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Manager Utilization Management Jobs in Minnesota

Essentia Health

RN Case Manager

Duluth, MN · Hybrid

$36.01 - $54.02/hr

The role integrates and coordinates utilization management, care facilitation and discharge planning functions. This role is accountable for planning effectively in order to meet patient needs ...

Mercy

RN Care Manager I-IPCM (Exempt)

Anoka, MN

Care Management or Utilization Management experience, preferred Licensure: Current License in the state of employment, required Certifications: BLS (CPR) at hire date, required, or within 90 days of ...

Blaze Health

RN Case Manager

Robbinsdale, MN · On-site

Hospital case management and utilization management experience preferred Knowledge of current case management principles, utilization management, length of stay management and/or transition/discharge ...

North Memorial Health

RN Case Manager

Robbinsdale, MN · On-site

$37.49 - $56.23/hr

Experience • Three to five years previous acute care nursing experience preferred. • Hospital case management and utilization management experience preferred • Knowledge of current case ...

North Memorial Health

RN Case Manager

Robbinsdale, MN · On-site

Hospital case management and utilization management experience preferred Knowledge of current case management principles, utilization management, length of stay management and/or transition/discharge ...

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Showing results 41-60

All JobsUtilization Management JobsManager Utilization Management JobsManager Utilization Management Jobs in Minnesota

Manager Utilization Management information

See Minnesota salary details

$38.2K

$89.1K

$164.1K

How much do manager utilization management jobs pay per year?

As of Sep 6, 2026, the average yearly pay for manager utilization management in Minnesota is $89,138.00, according to ZipRecruiter salary data. Most workers in this role earn between $58,300.00 and $107,200.00 per year, depending on experience, location, and employer.

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 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 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 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 the most commonly searched types of Utilization Management jobs in Minnesota?

The most popular types of Utilization Management jobs in Minnesota are:

What are popular job titles related to Manager Utilization Management jobs in Minnesota?

For Manager Utilization Management jobs in Minnesota, the most frequently searched job titles are:

What job categories do people searching Manager Utilization Management jobs in Minnesota look for?

The top searched job categories for Manager Utilization Management jobs in Minnesota are:

What cities in Minnesota are hiring for Manager Utilization Management jobs?

Cities in Minnesota with the most Manager Utilization Management job openings:

Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Minnesota as of August 2026, with employment types broken down into 84% Full Time, and 16% Contract. Highlights an 100% In-person job distribution, with an average salary of $89,138 per year, or $42.9 per hour.

Specialty Pharmacy Account Manager

Fairview Health Services

Shoreview, MN • On-site

$161K - $228K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 12 days ago

Key responsibilities

  • Manage key specialty pharmacy client relationships to ensure client satisfaction, retention, and profitability.

  • Oversee the development and presentation of strategic reports, solutions, and contract deliverables to clients.

  • Lead and coordinate RFP responses, monitor contract performance guarantees, and manage client issue resolution.

Fairview Health Services rating

7.7

Company rating: 7.7 out of 10

Based on 251 frontline employees who took The Breakroom Quiz

164th of 898 rated healthcare providers

Job description

Job Overview
Successfully manage key specialty pharmacy client account relationships resulting in client satisfaction, retention, and profitability by establishing Fairview Specialty Pharmacy as a best in class business partner for specialty pharmacy services. Provide best in class oversight of client expectations, contracted deliverables, and issue resolution by strategically collaborating across departments and balancing the financial interest of Fairview. Oversee all key processes that provide innovative products and services to clients while positioning Fairview for maximal profit and minimal business risk.
Responsibilities
  • Successfully manage critical specialty pharmacy client relationships with the goal of exceeding client satisfaction and client retention resulting in profitability and performance growth for Fairview Pharmacy Services.
  • Strategically position Fairview Specialty Pharmacy as market leader in novel and innovative client solution initiatives.
  • Provide expert oversight of specialty contract client deliverables, expectations, and management to drive long-term retention and profitability. Ongoing responsibility includes coordinating all areas of the quarterly business review meetings, creating presentation materials with strategic internal partners, and facilitating in-person or virtual client meetings. Quarterly business report package shall be disseminated to clients based on contractual requirements.
  • Provide consultative services and specialty development product offerings to clients to demonstrate value of Fairview Specialty Pharmacy pharmaceutical trend management.
  • Collaborate and lead a monthly strategic workgroup with internal partners and our clients to address solutions regarding current and expected market landscape disruptors. Develop solutions-based monthly presentation materials for dissemination to clients during monthly meetings.
  • Identify, create, and implement new solutions through products offerings and services to clients including enhancement of existing specialty suite of reports, new utilization management reports requested by clients, and internal reports for process improvements. Internal and external reports shall be developed with goal of exceeding client expectations and demonstrating superior services compared to Fairview Specialty Pharmacy market competitors.
  • Demonstrate proficiency successfully managing RFP initiatives including writing subject matter expert (SME) responses, critically reviewing other SME response, maintaining key RFP responses database, and submitting RFP submissions with goal of being awarded new specialty pharmacy business to drive sales growth for Fairview Pharmacy Services. Oversee, create, and review all RFP finalist presentation materials with SMEs and facilitate finalist meeting with client.
  • Execute stringent oversight of specialty pharmacy contract performance guarantees across all contracted client requirements to limit Fairview Specialty Pharmacy financial risk while demonstrating best in class execution of services for specialty pharmacy clients. Collaborate across departments to monitor and meet all contracted financial performance guarantees. Create client-facing deliverable materials to communicate Fairview Specialty Pharmacy's successful execution of all contracted performance guarantees.
  • Create and develop the monthly specialty drug fee schedule for appropriate and timely reimbursement and profitability for Fairview Specialty Pharmacy. Analyze and enhance the specialty fee schedule rates for clients on a quarterly basis to demonstrate the cost-effective value of our product offerings.
  • Assume responsibility to design client-facing specialty member and provider satisfaction survey summary results, including methodology calculation, annually according to contract deliverable requirements.
  • Assume responsibility to design client-facing specialty account management satisfaction survey summary results, including methodology calculation, annually according to contract deliverable requirements.
  • Assume and lead exceptional new client implementation deliverables for specialty pharmacy services and programs.
  • Execute best in class primary point of contact account management for client and client member issue resolution within client expectations and contract specific requirements and/or performance guarantees.
  • Ongoing and comprehensive evaluation and dissemination to key internal and external partners of competitive market intelligence with relevant impact to Fairview Specialty Pharmacy including but not limited to regional and national plan initiatives, Limited Distribution Drug network analysis, client specific initiatives and benefit design changes, specialty drug formulary placement and/or utilization management changes by plan type, and federal and state regulatory and legislative proposals.
  • Manage a comprehensive internal specialty drug database to include assigning new drug approvals accurate therapeutic categories for critical data analytics that impacts business processes across departments for Fairview Specialty Pharmacy. Continually monitor the specialty drug database to manage each contract client's specialty drug database for critical reporting across all of Fairview Specialty Pharmacy.

Required Qualifications
  • Bachelor of Science in pharmacy
  • 10 years specialty pharmacy experience in pharmacy, managed care or related

Preferred Qualifications
  • Doctorate in Pharmacy (PharmD)
  • 10 years leadership role in pharmacy, healthcare or pharmaceutical segment.
  • 3-5 years' proven experience with direct client account management role in specialty pharmacy

Benefit Overview
Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link foradditional information: https://www.fairview.org/careers/benefits/noncontract
Compensation Disclaimer
The posted pay range is for a 40-hour workweek (1.0 FTE). The actual rate of pay offered within this range may depend on several factors, such as FTE, skills, knowledge, relevant education, experience, and market conditions. Additionally, our organization values pay equity and considers the internal equity of our team when making any offer. Hiring at the maximum of the range is not typical. If your role is eligible for a sign-on bonus, the bonus program that is approved and in place at the time of offer, is what will be honored.
EEO Statement
EEO/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status

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About Fairview Health Services

Sourced by ZipRecruiter

Fairview Health Services is an industry-leading, award-winning nonprofit that offers an entire network of healthcare services. Fairview is one part of M Health Fairview, a partnership between the University of Minnesota, M Physicians and Fairview Health Services. Together, we combine the University's deep history of clinical innovation and training with Fairview's extensive roots in community medicine. Our care portfolio includes community hospitals, academic hospitals, primary and specialty care clinics, senior facilities, facilitated living centers, rehabilitation centers, home health care services, counseling, pharmacies and benefit management services.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Minneapolis, MN, US

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