Underpinned by technology, data, analytics, AI, change management, talent and sustainability ... As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise ...
Underpinned by technology, data, analytics, AI, change management, talent and sustainability ... As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise ...
The Utilization Review Specialist plays a crucial role in ensuring efficient utilization of ... Management Responsibilities * N/A Education and/or Experience * Bachelor's degree in nursing, healt ...
New
The Utilization Review Specialist plays a crucial role in ensuring efficient utilization of ... Management Responsibilities * N/A Education and/or Experience * Bachelor's degree in nursing, healt ...
New
Utilization Review Specialist
Wichita, KS · On-site
Job Summary The Utilization Review department manages all aspects of a patient's stay related to initial authorization, concurrent reviews and discharge coordination with health plans. The UR ...
Quick apply
Utilization Review Specialist
Wichita, KS · On-site
Job Summary The Utilization Review department manages all aspects of a patient's stay related to initial authorization, concurrent reviews and discharge coordination with health plans. The UR ...
Senior Pharmacist - Strategy
$54.75 - $66/hr
Formulary & Utilization Management Strategy & Development: May lead Highmark's evidence-based medicine drug evaluation program supporting Highmark's formulary and utilization management (UM) and/or ...
Senior Pharmacist - Strategy
$54.75 - $66/hr
Formulary & Utilization Management Strategy & Development: May lead Highmark's evidence-based medicine drug evaluation program supporting Highmark's formulary and utilization management (UM) and/or ...
Knowledge of case management practice * Knowledge of the nature and extent of injuries, periods of disability, and treatment needed * Knowledge of URAC standards, ODG, Utilization review, state ...
Knowledge of case management practice * Knowledge of the nature and extent of injuries, periods of disability, and treatment needed * Knowledge of URAC standards, ODG, Utilization review, state ...
Dir Of Care Management
Kansas City, KS · On-site
Utilization Management & Regulatory Compliance * Ensures care management practices align with regulatory requirements, professional standards, and accreditation expectations. * Promotes appropriate ...
Dir Of Care Management
Kansas City, KS · On-site
Utilization Management & Regulatory Compliance * Ensures care management practices align with regulatory requirements, professional standards, and accreditation expectations. * Promotes appropriate ...
Dir Of Care Management
Kansas City, KS · On-site
Utilization Management & Regulatory Compliance * Ensures care management practices align with regulatory requirements, professional standards, and accreditation expectations. * Promotes appropriate ...
Dir Of Care Management
Kansas City, KS · On-site
Utilization Management & Regulatory Compliance * Ensures care management practices align with regulatory requirements, professional standards, and accreditation expectations. * Promotes appropriate ...
Dir Of Care Management
Kansas City, KS · On-site
Utilization Management & Regulatory Compliance * Ensures care management practices align with regulatory requirements, professional standards, and accreditation expectations. * Promotes appropriate ...
Dir Of Care Management
Kansas City, KS · On-site
Utilization Management & Regulatory Compliance * Ensures care management practices align with regulatory requirements, professional standards, and accreditation expectations. * Promotes appropriate ...
Epic Tapestry Consultant
Wichita, KS · On-site +1
Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Strong desktop skills including Word, Excel, PowerPoint * Work Experience/Direct Knowledge of ...
Epic Tapestry Consultant
Wichita, KS · On-site +1
Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Strong desktop skills including Word, Excel, PowerPoint * Work Experience/Direct Knowledge of ...
Epic Tapestry Specialist
Wichita, KS · On-site +1
Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Ability to work independently and collaborate as part of a team * Effective written and verbal ...
Epic Tapestry Specialist
Wichita, KS · On-site +1
Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Ability to work independently and collaborate as part of a team * Effective written and verbal ...
Epic Tapestry Sr Analyst
Wichita, KS · On-site +1
Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Analytical/ Decision Making Responsibilities * Analytical ability to manage multiple projects and ...
Epic Tapestry Sr Analyst
Wichita, KS · On-site +1
Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Analytical/ Decision Making Responsibilities * Analytical ability to manage multiple projects and ...
Underwriting Quality Manager
Lenexa, KS · On-site
$104K - $114K/yr
Review underwriting quality, pricing compliance, portfolio management utilization, management controls and provide senior management with commentary on the overall underwriting, go-forward critical ...
Underwriting Quality Manager
Lenexa, KS · On-site
$104K - $114K/yr
Review underwriting quality, pricing compliance, portfolio management utilization, management controls and provide senior management with commentary on the overall underwriting, go-forward critical ...
... utilization management review programs. The Manager will lead the nurse case management team to strategize with claim professionals in management of medical and disability exposure, delivering ...
... utilization management review programs. The Manager will lead the nurse case management team to strategize with claim professionals in management of medical and disability exposure, delivering ...
... utilization management review programs. The Manager will lead the nurse case management team to strategize with claim professionals in management of medical and disability exposure, delivering ...
... utilization management review programs. The Manager will lead the nurse case management team to strategize with claim professionals in management of medical and disability exposure, delivering ...
... utilization management review programs. The Manager will lead the nurse case management team to strategize with claim professionals in management of medical and disability exposure, delivering ...
... utilization management review programs. The Manager will lead the nurse case management team to strategize with claim professionals in management of medical and disability exposure, delivering ...
As a FMD, Interventional Pain Management, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical ...
As a FMD, Interventional Pain Management, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical ...
Appeals Pharmacist (Remote)
Wichita, KS · On-site +1
$48.25 - $58.75/hr
Experience: Prior managed care or utilization management experience preferred - retail and hospital pharmacists with strong clinical and documentation skills are encouraged to apply. * Skills:
Appeals Pharmacist (Remote)
Wichita, KS · On-site +1
$48.25 - $58.75/hr
Experience: Prior managed care or utilization management experience preferred - retail and hospital pharmacists with strong clinical and documentation skills are encouraged to apply. * Skills:
Appeals Pharmacist (Remote)
Olathe, KS · On-site +1
$55.50 - $67.50/hr
Experience: Prior managed care or utilization management experience preferred - retail and hospital pharmacists with strong clinical and documentation skills are encouraged to apply. * Skills:
Appeals Pharmacist (Remote)
Olathe, KS · On-site +1
$55.50 - $67.50/hr
Experience: Prior managed care or utilization management experience preferred - retail and hospital pharmacists with strong clinical and documentation skills are encouraged to apply. * Skills:
Implementation and Project Management * Develop effective plans for large scale customer deployments and utilization with identified milestones and goals * Understand and uncover customer needs ...
Implementation and Project Management * Develop effective plans for large scale customer deployments and utilization with identified milestones and goals * Understand and uncover customer needs ...
Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements. • ...
Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements. • ...
Manager Utilization Management information
See Kansas salary details
$34.8K - $45.2K
9% of jobs
$52.9K is the 25th percentile. Wages below this are outliers.
$45.2K - $55.6K
22% of jobs
$55.6K - $66K
11% of jobs
The median wage is $72.4K / yr.
$66K - $76.5K
14% of jobs
$76.5K - $86.9K
12% of jobs
$93.4K is the 75th percentile. Wages above this are outliers.
$86.9K - $97.3K
13% of jobs
$97.3K - $107.7K
13% of jobs
$107.7K - $118.1K
5% of jobs
$118.1K - $128.5K
2% of jobs
$128.5K - $139K
0% of jobs
$139K - $149.4K
0% of jobs
$34.8K
$81.2K
$149.4K
How much do manager utilization management jobs pay per year?
What are the key skills and qualifications needed to thrive as a Manager Utilization Management, and why are they important?
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?
What does a Manager of Utilization Management do?

Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 7 days ago
Accenture Federal Services rating
8.4
Based on 19 frontline employees who took The Breakroom Quiz
45th of 427 rated business services
Job description
Accenture is a leading global professional services company that helps the world's leading businesses, governments and other organizations build their digital core,optimizetheir operations, accelerate revenuegrowthand enhance citizen services-creating tangible value at speed and scale. We are a talent- andinnovation-led company with approximately750,000 peopleserving clients in more than 120 countries. Technology is at the core of change today, and we are one of the world's leaders in helping drive that change, with strong ecosystem relationships. We combine our strength in technology and leadership in cloud, data and AI with unmatched industry experience, functionalexpertiseand global delivery capability. We are uniquely able to deliver tangible outcomes because of our broad range of services, solutions and assets across Strategy & Consulting, Technology, Operations, Industry X and Song. These capabilities, together with our culture of shared success and commitment to creating 360 value, enable us to help our clients reinvent and build trusted, lasting relationships. We measure our success by the 360 value we create for our clients, each other, our shareholders,partnersand communities. Visit us atwww.accenture.com.
Strategy & Consulting:We work with C-suite executives, leaders and boards of the world's leading organizations, helping them reinvent every part of their enterprise to drive greater growth, enhance competitiveness, implement operational improvements, reduce cost, deliver sustainable 360 stakeholder value, and set a new performance frontier for themselves and the industry in which they operate. Our deep industry and functionalexpertiseissupported by proprietary assets and solutions that help organizations transform faster and become more resilient. Underpinned by technology, data, analytics, AI, change management, talent and sustainability capabilities, our Strategy & Consulting services help architect and accelerate all aspects of an organization's total enterprise reinvention.
Role Summary
Advise clients on network strategy,utilizationperformance, and provider market challenges across Medicaid, rural, and financially pressured environments. The successful candidate will combine deep domainexpertisewith strong consulting judgment and will be expected to manage teams, advise senior clients, and deliver complex engagements in network strategy,utilization, and provider performance. This individual will build trusted client relationships and help clients improve network performance, access, and provider sustainability in line with their strategic priorities.
As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include:
Advise clients on network strategy, provider capacity,utilizationtrends, access challenges, and market performance.
Advise clients on evaluating leakage, referral patterns, service distribution, network adequacy, and provider sustainability.
Develop strategic recommendations to improve network design, access,utilizationmanagement, provider alignment, and value-based outcomes.
Translate claims,encounter,provider, and market data into clear insights, strategic options, and executive decision materials.
Manage day-to-day engagement delivery, including workplans, team coordination, deliverable quality, and client communications.
Work across reimbursement, analytics, policy, and provider strategy teams to solve complex market and performance challenges.
Build trusted relationships with client stakeholders and help grow the practice's network performance andutilizationwork.
Travel: As required, up to 80%
Why should I join the Accenture Health team?
Innovate every day.Be at the forefront of designing and delivering health technology solutions that push boundaries and create new opportunities for our clients.
Lead with the industry's best. Join an industry-recognized healthcare leader with more than 20,000 global healthcare professionals collaborating to drive enterprise-wide transformational projects on a global scale. Accenture has worked with more than 200 clients to deliver healthcaretransformationto meet the diverse needs of patients and members.
Learn and grow continuously.Harness unmatched training and professional development to help you build and advance your health, consultative and delivery skills. With learning resources, interactive classroom courses, real-life clientsimulationsand ongoing mentoring available when you need it,you'llexpand your thinking beyond the core Workday implementation.
Qualification
Here'swhat you need:
Minimum of 5 years of experience in network strategy,utilizationanalytics, provider economics, or healthcare market analysis.
Minimum of 2 years of experience assessing hospitals, rural providers, FQHCs, specialty providers, and community-based providers in Medicaid-heavy or financially distressed environments.
Minimum of 2 years of experience turning claims,encounter,provider, and market data into strategic recommendations.
Bachelor's Degree
Bonus points if you have:
Familiarity with provider directory and network data management, data quality, and encounter completeness.
Strong understanding of provider capacity, leakage, referral patterns,utilizationdrivers, access, and network adequacy.
Ability to connectutilizationperformance to reimbursement, provider sustainability, and VBC outcomes.
Experience building provider performance scorecards (utilization, quality, access, equity,financial impact).
Understanding ofservice line strategy and site-of-care optimization (ASC vs HOPD, home-based care, telehealth).
Compensation at Accenture varies depending on a wide array of factors, which may include but are not limited to the specific office location, role, skill set, and level of experience. As required by local law, Accenture provides a reasonable range of compensation for roles that may be hired as set forth below.
We anticipate this job posting will be posted until 06/18/2026.
Accenture offers a market competitive suite of benefits including medical, dental, vision, life, and long-term disability coverage, a 401(k) plan, bonus opportunities, paid holidays, and paid time off. See more information on our benefits here:
U.S. Employee Benefits | Accenture
Role Location Annual Salary Range
California $94,400 to $293,800
Cleveland $87,400 to $235,000
Colorado $94,400 to $253,800
District of Columbia $100,500 to $270,300
Illinois $87,400 to $253,800
Maine $80,400 to $216,200
Maryland $94,400 to $253,800
Massachusetts $94,400 to $270,300
Minnesota $94,400 to $253,800
New York $87,400 to $293,800
New Jersey $100,500 to $293,800
Virginia $87,400 to $270,300
Washington $100,500 to $270,300
About Accenture
Accenture is a leading global professional services company that helps the world's leading businesses, governments and other organizations build their digital core, optimize their operations, accelerate revenue growth and enhance citizen services-creating tangible value at speed and scale. We are a talent- and innovation-led company with approximately 791,000 people serving clients in more than 120 countries. Technology is at the core of change today, and we are one of the world's leaders in helping drive that change, with strong ecosystem relationships. We combine our strength in technology and leadership in cloud, data and AI with unmatched industry experience, functional expertise and global delivery capability. Our broad range of services, solutions and assets across Strategy & Consulting, Technology, Operations, Industry X and Song, together with our culture of shared success and commitment to creating 360 value, enable us to help our clients reinvent and build trusted, lasting relationships. We measure our success by the 360 value we create for our clients, each other, our shareholders, partners and communities.Visit us atwww.accenture.com
What We Believe
We have an unwavering commitment to diversity with the aim that every one of our people has a full sense of belonging within our organization. As a business imperative, every person at Accenture has the responsibility to create and sustain an inclusive environment.
Inclusion and diversity are fundamental to our culture and core values. Our rich diversity makes us more innovative and more creative, which helps us better serve our clients and our communities.Read more here
Requesting An Accommodation
Accenture is committed to providing equal employment opportunities for persons with disabilities or religious observances, including reasonable accommodation when needed. If you are hired by Accenture and require accommodation to perform the essential functions of your role, you will be asked to participate in our reasonable accommodation process. Accommodations made to facilitate the recruiting process are not a guarantee of future or continued accommodations once hired.
If you would like to be considered for employment opportunities with Accenture and have accommodation needs such as for a disability or religious observance, please call us toll free at 1 (877) 889-9009 or send us anemailor speak with your recruiter.
Equal Employment Opportunity Statement
We believe that no one should be discriminated against because of their differences.All employment decisions shall be made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, military veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status or any other basis as protected by applicable law.Our rich diversity makes us more innovative, more competitive, and more creative, which helps us better serve our clients and our communities.
For details, view a copy of the Accenture Equal Opportunity Statement
Accenture is an EEO and Affirmative Action Employer of Veterans/Individuals with Disabilities.
Accenture is committed to providing veteran employment opportunities to our service men and women.
Other Employment Statements
Applicants for employment in the US must have work authorization that does not now or in the future require sponsorship of a visa for employment authorization in the United States.
Candidates who are currently employed by a client of Accenture or an affiliated Accenture business may not be eligible for consideration.
Job candidates will not be obligated to disclose sealed or expunged records of conviction or arrest as part of the hiring process. Further, at Accenture a criminal conviction history is not an absolute bar to employment.
The Company will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. Additionally, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company's legal duty to furnish information.
California requires additional notifications for applicants and employees. If you are a California resident, live in or plan to work from Los Angeles County upon being hired for this position, pleaseclick herefor additional important information.
Please read Accenture'sRecruiting and Hiring Statementfor more information on how we process your data during the Recruiting and Hiring process.
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About Accenture Federal Services
Sourced by ZipRecruiter
Industry
It services
Company size
10,000+ Employees
Headquarters location
Arlington, VA, US
Year founded
1989