ZipRecruiter

Log In

1

Manager Utilization Management Jobs in Rancho Cordova, CA

next page

Showing results 1-20

All JobsUtilization Management JobsManager Utilization Management JobsManager Utilization Management Jobs in Rancho Cordova, CA

Manager Utilization Management information

See Rancho Cordova, CA salary details

$41.6K

$97.1K

$178.7K

How much do manager utilization management jobs pay per year?

As of Aug 22, 2026, the average yearly pay for manager utilization management in Rancho Cordova, CA is $97,088.00, according to ZipRecruiter salary data. Most workers in this role earn between $63,500.00 and $116,800.00 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 job categories do people searching Manager Utilization Management jobs in Rancho Cordova, CA look for?

The top searched job categories for Manager Utilization Management jobs in Rancho Cordova, CA are:

What cities near Rancho Cordova, CA are hiring for Manager Utilization Management jobs?

Cities near Rancho Cordova, CA with the most Manager Utilization Management job openings:

Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Rancho Cordova, CA as of August 2026, with employment types broken down into 96% Full Time, and 4% Part Time. Highlights an 87% In-person, 4% Hybrid, and 9% Remote job distribution, with an average salary of $97,088 per year, or $46.7 per hour.

Utilization Management Nurse, Senior

Blue Shield of CA

El Dorado Hills, CA • On-site

Other

Re-posted 9 days ago

Job description

Your Role

The Utilization Management team independently manages complex utilization and retrospective clinical reviews across multiple lines of business, assessing medical necessity, coding accuracy, treatment plans, discharge planning, and compliance requirements while supporting clinical consistency, process improvement, quality, timeliness, and appropriate escalation of high-risk cases.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Knowledge and Experience

  • Associate Degree in Nursing required
  • Bachelor of Science in Nursing or advanced degree is preferred
  • 5 years of prior relevant experience managed care environment or clinical setting
  • Maintain active, unrestricted RN License in assigned states or the ability to obtain required state (in addition to primary state license) RN license within 90 days of hire

Hybrid Virtual Work

This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.

Apply