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Manager Utilization Management Jobs in Boise, ID

Pharmacy Careers

Formulary Management Pharmacist

Meridian, ID · On-site

$56.50 - $67.75/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 ...

Pharmacy Careers

Formulary Management Pharmacist

Boise, ID · On-site

$55.50 - $66.50/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 ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Meridian, ID · On-site

$55.50 - $67.50/hr

Experience: Managed care or utilization management preferred. Hospital, ambulatory, and community pharmacists with strong documentation and clinical skills are encouraged to apply. * Skills:

Pharmacy Careers

Appeals Pharmacist (Remote)

Boise, ID · On-site

$54.50 - $66.50/hr

Experience: Managed care or utilization management preferred. Hospital, ambulatory, and community pharmacists with strong documentation and clinical skills are encouraged to apply. * Skills:

Trinity Health

Clinical Resource Manager

Boise, ID · On-site

$61K - $85K/yr

Provides hospital case management/utilization review and discharge planningcollaboratively determining level of care needs beyond acute care, providing decision support to patients/families and ...

Trinityhealth

Clinical Resource Manager

Boise, ID · On-site

$61K - $85K/yr

Provides hospital case management/utilization review and discharge planningcollaboratively determining level of care needs beyond acute care, providing decision support to patients/families and ...

Evolent

Field Medical Director, Vascular Surgeon

Boise, ID · On-site

$130 - $140/hr

As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical ...

Trinity Health

Clinical Resource Manager

Boise, ID · On-site

$61K - $85K/yr

Provides hospital case management/utilization review and discharge planning collaboratively determining level of care needs beyond acute care, providing decision support to patients/families and ...

Evolent

Physician Reviewer-Radiology (Full-Time)

Boise, ID · On-site

$95 - $96/hr

As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical environment. You can enjoy ...

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Showing results 21-40

All JobsUtilization Management JobsManager Utilization Management JobsManager Utilization Management Jobs in Boise, ID

Manager Utilization Management information

See Boise, ID salary details

$37.1K

$86.6K

$159.4K

How much do manager utilization management jobs pay per year?

As of Sep 8, 2026, the average yearly pay for manager utilization management in Boise, ID is $86,621.00, according to ZipRecruiter salary data. Most workers in this role earn between $56,600.00 and $104,200.00 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 Boise, ID?

The most popular types of Utilization Management jobs in Boise, ID are:

What are popular job titles related to Manager Utilization Management jobs in Boise, ID?

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

What job categories do people searching Manager Utilization Management jobs in Boise, ID look for?

The top searched job categories for Manager Utilization Management jobs in Boise, ID are:

What cities near Boise, ID are hiring for Manager Utilization Management jobs?

Cities near Boise, ID with the most Manager Utilization Management job openings:

Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Boise, ID as of August 2026, with employment types broken down into 85% Full Time, and 15% Contract. Highlights an 100% In-person job distribution, with an average salary of $86,621 per year, or $41.6 per hour.

Formulary Management Pharmacist

Pharmacy Careers

Meridian, ID • On-site

$56.50 - $67.75/hr

Other

Posted 23 days ago

Job description

Formulary Management Pharmacist - Influence Therapy Access at Scale | Hybrid/Remote Friendly
Shape which medications patients can access by evaluating new drugs, analyzing clinical and economic data, and supporting P&T; Committee decisions. This role offers strong intellectual challenge and often hybrid or remote flexibility.
Key Responsibilities

  • Evaluate and review new drug products for formulary inclusion or exclusion.
  • Analyze clinical trial data, cost-effectiveness, and therapeutic outcomes to support recommendations.
  • Collaborate with Pharmacy & Therapeutics (P&T;) Committees on formulary decisions.
  • Maintain and update formulary lists in compliance with health-plan, PBM, and regulatory standards.
  • 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. pharmacist license.
  • Experience: Managed care, PBM, or health-plan ideal. All pharmacists interested in formulary and policy work are encouraged to apply.
  • Skills: Strong analytical ability, interpretation of clinical research, and excellent written communication.
Why This Role?
  • Influence therapy access decisions that affect large populations.
  • Gain specialized expertise in managed-care pharmacy.
  • Many positions are hybrid or remote-friendly.
  • Competitive pay, benefits, and professional development.

About Us
We are a confidential healthcare organization working with PBMs, insurers, and health systems nationwide. Our pharmacists drive evidence-based decisions that balance patient care with responsible resource use.
Apply Today
Take the next step - apply now for our Formulary Management Pharmacist opening and make your expertise count system-wide.

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