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Manager Utilization Management Jobs in Wisconsin

Lift Solutions

Production Manager

Neenah, WI · On-site

Accountable for inventory utilization, management and control * Play an active and significant role in the S&OP process. Qualifications: * Bachelor's degree in Industrial Engineering, Manufacturing ...

Byrider

Sales Manager

Madison, WI

$100K - $125K/yr

... M utilization * Oversee underwriting decisions and portfolio health * Forecast sales and performance metrics * Ensure high levels of customer satisfaction and retention * Maintain compliance with ...

Byrider

Sales Manager

Madison, WI · On-site

$100K - $125K/yr

... M utilization * Oversee underwriting decisions and portfolio health * Forecast sales and performance metrics * Ensure high levels of customer satisfaction and retention * Maintain compliance with ...

Byrider

Sales Manager

Madison, WI · On-site

$100K - $125K/yr

... M utilization * Oversee underwriting decisions and portfolio health * Forecast sales and performance metrics * Ensure high levels of customer satisfaction and retention * Maintain compliance with ...

Bcbsa

$155K - $175K/yr

Analytics Team - Collaborate on drug trends and utilization data to inform clinical policy decisions, medical policy and formulary compliance, drug share shift and utilization management strategies

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All JobsUtilization Management JobsManager Utilization Management JobsManager Utilization Management Jobs in Wisconsin

Manager Utilization Management information

See Wisconsin salary details

$39.4K

$91.9K

$169.1K

How much do manager utilization management jobs pay per year?

As of Aug 16, 2026, the average yearly pay for manager utilization management in Wisconsin is $91,863.00, according to ZipRecruiter salary data. Most workers in this role earn between $60,100.00 and $110,500.00 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 Wisconsin?

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

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

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

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

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

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

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

Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Wisconsin as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 16% Part Time, and 2% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $91,863 per year, or $44.2 per hour.

CLINICAL DOC IMPROVEMENT SPECIALIST - CLINICAL DOCUMENTATION

ASPIRUS HEALTH

Wausau, WI • On-site

$37.25 - $50/hr

Full-time

Medical, Retirement

Posted 3 days ago

New

Aspirus Health rating

6.5

Company rating: 6.5 out of 10

Based on 259 frontline employees who took The Breakroom Quiz

605th of 887 rated healthcare providers

Job description

CLINICAL DOCUMENTATION IMPROVEMENT SPECIALIST (Fully Remote)Aspirus Health
Full Time (1.0 FTE, 80 hours every pay period)
Weekdays, general no weekends
Compassion. Accountability. Collaboration. Foresight. Joy. These are the Aspirus Core Values; and we are looking for the BEST around to join us as we demonstrate those values Every. Single. Day.
Job Description:
The Clinical Documentation Improvement Specialist will communicate with the healthcare team regarding missing, unclear, or conflicting medical record documentation to clarify and obtain the documentation that will support the appropriate severity of illness, expected risk of mortality and complexity of care.
The ideal candidate would have a robust hospital direct patient care so that they understand the disease processes and diagnosis and symptomology of diagnoses. It would also be ideal if the candidate would have awareness of what CDI, understanding DRG's, coding guidelines and as it has a significant impact on our quality metrics. This is accomplished by in depth chart reviews all day long.
Training is quite extensive. There are modules (up to 40 hrs.) that need to be completed and then a one on one with a CDI trainer.
Experience/Qualifications:
  • Minimum of two years' acute care hospital experience.
  • Experience in critical care, general medical and/or surgical nursing, and experience in educational presentations are beneficial.
  • Previous experience with criteria-based chart reviews such as case management, utilization
  • management, managed care, or quality improvement.
  • Clinical documentation improvement experience with knowledge and/or experience related to ICD code assignment and DRG assignment preferred.

Employee Benefits
  • Full benefits packages available for part- and full-time status.
  • Time away from work accrual.
  • Retirement plans available.
  • Wellness program for employees and their families.

Our Mission: We heal people, promote health and strengthen communities.
Our Vision: Aspirus is a catalyst for creating healthy, thriving communities, trusted and engaged above all others.
As an Aspirus team, we demonstrate caring, we plan to impact the future, work with happiness and enthusiasm, recognize our power to make a difference and improve the health of our communities.
Aspirus Health is a nonprofit, community-directed health system based in Wausau, Wisconsin, serving northeastern Minnesota, northern and central Wisconsin and the Upper Peninsula of Michigan. The health system operates 18 hospitals and 130 outpatient locations with nearly 14,000 team members, including 1,300 employed physicians and advanced practice clinicians. For more information visit aspirus.org.
Click here to learn more.

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