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Manager Utilization Management Jobs in Washington

Luminis Health

Utilization Management Nurse

Lanham, MD

$34 - $55/hr

Monitors and identifies patterns or trends in utilization management; monitors potential and actual denials and collaborates with care coordinator for any follow up necessary; documents actions taken ...

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Manager Utilization Management information

See Washington salary details

$44.2K

$103.1K

$189.7K

How much do manager utilization management jobs pay per year?

As of Aug 27, 2026, the average yearly pay for manager utilization management in Washington is $103,079.00, according to ZipRecruiter salary data. Most workers in this role earn between $67,400.00 and $124,000.00 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 Washington?

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

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

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

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

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

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

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

Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Washington as of August 2026, with employment types broken down into 82% Full Time, and 18% Contract. Highlights an 100% In-person job distribution, with an average salary of $103,079 per year, or $49.6 per hour.

Registered Nurse - Utilization Management

Suitland, MD • On-site

Spectrum Healthcare Resources
Health Care and Social Assistance • 1 - 5K employees
Learn more about Spectrum Healthcare Resourcesexternal

Other

Posted 16 days ago

Job description

Registered Nurse Utilization Management (UMRN)

Spectrum Healthcare Resources has an opportunity for a Registered Nurse Utilization Management (UMRN) working at Joint Base Andrews in Washington, D.C.

Requirements:

  • Associates Degree of Nursing
  • Current, full, active, and unrestricted license to practice as a Registered Nurse (Any State)
  • Must have at least 36 months of total nursing experience in direct patient care clinical setting. Must have utilization management, utilization review or case management experience for 24 recent consecutive months
  • Certified/certification eligible in relevant specialty, such as Certified Managed Care Nurse through the American Board of Managed Care Nurses, or Certified Informatics Nursing, Ambulatory Care Nursing, Medical-Surgical Nursing, or Nursing Case Management through the American Nurses Credentialing Center.
  • Highly organized, self-directed worker able to function in a high-volume environment without distractions.
  • Strong verbal and written communication skills.
  • Proficient level of experience with Microsoft Office applications and strong technical aptitude.

Work Schedule:

  • Monday - Friday
  • No nights and weekends
  • 8 hours a day

Company Overview:

Spectrum Healthcare Resources (SHR) was established in 1988 to deliver systems and processes designed to meet the unique needs of Military and VA Health Systems. SHR is a leading organization that provides physician and clinical staffing and management services to United States Military Treatment Facilities, VA clinics and other Federal Agencies through various contracting vehicles. A Joint Commission Health Care Staffing Services firm, SHR is the military staffing division of TeamHealth, a Nationwide organization that serves 850 civilian and military hospitals with a team of 9,600 affiliated health care professionals.

EOE/Disabled/Veterans

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About Spectrum Healthcare Resources

Sourced by ZipRecruiter

Spectrum is a leading organization that provides program management and physician and clinical staffing services to United States Military Treatment Facilities, VA Clinics and Federal Agencies. We are dedicated to the markets we serve, leading our organization’s experience for almost three decades.

Industry

Health care and social assistance

Company size

1,001 - 5,000 Employees

Headquarters location

Saint Louis, MO, US

Year founded

1988

Social media

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