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Manager Utilization Management Jobs in Mississippi

Acadia Healthcare

Utilization Specialist

Magee, MS · On-site

PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize ... Act as liaison between managed care organizations and the facility professional clinical staff.

Acadia Healthcare

Utilization Specialist

Magee, MS · On-site

Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.

Millcreek of Magee

Utilization Specialist

Magee, MS

Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.

MDB Health Services

Care Management Director

Flowood, MS · On-site

$80 - $100/hr

The ideal candidate is a strong clinical leader with experience in care management, utilization review, and interdisciplinary team leadership. Key Responsibilities * Provide leadership and oversight ...

Merit Health River Region

LPN Case Manager PRN

Vicksburg, MS · On-site

$24.50 - $32.25/hr

Experience in utilization review, case management, or discharge planning preferred Knowledge, Skills and Abilities * Strong understanding of nursing practice, utilization management principles ...

Community Health Systems

LPN Case Manager PRN

Vicksburg, MS · On-site

$24.50 - $32.25/hr

Experience in utilization review, case management, or discharge planning preferred Knowledge, Skills and Abilities * Strong understanding of nursing practice, utilization management principles ...

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All JobsUtilization Management JobsManager Utilization Management JobsManager Utilization Management Jobs in Mississippi

Manager Utilization Management information

See Mississippi salary details

$36.9K

$86.2K

$158.6K

How much do manager utilization management jobs pay per year?

As of Aug 24, 2026, the average yearly pay for manager utilization management in Mississippi is $86,194.00, according to ZipRecruiter salary data. Most workers in this role earn between $56,400.00 and $103,700.00 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 Mississippi?

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

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

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

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

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

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

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

Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Mississippi as of August 2026, with employment types broken down into 85% Full Time, and 15% Contract. Highlights an 100% In-person job distribution, with an average salary of $86,194 per year, or $41.4 per hour.

Utilization Management Manager-Utilization Mgmt- Days - FT

Memorial Health System

Gulfport, MS • On-site

Full-time

Re-posted 15 days ago

Job description


Oversee the management of patient care utilization, ensuring appropriate healthcare services are provided while optimizing resource use. This individual will be responsible for leading a team of nurses who review medical necessity, appropriateness and efficiency of healthcare services. Ensure compliance with regulatory requirements and maintain high standards of care.
Responsibilities
  • Supervise and lead the UM nursing team and Pre-Certification Specialists, ensuring the review of patient cases for appropriate medical necessity and care protocols
  • Develop, implement and maintain UM policies and procedures in accordance with healthcare regulation and organizational standards
  • Conduct regular training and provide ongoing support for UR team to improve knowledge and performance
  • Collaborate with physicians, other healthcare providers and insurance companies to review and improve treatment plans. Ensure all services are medically necessary and cost effective
  • Evaluate and analyze healthcare utilization trends, identify opportunities for improvement and solutions to improve outcome
  • Monitor and ensure compliance with regulatory requirements including Medicare, Medicaid and other payer policies
  • Prepare and present reports on utilization metrics, case reviews and outcomes to administration leadership groups
  • Resolve complex case issues and provide guidance on challenging utilization decisions
  • Ensure accurate documentation of all UM reviews, ensuring compliance with internal and external audit
  • Foster effective communication between departments, stakeholders and healthcare professionals

Qualifications
Education Requirements
Required: Bachelor Degree
  • Bachelor of Science in Nursing, with an active unrestricted license

Preferred: Master's Degree
  • Nursing or other clinical discipline, Health Administration, Finance, Business Administration, or a related field

License or Certification Requirements
Required: License
  • Nursing degree (RN, BS, BSN, or advanced degree) and unrestricted active nursing license

Experience Requirements
Required: 5 years
  • Nursing experience with at least 2 years in Utilization Management or case management role

Preferred: 2 years
  • Leadership or management experience in nursing or related field

Core Competencies
Knowledge:
  • In depth knowledge of healthcare utilization management processes, medical terminology and clinical guidelines
  • Familiarity with payer requirements and regulation including Medicare, Medicaid and private insurers
  • Working knowledge of applications that are used to enhance utilization management based on evidenced based approach and guidelines
  • Strong knowledge of Microsoft Office applications

Skills:
  • Analytical Skills: The ability to analyze large data sets, determine trends, synthesize results, and deliver prioritized details through effective reporting
  • Communication Skills: Strong communication and interpersonal skills for effective collaboration and education
  • Problem-Solving Skills: The capacity to understand issues, derive many potential solutions, troubleshoot discrepancies, and understand systematic approaches to problem resolution

Abilities:
  • Attention to Detail: Precision is essential when reporting critical analysis to inform decision-making and operational change
  • Time Management: Managing multiple tasks and deadlines while prioritizing work is essential in a fast-paced healthcare environment
  • Technology Proficiency: Beyond EHR systems, familiarity with various billing software and technology tools

Work Environment: This position may involve working in a variety of clinical and administrative settings, requiring adaptability and a proactive approach to problem-solving.
Physical Demands: Frequent reaching, sitting, walking, and standing may be required. No special coordination beyond that used for normal mobility and handling of everyday objects and materials is needed to perform the job.

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