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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Overview Join our team at TrustPoint Hospital as a Full Time Utilization Specialist! We are seeking ... Act as liaison between managed care organizations and the facility professional clinical staff.
Overview Join our team at TrustPoint Hospital as a Full Time Utilization Specialist! We are seeking ... Act as liaison between managed care organizations and the facility professional clinical staff.
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 ...
Utilization Specialist
Murfreesboro, TN · On-site
Overview Join our team at TrustPoint Hospital as a Full Time Utilization Specialist! We are seeking ... Act as liaison between managed care organizations and the facility professional clinical staff.
Utilization Specialist
Murfreesboro, TN · On-site
Overview Join our team at TrustPoint Hospital as a Full Time Utilization Specialist! We are seeking ... Act as liaison between managed care organizations and the facility professional clinical staff.
Utilization Management supporting medical necessity and denial prevention; Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction; Care ...
Utilization Management supporting medical necessity and denial prevention; Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction; Care ...
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 ...
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.
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.
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.
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.
Director Case Management - Memphis TN (relo avail) to $165,000
Memphis, TN · On-site
$110K - $165K/yr
Utilization Management supporting medical necessity and denial prevention; Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction; Care ...
Director Case Management - Memphis TN (relo avail) to $165,000
Memphis, TN · On-site
$110K - $165K/yr
Utilization Management supporting medical necessity and denial prevention; Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction; Care ...
Director Case Management - Memphis TN (relo avail) to $165,000
Memphis, TN · On-site
$110K - $165K/yr
Utilization Management supporting medical necessity and denial prevention; Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction; Care ...
Quick apply
Director Case Management - Memphis TN (relo avail) to $165,000
Memphis, TN · On-site
$110K - $165K/yr
Utilization Management supporting medical necessity and denial prevention; Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction; Care ...
An experienced Epic Tapestry Certified - Utilization Management - Consultant The Work: Depending on the client engagement, the Epic Tapestry Certified - Utilization Management - Consultant will be ...
An experienced Epic Tapestry Certified - Utilization Management - Consultant The Work: Depending on the client engagement, the Epic Tapestry Certified - Utilization Management - Consultant will be ...
Utilization Review * Discipline: RN * Start Date: 08/24/2026 * Duration: 13 weeks * 36 hours per ... BLS * 2 years case management experience in an acute hospital setting * Acute hospital experience ...
Utilization Review * Discipline: RN * Start Date: 08/24/2026 * Duration: 13 weeks * 36 hours per ... BLS * 2 years case management experience in an acute hospital setting * Acute hospital experience ...
RN Utilization Review
Knoxville, TN · On-site
$63K - $65K/yr
... Utilization Review As a nurse at Sedgwick, you can build a meaningful and rewarding career while ... Apply your RN clinical knowledge and experience to assist in the management of complex medical ...
RN Utilization Review
Knoxville, TN · On-site
$63K - $65K/yr
... Utilization Review As a nurse at Sedgwick, you can build a meaningful and rewarding career while ... Apply your RN clinical knowledge and experience to assist in the management of complex medical ...
RN Utilization Review
Memphis, TN · On-site
$63K - $65K/yr
... Utilization Review As a nurse at Sedgwick, you can build a meaningful and rewarding career while ... Apply your RN clinical knowledge and experience to assist in the management of complex medical ...
RN Utilization Review
Memphis, TN · On-site
$63K - $65K/yr
... Utilization Review As a nurse at Sedgwick, you can build a meaningful and rewarding career while ... Apply your RN clinical knowledge and experience to assist in the management of complex medical ...
RN Utilization Review
Nashville, TN · On-site
$63K - $65K/yr
... Utilization Review As a nurse at Sedgwick, you can build a meaningful and rewarding career while ... Apply your RN clinical knowledge and experience to assist in the management of complex medical ...
RN Utilization Review
Nashville, TN · On-site
$63K - $65K/yr
... Utilization Review As a nurse at Sedgwick, you can build a meaningful and rewarding career while ... Apply your RN clinical knowledge and experience to assist in the management of complex medical ...
Assistant-Case Management
Memphis, TN · On-site
Prioritizes daily activities to facilitate the utilization/case management processes. * Participates in discharge planning activities in collaboration with Case Managers/Social Workers. * Other ...
Assistant-Case Management
Memphis, TN · On-site
Prioritizes daily activities to facilitate the utilization/case management processes. * Participates in discharge planning activities in collaboration with Case Managers/Social Workers. * Other ...
Manager Utilization Management information
See Tennessee salary details
$35.4K - $46K
9% of jobs
$53.8K is the 25th percentile. Wages below this are outliers.
$46K - $56.6K
22% of jobs
$56.6K - $67.2K
11% of jobs
The median wage is $73.7K / yr.
$67.2K - $77.8K
14% of jobs
$77.8K - $88.4K
12% of jobs
$95K is the 75th percentile. Wages above this are outliers.
$88.4K - $99K
13% of jobs
$99K - $109.6K
13% of jobs
$109.6K - $120.2K
5% of jobs
$120.2K - $130.8K
2% of jobs
$130.8K - $141.4K
0% of jobs
$141.4K - $152K
0% of jobs
$35.4K
$82.6K
$152K
How much do manager utilization management jobs pay per year?
As of Aug 7, 2026, the average yearly pay for manager utilization management in Tennessee is $82,603.00, according to ZipRecruiter salary data. Most workers in this role earn between $54,000.00 and $99,400.00 per year, depending on experience, location, and employer.
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?
| 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 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 Tennessee? The most popular types of Utilization Management jobs in Tennessee are:
What are popular job titles related to Manager Utilization Management jobs in Tennessee? For Manager Utilization Management jobs in Tennessee, the most frequently searched job titles are:
What job categories do people searching Manager Utilization Management jobs in Tennessee look for? The top searched job categories for Manager Utilization Management jobs in Tennessee are:
What cities in Tennessee are hiring for Manager Utilization Management jobs? Cities in Tennessee with the most Manager Utilization Management job openings:
Part-time
Re-posted 7 days ago
Acadia Healthcare rating
6.2
Based on 190 frontline employees who took The Breakroom Quiz
701st of 887 rated healthcare providers
Job description
Overview
PURPOSE STATEMENT:
Proactively monitor utilization of services for patients to optimize reimbursement for the facility.
Responsibilities
ESSENTIAL FUNCTIONS:
OTHER FUNCTIONS:
Qualifications
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
LICENSES/DESIGNATIONS/CERTIFICATIONS:
ADDITIONAL REGULATORY REQUIREMENTS:
While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances
(e.g. emergencies, changes in workload, rush jobs or technological developments) dictate.
We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.
ASCST
PURPOSE STATEMENT:
Proactively monitor utilization of services for patients to optimize reimbursement for the facility.
Responsibilities
ESSENTIAL FUNCTIONS:
- Act as liaison between managed care organizations and the facility professional clinical staff.
- Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
- Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.
- Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
- Conduct quality reviews for medical necessity and services provided.
- Facilitate peer review calls between facility and external organizations.
- Initiate and complete the formal appeal process for denied admissions or continued stay.
- Assist the admissions department with pre-certifications of care.
- Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.
OTHER FUNCTIONS:
- Perform other functions and tasks as assigned.
Qualifications
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
- Required Education: High school diploma or equivalent.
- Preferred Education: Associate's, Bachelor's, or Master's degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field.
- Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred
LICENSES/DESIGNATIONS/CERTIFICATIONS:
- Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
- CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.
- First aid may be required based on state or facility requirements.
ADDITIONAL REGULATORY REQUIREMENTS:
While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances
(e.g. emergencies, changes in workload, rush jobs or technological developments) dictate.
We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.
ASCST
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About Acadia Healthcare
Sourced by ZipRecruiter
Acadia Healthcare is a leading provider in the healthcare and hospital industry, based in Franklin, Tennessee, United States. The company is recognised for its commitment to creating a behavioural health network that provides accessible, high-quality treatment options for individuals suffering from mental health issues, addiction, eating disorders, and PTSD. Acadia Healthcare was founded in 2005, with the mission to create a world-class organization that sets the standard of excellence in the treatment of specialty behavioural health and addiction disorders.
Industry
Hospitals
Company size
10,000+ Employees
Headquarters location
Franklin, TN, US
Year founded
2005