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 ...
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 ...
Clinical Manager - $5,000 Sign on Bonus!
Hays, KS · On-site
$68K - $75K/yr
... utilization management services within established guidelines and standards. This Manager will help provide support for all therapeutic care for patients and families. The Clinical Manager is ...
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Clinical Manager - $5,000 Sign on Bonus!
Hays, KS · On-site
$68K - $75K/yr
... utilization management services within established guidelines and standards. This Manager will help provide support for all therapeutic care for patients and families. The Clinical Manager is ...
Remote Prior Authorization Pharmacist
Wichita, KS · Remote
$49 - $59/hr
Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply. * Skills: Excellent clinical review ...
Remote Prior Authorization Pharmacist
Wichita, KS · Remote
$49 - $59/hr
Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply. * Skills: Excellent clinical review ...
Remote Prior Authorization Pharmacist
Olathe, KS · Remote
$56.50 - $67.75/hr
Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply. * Skills: Excellent clinical review ...
Remote Prior Authorization Pharmacist
Olathe, KS · Remote
$56.50 - $67.75/hr
Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply. * Skills: Excellent clinical review ...
Utilization management experience in Cardiovascular or Radiology. * Highly organized and analytical with strong attention to detail. * Ability to manage multiple priorities while maintaining ...
Utilization management experience in Cardiovascular or Radiology. * Highly organized and analytical with strong attention to detail. * Ability to manage multiple priorities while maintaining ...
Strong financial and operational acumen, including forecasting, utilization management, margin awareness, and consulting services performance metrics. Job Expectations: * Willing to travel up to 30 ...
Strong financial and operational acumen, including forecasting, utilization management, margin awareness, and consulting services performance metrics. Job Expectations: * Willing to travel up to 30 ...
Strong financial and operational acumen, including forecasting, utilization management, margin awareness, and consulting services performance metrics. Job Expectations: * Willing to travel up to 30 ...
Strong financial and operational acumen, including forecasting, utilization management, margin awareness, and consulting services performance metrics. Job Expectations: * Willing to travel up to 30 ...
MUST HAVE UM experience, inpatient utilization management review. * MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. * MUST HAVE 6 months of Prior Authorization.
MUST HAVE UM experience, inpatient utilization management review. * MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. * MUST HAVE 6 months of Prior Authorization.
Case Management Assistant
$19.65/hr
Facilitate the documentation process with payers, meticulously recording interactions and keeping the Utilization Management Nurses looped in so they can own the full documentation and patient ...
Case Management Assistant
$19.65/hr
Facilitate the documentation process with payers, meticulously recording interactions and keeping the Utilization Management Nurses looped in so they can own the full documentation and patient ...
Case Management Assistant
Wichita, KS · On-site
Facilitate the documentation process with payers, meticulously recording interactions and keeping the Utilization Management Nurses looped in so they can own the full documentation and patient ...
Case Management Assistant
Wichita, KS · On-site
Facilitate the documentation process with payers, meticulously recording interactions and keeping the Utilization Management Nurses looped in so they can own the full documentation and patient ...
As a Vascular Surgery, Field Medical Director 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 Vascular Surgery, Field Medical Director 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 ...
... utilization management programs, ensuring compliance with TJC, state and other regulatory agencies. Responsibilities include but are not limited to: * Managing designated aspects of the case ...
... utilization management programs, ensuring compliance with TJC, state and other regulatory agencies. Responsibilities include but are not limited to: * Managing designated aspects of the case ...
... utilization management programs, ensuring compliance with TJC, state and other regulatory agencies. Responsibilities include but are not limited to: * Managing designated aspects of the case ...
... utilization management programs, ensuring compliance with TJC, state and other regulatory agencies. Responsibilities include but are not limited to: * Managing designated aspects of the case ...
... utilization management programs, ensuring compliance with TJC, state and other regulatory agencies. Responsibilities include but are not limited to: * Managing designated aspects of the case ...
... utilization management programs, ensuring compliance with TJC, state and other regulatory agencies. Responsibilities include but are not limited to: * Managing designated aspects of the case ...
RN Case Manager - Behavioral Health Utilization Review Join a dedicated healthcare team in the ... Experience in behavioral health settings, particularly crisis management and inpatient care.
RN Case Manager - Behavioral Health Utilization Review Join a dedicated healthcare team in the ... Experience in behavioral health settings, particularly crisis management and inpatient care.
Experience in Utilization Review (UR) and Utilization Management (UM) within behavioral health or medical settings. Clinical quality review experience, including the evaluation of medical records.
Experience in Utilization Review (UR) and Utilization Management (UM) within behavioral health or medical settings. Clinical quality review experience, including the evaluation of medical records.
Demonstrates compliance with facility-wide Utilization Management policies and procedures. * Coordinates UR compliance with Quality Management to assure all licensure and accrediting requirements are ...
Demonstrates compliance with facility-wide Utilization Management policies and procedures. * Coordinates UR compliance with Quality Management to assure all licensure and accrediting requirements are ...
Case Manager, Registered Nurse
Topeka, KS · Remote
$54K - $155K/yr
Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support cost-effective quality care ...
Case Manager, Registered Nurse
Topeka, KS · Remote
$54K - $155K/yr
Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support cost-effective quality care ...
Demonstrates compliance with facility-wide Utilization Management policies and procedures. * Coordinates UR compliance with Quality Management to assure all licensure and accrediting requirements are ...
Demonstrates compliance with facility-wide Utilization Management policies and procedures. * Coordinates UR compliance with Quality Management to assure all licensure and accrediting requirements are ...
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, Retirement, PTO
Posted 25 days ago
Wolters Kluwer rating
8.8
Based on 23 frontline employees who took The Breakroom Quiz
32nd of 189 rated software companies
Job description
Location: this is a hybrid position open to US based applicants within 50 miles of a Wolters Kluwer office.
Product(s) you'll be supporting: UpToDate and other Healthcare SaaS products
Region: Central/Midwest
*This is an individual contributorposition
BASIC FUNCTION
Wolters Kluwer Health's Clinical Effectiveness (CE) organization is a fast-growing and innovation-driven healthcare information
technology (HIT) provider working on the front lines of clinical care. Our talented team of physician and pharmacist editors,
technologists, and product visionaries collaborate to provide advanced clinical decision support solutions that measurably improve
clinical effectiveness by helping healthcare professionals provide optimal care for their patients.
CE's mission is to improve care worldwide. To achieve this vision, CE has strived to deeply understand the challenges facing
clinicians and provider organizations as they evolve their workflow to cope with changing regulatory payment pressures while
striving to deliver high quality and effective care.
ESSENTIAL DUTIES AND RESPONSIBILITIES
The Customer Success Engagement Manager plays a high-impact role in managing strategy and product utilization across the CE product portfolio. They serve as a trusted advisor for our largest and most strategic accounts and are responsible for optimizing customer outcomes to ensure alignment with the client's clinical, operational, and strategic goals. They ensure strategic customer relationships are established and strengthened, drive product adoption and ensure utilization goals are achieved to maximize value realization, implementation projects are well-managed, communication plans are effectively designed and executed and ongoing performance is managed. They work directly with Sales Account Managers to ensure that customer needs are identified and satisfied, that expectations are met and exceeded and that renewals are achieved. Internally, this position contributes to the development of both internal and external best practices, participates in training and onboarding, and mentors teammates in their growth and development.
This includes but is not limited to:
Customer Relationship Management
Partner with Sales to build and maintain the health and well-being of assigned accounts, effectively managing customer expectations, and supporting success and renewal
Enable team members to act as CE liaisons for customer executive leadership as it relates to project planning, execution, implementation and utilization efforts and serve as part of an escalation path for project plan related issues or questions
Complete executive planning sessions for assigned customer accounts under the direction of, and in collaboration with, senior management and Sales
Share best practices and encourage their adoption
Interview and shadow customers to design workflows, trainings and deployment plans to meet unique customer needs and position CE positively
Present findings both internally and externally to win support for process and performance improvement plans related to customer success
Work with customers to set utilization goals and benchmark success, leveraging tools (reports, case studies, client references, etc.) to win and maintain customer support
Implementation and Project Management
Develop effective plans for large scale customer deployments and utilization with identified milestones and goals
Understand and uncover customer needs, initiatives, and deployment opportunities to develop and align prioritized project plans for assigned accounts
Lead the development and execution of comprehensive customer project plans, including implementation and optimization activities. This includes ensuring the coordinated execution of tasks across a multi-disciplinary team (Systems Implementation, Customer Support, Enterprise Support, Research & Analytics, Lifecycle Marketing, etc.) and for a variety of activities (access planning, configuration, and execution; training & onboarding; communication plans & digital programs; reporting, etc.)
Assess internal resource needs and requirements for efficient and effective implementation
Track and review implementation project plan, including risk identification, gap assessment, and escalation
Report on progress and effectiveness of plans to customer leadership and internal stakeholders, triggering escalation paths and creating remediation strategies when necessary
Direct Customer Success Specialists in executing supporting implementation activities, including workflow design, customer configuration, branding & tailoring, and customer training
Ensure plan execution by direct contribution and oversight of assigned team members' efforts, prioritizing efforts and resources for assigned customer portfolio.
Ongoing Utilization Management
Oversee customer utilization and product performance
Analyze customer utilization patterns to identify areas of risk, opportunity and need
Conduct utilization reviews with customer providing insight to utilization and making recommendations for improvement
Work with customers to re-engineer workflow processes where necessary
Partner with marketing on communication planning including lifecycle marketing, targeted customer communications, and thought leadership campaigns
Identify cross-sell/up-sell opportunities for sales organization
Implementation Scoping (as assigned)
Advise sales team in establishing contract terms and pricing for the solution
Collaborate with sales team in reviewing and finalizing implementation scopes during select, active sales opportunities
Provide feedback, as needed, on Implementation scopes and milestones to ensure that timelines are appropriate and strategies will be effective to achieve desired results
On-going support
Support customer with ad-hoc advisory and utilization support
OTHER RELATED DUTIES
Establish positive, collaborative relationships with customer representatives even under difficult or escalated
circumstances
Act and communicate professionally as a representative of the CE team
Respond quickly and appropriately to customer questions, needs and requests and coordinate resources to meet those
needs
Performs other duties as assigned by supervisor
JOB QUALIFICATIONS
Education: Bachelor's degree required, Business/Health Administration preferred. Advanced degree or equivalent experience
recommended.
Experience:
5+ years of experience in Saas-based customer success role, with a focus on strategic or enterprise-level customer engagement and value realization. Must have experience owning a book of business.
AND
Deep understanding of the healthcare industry, including clinical environments and workflows, medical devices, and healthcare regulations.
Comprehensive awareness of challenges faced by healthcare organizations, such as patient outcomes, compliance, and cost pressures
o Must remain current on trends, regulatory changes, and innovations in the industry
o Must act as a thought leader by sharing insights, whitepapers, and case studies with strategic accounts
Other Knowledge, Skills, Abilities or Certifications:
In-depth knowledge of clinical decision support (CDS) products and awareness of the competition and market differentiators
Excellent project management skills to track large, complex software implementations across multiple customer sites
Familiarity with customer success platforms and CRMs
Data-oriented, consultative approach to promote product utilization with customers
Proven ability to quickly establish rapport with all level of personnel up to and including C-suite executives
Superb presentation, oral, and written communication skills to effectively engage with C-level executives and cross-
functional teams
TRAVEL REQUIREMENTS
~30% - 40% travel domestically
PHYSICAL DEMANDS
Normal office environment
The above statements are intended to describe the general nature and level of work being performed by most people assigned to this job. They are not intended to be an exhaustive list of all duties and responsibilities and requirements.
Our Interview PracticesTo maintain a fair and genuine hiring process, we kindly ask that all candidates participate in interviews without the assistance of AI tools or external prompts. Our interview process is designed to assess your individual skills, experiences, and communication style. We value authenticity and want to ensure we're getting to know you-not a digital assistant. To help maintain this integrity, we ask to remove virtual backgrounds and include in-person interviews in our hiring process. Please note that use of AI-generated responses or third-party support during interviews will be grounds for disqualification from the recruitment process.
Applicants may be required to appear onsite at a Wolters Kluwer office as part of the recruitment process.
Compensation:
$98,500.00 - $172,700.00 USDThis role is eligible for Bonus.Compensation range listed is based on primary location of the position. Actual base salary offer is influenced by a wide array of factors including but not limited to skills, experience and actual hiring location. Your recruiter can share more information about the specific offer for the job location during the hiring process.
Additional Information:Wolters Kluwer offers a wide variety of competitive benefits and programs to help meet your needs and balance your work and personal life, including but not limited to: Medical, Dental, & Vision Plans, 401(k), FSA/HSA, Commuter Benefits, Tuition Assistance Plan, Vacation and Sick Time, and Paid Parental Leave. Full details of our benefits are available upon request.
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