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Manager Utilization Management Jobs in Edmonds, WA

ProMed Healthcare PLLC

Case Management RN

Everett, WA · On-site

Care Manager RN ED - Permanent Position - FT Shift: Multiple shifts available Days and Nights ... Accountabilities include assessment and planning, coordination of care, resource utilization ...

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All JobsUtilization Management JobsManager Utilization Management JobsManager Utilization Management Jobs in Edmonds, WA

Manager Utilization Management information

See Edmonds, WA salary details

$42.8K

$99.9K

$183.9K

How much do manager utilization management jobs pay per year?

As of Aug 10, 2026, the average yearly pay for manager utilization management in Edmonds, WA is $99,942.00, according to ZipRecruiter salary data. Most workers in this role earn between $65,300.00 and $120,200.00 per year, depending on experience, location, and employer.

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 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 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 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 job categories do people searching Manager Utilization Management jobs in Edmonds, WA look for? The top searched job categories for Manager Utilization Management jobs in Edmonds, WA are:
What cities near Edmonds, WA are hiring for Manager Utilization Management jobs? Cities near Edmonds, WA with the most Manager Utilization Management job openings:
Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Edmonds, WA as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 16% Part Time, and 3% Contract. Highlights an 91% Physical, 4% Hybrid, and 5% Remote job distribution, with an average salary of $99,942 per year, or $48 per hour.

Manager Care Management Social Work

Ambition 24Hours Inc

Everett, WA • On-site

$113K - $178K/yr

Full-time

Re-posted 20 days ago

Job description

Manager Care Management – Social Work

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Location: Everett, Washington
Setting: Acute Care Hospital
Schedule: Full Time
Estimated Salary Range: $113,000 – $178,630 annually
Relocation Assistance: Available
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Job Overview
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We are seeking an experienced Manager Care Management – Social Work to lead care management operations within a large acute care hospital setting in Everett, Washington. This leadership role is responsible for overseeing daily operations related to care coordination, case management, discharge planning, utilization management, and social work services.

The Manager will collaborate closely with physicians, hospital leadership, interdisciplinary healthcare teams, patients, families, and community agencies to ensure high-quality patient care, effective discharge planning, and operational efficiency. This role requires strong leadership, clinical expertise, and experience managing complex case management programs within a hospital environment.

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Key Responsibilities
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Oversee daily operations of the Care Management Department
Lead teams responsible for case management, discharge planning, and social work services
Develop and implement clinical standards, workflows, and quality improvement initiatives
Collaborate with physicians, nursing leadership, and interdisciplinary teams
Ensure effective utilization management and care coordination practices
Support patient transitions of care and discharge planning processes
Maintain compliance with regulatory, accreditation, and organizational standards
Supervise staff performance, development, scheduling, and operational goals
Serve as liaison between patients, families, healthcare teams, and community resources

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Requirements
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Master’s Degree in Social Work from an accredited program required
Active Washington Clinical Independent Social Worker License required
Minimum 6 years of case management experience in an acute care setting required
Minimum 2 years of managerial or director-level leadership experience required
Large hospital experience strongly preferred
Strong knowledge of care coordination, utilization management, and discharge planning
Excellent leadership, communication, and organizational skills
Ability to manage complex operations within a fast-paced healthcare environment