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Manager Utilization Management Jobs in Birmingham, AL

Pharmacy Careers

Formulary Management Pharmacist

Birmingham, AL · On-site

$54.50 - $65.50/hr

Provide clinical support for utilization management, prior-authorization criteria, and step-therapy guidelines. What You'll Bring * Education: PharmD or Bachelor of Pharmacy. * Licensure: Active U.S ...

DCH Health System

Rehab Care Manager /RN

Northport, AL · On-site

Utilization Management * Provides an Important Message notice and choice on Medicare patients as appropriate. * Identifies and reports process improvement opportunities. * Monitors and facilitates ...

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VIVA Health

Senior Clinical Pharmacist

Birmingham, AL

$111K - $132K/yr

This includes formulary selection and maintenance, application of utilization management tools (prior authorization, step therapy, quantity limits, etc.), review of member disruption related to ...

VIVA Health

Senior Clinical Pharmacist

Birmingham, AL · On-site

$111K - $132K/yr

This includes formulary selection and maintenance, application of utilization management tools (prior authorization, step therapy, quantity limits, etc.), review of member disruption related to ...

Viva Health

Senior Clinical Pharmacist

Birmingham, AL · On-site

$111K - $132K/yr

This includes formulary selection and maintenance, application of utilization management tools (prior authorization, step therapy, quantity limits, etc.), review of member disruption related to ...

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All JobsUtilization Management JobsManager Utilization Management JobsManager Utilization Management Jobs in Birmingham, AL

Manager Utilization Management information

See Birmingham, AL salary details

$36.5K

$85.3K

$157K

How much do manager utilization management jobs pay per year?

As of Sep 7, 2026, the average yearly pay for manager utilization management in Birmingham, AL is $85,295.00, according to ZipRecruiter salary data. Most workers in this role earn between $55,800.00 and $102,600.00 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 Birmingham, AL?

The most popular types of Utilization Management jobs in Birmingham, AL are:

What are popular job titles related to Manager Utilization Management jobs in Birmingham, AL?

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

What job categories do people searching Manager Utilization Management jobs in Birmingham, AL look for?

The top searched job categories for Manager Utilization Management jobs in Birmingham, AL are:

What cities near Birmingham, AL are hiring for Manager Utilization Management jobs?

Cities near Birmingham, AL with the most Manager Utilization Management job openings:

Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Birmingham, AL as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $85,295 per year, or $41 per hour.

Utilization Management Nurse

Blue Eagle Consulting (BEC)

Birmingham, AL

Full-time

Re-posted 3 days ago

Job description

Blue Eagle is looking for Pre-Cert Nurse(s) to assist with inpatient and outpatient PA reviews.

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