge of
utilization management programs as related to use of pre-set criteria and
protocols. Familiarity with business practices and protocols with ability
to access data and information using automated systems. Ability to work
within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and meeting
deadlines. Strong organizational skills required. Effective telephone and
computer data entry skills required. Valid California Driver's License
and proof of current automobile insurance compliant with Partnership's policies
are required to operate a vehicle and travel for company business.
Performance Based Competencies
Desired competencies (ex: Knowledge of DHCS, Medi-Cal, CMS,
medically necessary criteria, CalAIM and/or NCQA regulations. Ability
to work within an interdisciplinary structure and function independently
in a fast-paced environment while managing multiple priorities and
deadlines. Strong organizational skills required. Computer literacy and
proficiency. Excellent written and verbal communication skills in
English. Demonstrated experience and ability to build effective working
relationships and to represent the department effectively in order to
accomplish goals. Ability to manage multiple concurrent projects and
maintain a work pace appropriate to the workload. Ability to assist
individuals in recognizing and solving problems. Ability to supervise,
train, motivate, provide guidance to staff.
Work Environment And Physical Demands
Ability to use a computer keyboard. Ability to prioritize workload and
initiate action to acquire needed information from professionals by
phone. Ability to function effectively with frequent interruptions and
direction from multiple team members. More than 50% of work time is
spent in front of a computer monitor. Must be able to lift, move, or carry
objects of varying size, weighing up to 10 lbs. Some travel required (up
to 25%) including occasional overnight.
All HealthPlan employees are expected to:
  • Provide the highest possible level of service to clients;
  • Promote teamwork and cooperative effort among employees;
  • Maintain safe practices; and
  • Abide by the HealthPlan's policies and procedures, as they may from time to time be updated.

HIRING RANGE:
$141,067.17 - $183,387.32
IMPORTANT DISCLAIMER NOTICE
The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Apply