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Manager Utilization Management Jobs in Appleton, WI

UnitedHealth Group

Specialty Pharmacist

Green Bay, WI · On-site

$91.70K - $163.70K/yr

Oversee prior authorizations and utilization management, ensuring compliance with payer and program requirements * Monitor effectiveness and safety of therapy, including lab values, adherence metrics ...

UnitedHealth Group

Specialty Pharmacist

Green Bay, WI

$91.70K - $163.70K/yr

Oversee prior authorizations and utilization management, ensuring compliance with payer and program requirements * Monitor effectiveness and safety of therapy, including lab values, adherence metrics ...

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Manager Utilization Management information

See Appleton, WI salary details

$38.1K

$88.8K

$163.4K

How much do manager utilization management jobs pay per year?

As of May 30, 2026, the average yearly pay for manager utilization management in Appleton, WI is $88,802.00, according to ZipRecruiter salary data. Most workers in this role earn between $58,100.00 and $106,800.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Manager Utilization Management, and why are they important?

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 in 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 of 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 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 Appleton, WI? The most popular types of Utilization Management jobs in Appleton, WI are:
What are popular job titles related to Manager Utilization Management jobs in Appleton, WI? For Manager Utilization Management jobs in Appleton, WI, the most frequently searched job titles are:
What job categories do people searching Manager Utilization Management jobs in Appleton, WI look for? The top searched job categories for Manager Utilization Management jobs in Appleton, WI are:
What cities near Appleton, WI are hiring for Manager Utilization Management jobs? Cities near Appleton, WI with the most Manager Utilization Management job openings:
Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Appleton, WI as of May 2026, with employment types broken down into 81% Full Time, 16% Part Time, and 3% Contract. Highlights an 37% Physical, 8% Hybrid, and 55% Remote job distribution, with an average salary of $88,802 per year, or $42.7 per hour.
Manager of Engineering

Manager of Engineering

Jedson Engineering Inc

Appleton, WI • On-site

Full-time

Posted 20 hours ago

Job description

JOB SUMMARY:

The Manager of Engineering is responsible for day-to-day operations leadership of the engineering office(s) within his/her respective region. This person will drive operational performance across all engineering disciplines through the management of KPI’s and upholding our high standards of quality and project delivery. The MOE must naturally possess an entrepreneurial spirit and the ability to cultivate a culture of safety, accountability, and project excellence.


KEY RESPONSIBILITIES:

  • Provide overall leadership to Department Managers and Discipline Leads, ensuring the safe, efficient, and effective management of each engineering discipline.
  • Manage to the utilization KPI’s set by the organization.
  • Influence and drive personnel actions to ensure each department’s ability execute with excellence and ultimately contribute to the sustainable growth of Jedson, including but not limited to hiring, workshare across offices, workload forecasting, disciplinary actions, etc.
  • Work with Department Managers, PMs, Vertical Leaders and GMs on recruiting project specific and strategic hires
  • Foster a continuous learning environment, working with DM’s to determine training and development needs for individuals and company-wide.
  • Champion Jedson’s quality system, consistently enforcing and continuously improving the process.
  • Evaluate and recommend the tools used by disciplines to maintain an efficient and effective engineering workflow across disciplines and throughout a project.
  • Work with Project Management and Project Controls teams to implement best practices for project execution strategies.


YOUR IDEAL BACKGROUND:

  • Bachelor’s degree in Engineering.
  • 10+ years’ experience in a consulting engineering services environment with 5+ years of leadership responsibility.
  • Naturally possess a strong work ethic with commitment to helping all Jedson employees, project teams and clients be successful.
  • Excellent leadership, communication (written, verbal and presentation) and interpersonal skills. Must be results-oriented, proactive, confident, and influential.
  • NOTE: This position will require approximately 10% travel to be available on appropriate project sites when needed.