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Manager Utilization Management Jobs in Connecticut

Yale New Haven Health

Case Manager

New Haven, CT · On-site

$20 - $26/hr

Utilization management and case management experience preferred. Knowledge of computer software and hardware applications and a basic knowledge of statistics. PHYSICAL DEMAND 50% sedentary; sitting ...

Yale New Haven Health

Case Manager

New Haven, CT · On-site

$20 - $26/hr

Utilization management and case management experience preferred. Knowledge of computer software and hardware applications and a basic knowledge of statistics. PHYSICAL DEMAND 50% sedentary; sitting ...

Yale New Haven Health

Case Manager

New Haven, CT · On-site

$20 - $26/hr

Utilization management and case management experience preferred. Knowledge of computer software and hardware applications and a basic knowledge of statistics. PHYSICAL DEMAND 50% sedentary; sitting ...

Yale New Haven Health

Case Manager

New Haven, CT · On-site

$20 - $26/hr

Utilization management and case management experience preferred. Knowledge of computer software and hardware applications and a basic knowledge of statistics. PHYSICAL DEMAND 50% sedentary; sitting ...

Yale New Haven Health

Case Manager

New Haven, CT · On-site

$20 - $26/hr

Utilization management and case management experience preferred. Knowledge of computer software and hardware applications and a basic knowledge of statistics. PHYSICAL DEMAND 50% sedentary; sitting ...

Pyramid Healthcare

LCSW, LPC, LMFT

Norwalk, CT

$68K - $70K/yr

Participate in treatment team meetings, case reviews, utilization management activities, and interdisciplinary planning processes. * Assist with staff development, orientation, training, coaching ...

Yale New Haven Health

Case Manager

New Haven, CT

$20 - $26/hr

Utilization management and case management experience preferred. Knowledge of computer software and hardware applications and a basic knowledge of statistics. PHYSICAL DEMAND 50% sedentary; sitting ...

Yale New Haven Health

Case Manager

New Haven, CT

$20 - $26/hr

Utilization management and case management experience preferred. Knowledge of computer software and hardware applications and a basic knowledge of statistics. PHYSICAL DEMAND 50% sedentary; sitting ...

Yale New Haven Health

Case Manager

New Haven, CT · On-site

$20 - $26/hr

Utilization management and case management experience preferred. Knowledge of computer software and hardware applications and a basic knowledge of statistics. PHYSICAL DEMAND 50% sedentary; sitting ...

Yale New Haven Health

Care Manager

New Haven, CT

Utilization management and case management experience preferred. Knowledge of computer software and hardware applications and a basic knowledge of statistics. PHYSICAL DEMAND 50% sedentary; sitting ...

Yale New Haven Health

Case Manager

New Haven, CT · On-site

$20 - $26/hr

Utilization management and case management experience preferred. Knowledge of computer software and hardware applications and a basic knowledge of statistics. PHYSICAL DEMAND 50% sedentary; sitting ...

Yale New Haven Health

Case Manager

New Haven, CT · On-site

$20 - $26/hr

Utilization management and case management experience preferred. Knowledge of computer software and hardware applications and a basic knowledge of statistics. PHYSICAL DEMAND 50% sedentary; sitting ...

Yale New Haven Health

Care Manager

New Haven, CT · On-site

Utilization management and case management experience preferred. Knowledge of computer software and hardware applications and a basic knowledge of statistics. PHYSICAL DEMAND 50% sedentary; sitting ...

Yale New Haven Health

Case Manager

New Haven, CT

$20 - $26/hr

Utilization management and case management experience preferred. Knowledge of computer software and hardware applications and a basic knowledge of statistics. PHYSICAL DEMAND 50% sedentary; sitting ...

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All JobsUtilization Management JobsManager Utilization Management JobsManager Utilization Management Jobs in Connecticut

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 are popular job titles related to Manager Utilization Management jobs in Connecticut? For Manager Utilization Management jobs in Connecticut, the most frequently searched job titles 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:
Manager Utilization Management jobs near you
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.

Case Manager

Yale New Haven Health

New Haven, CT • On-site

$20 - $26/hr

Full-time

Re-posted 13 days ago

Yale New Haven Health rating

7.3

Company rating: 7.3 out of 10

Based on 232 frontline employees who took The Breakroom Quiz

305th of 887 rated healthcare providers

Job description

Overview
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
The Case Manager is responsible and accountable for ensuring high-value patient care that is coordinated, efficient, and aligned with institutional clinical and financial objectives. In collaboration with the healthcare team, the Case Manager utilizes evidence-based practice to ensure that specific patient outcomes are reliably achieved and that resources are appropriately used within designated fiscal time frames. With our members of the health care team, the Case Manager participates in the ongoing evaluation of practice patterns and supports efforts to improve patient care and enhance the efficiency of operations. The Case Manager interacts with others in the identification of trends and barriers to all aspects of care. Through this interaction, the Case Manager identifies and works toward a resolution as a part of the multidisciplinary team.
EEO/AA/Disability/Veteran
Responsibilities
  • 1. As part of the interdisciplinary health care team, coordinates and ensures the implementation of the plan of care, utilizing the principles of case management.
    • 1.1 Establishes a system for coordinating the care of a patient throughout the continuum of care, linking the inpatient care with outpatient care, services, and case management.
  • 2. Optimizes the efficiency of hospital systems which impact quality and/or length of stay
    • 2.1 Identifies and monitors compliance with documenting variances from established parameters in the clinical pathway or treatment plan.
  • 3. Utilizes information obtained from various resources available to:
    • 3.1 Ensure that each patient meets the clinical needs for admission, treatment, and discharge and initiates appropriate follow through with the health care team.
  • 4. Assist clinicians in documenting the appropriateness of admissions and continued stays
    • 4.1 Responsible for Medicare notices of non-coverage and help provide appropriate documentation to appeal inappropriate denials.
  • 5. Ensures that an appropriate discharge plan is developed and implemented with the health care teams members to include:
    • 5.1 Identifying service, treatment, and funding options;
  • 6. Ensures that the discharge plan provides a continuum of care with the appropriate outpatient physician and needed services.
  • 7. Ensure that the appropriate outside agencies are contacted and necessary referrals are initiated and followed through.
    • 7.1 Links patient and family with the appropriate institutional or community resources, advocating on their behalf for scarce resources, and developing new resources where gaps exist in the service continuum.
  • 8. Works collaboratively with PSM and unit leadership team to actively involve clinical nurses in the assessment and planning for patient's discharge to facility.
  • 9. Along with other members of the health care team, acts as a patient advocate.
    • 9.1 Exhibits awareness of ethical/legal issues concerning patient care and strives to manage situations to reduce risk.

Qualifications
EDUCATION
Minimum of a Baccalaureate degree in clinically related field. R.N. required
EXPERIENCE
Minimum of three (3) years of relevant clinical experience
LICENSURE
Active RN Licensure in Connecticut
SPECIAL SKILLS
Recent appropriate nursing experience, theoretical knowledge of the nursing process, case management and continuity of care. Advanced communication and interpersonal skills with all levels of internal and external customers. Ability to obtain and interpret information appropriate to patient needs and age. Advanced assessment and teaching skills. Leadership skills in planning and managing patient care as acquired through greater than 3 years of clinical nursing experience in an acute care hospital. Utilization management and case management experience preferred. Knowledge of computer software and hardware applications and a basic knowledge of statistics.
PHYSICAL DEMAND
50% sedentary; sitting, standing, walking from unit to unit, carrying records, speaking before groups. Must be able to speak and hear in a manner understood by most people. Must be able to communicate effectively by telephone.
YNHHS Requisition ID
175218

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