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Manager Utilization Management Jobs in Connecticut

Medical Director

Hartford, CT ยท On-site

$230 - $320/hr

Lead medical oversight for utilization management, case management, and clinical review processes. * Evaluate complex medical cases for medical necessity and cost-effectiveness. * Guide the ...

Provides ongoing assessment in case management of patients to ensure an accurate evaluation of patient needs, appropriate level of care, proper resource utilization, quality of care and risk ...

Medical Director

Hartford, CT ยท On-site

$263K - $305K/yr

Lead medical oversight for utilization management, case management, and clinical review processes. * Evaluate complex medical cases for medical necessity and cost-effectiveness. * Guide the ...

Provides ongoing assessment in case management of patients to ensure an accurate evaluation of patient needs, appropriate level of care, proper resource utilization, quality of care and risk ...

Provides ongoing assessment in case management of patients to ensure an accurate evaluation of patient needs, appropriate level of care, proper resource utilization, quality of care and risk ...

Has overall accountability for the utilization management and transition management for patients within the assigned caseload. Ensures the appropriate status and level of care is determined and ...

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Manager Utilization Management information

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 Connecticut? The most popular types of Utilization Management jobs in Connecticut are:
What job categories do people searching Manager Utilization Management jobs in Connecticut look for? The top searched job categories for Manager Utilization Management jobs in Connecticut are:
What cities in Connecticut are hiring for Manager Utilization Management jobs? Cities in Connecticut with the most Manager Utilization Management job openings:
Infographic showing various Manager Utilization Management job openings in Connecticut 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 86% Physical, 2% Hybrid, and 12% Remote job distribution.

RN Utilization Management - $60/hr - Hamden, CT

Mercury Group Staffing

Hamden, CT โ€ข On-site

$60/hr

Other

Re-posted 15 days ago


Job description

RN Utilization Management - $60/hr - Hamden, CT

Hamden, Connecticut, United States Or refer someone Job Openings RN Utilization Management - $60/hr - Hamden, CT

About the Job RN Utilization Management - $60/hr - Hamden, CT

Job Title: RN Utilization Management (UM)

Pay Rate: $60.00/hr

Contract Weeks: 12

Shift: 3:00 PM - 11:30 PM

Guaranteed Hours: 40

Location: Hamden, CT

Requirements:

  • Minimum 6 months of Utilization Management (UM) experience
  • RN License in CT

Description: We are looking for a dedicated RN with Utilization Management experience for a 12-week contract in Hamden, CT. The ideal candidate will have a strong understanding of UM practices and be able to work effectively in a fast-paced environment.

To Apply: please email your resume to jobs@mercurygroupstaffing.com and text (267) 209-3262 to schedule an interview.

Job ID: CS 8097419, 8097420, 8097421