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Manager Utilization Management Jobs in Rio Rancho, NM

GQR

RN - Case Manager

Albuquerque, NM · On-site

$1.6K - $1.7K/wk

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Albuquerque, New Mexico Start Date: July 20, 2026 Profession: Registered Nurse (RN) Facility: Rehabilitation ...

Prime Staffing

Travel RN Case Manager

Albuquerque, NM · On-site

Travel Work Settings Acute Hospital Long Term Acute Care/Rehab/Skilled Nursing Case Management/Utilization Review Admission Criteria Care coordination Discharge Planning Utilize InterQual Criteria ...

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All JobsUtilization Management JobsManager Utilization Management JobsManager Utilization Management Jobs in Rio Rancho, NM

Manager Utilization Management information

See Rio Rancho, NM salary details

$36.7K

$85.6K

$157.6K

How much do manager utilization management jobs pay per year?

As of Jul 12, 2026, the average yearly pay for manager utilization management in Rio Rancho, NM is $85,606.00, according to ZipRecruiter salary data. Most workers in this role earn between $56,000.00 and $103,000.00 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 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 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 are popular job titles related to Manager Utilization Management jobs in Rio Rancho, NM? For Manager Utilization Management jobs in Rio Rancho, NM, the most frequently searched job titles are:
What job categories do people searching Manager Utilization Management jobs in Rio Rancho, NM look for? The top searched job categories for Manager Utilization Management jobs in Rio Rancho, NM are:
What cities near Rio Rancho, NM are hiring for Manager Utilization Management jobs? Cities near Rio Rancho, NM with the most Manager Utilization Management job openings:
Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Rio Rancho, NM as of July 2026, with employment types broken down into 1% As Needed, 79% Full Time, 17% Part Time, 1% Temporary, and 2% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $85,606 per year, or $41.2 per hour.
RN CASE MANAGER

RN CASE MANAGER

University of New Mexico - Hospitals

Albuquerque, NM

$35.56 - $50.48/hr

Full-time, Part-time, Per diem

Re-posted 22 days ago

UNM Health System rating

7.0

Company rating: 7.0 out of 10

Based on 34 frontline employees who took The Breakroom Quiz

411th of 881 rated healthcare providers

Job description

RN CASE MANAGER – CARE MANAGEMENT DEPARTMENT - University of New Mexico Hospital – Albuquerque

*Inpatient

*Outpatient

*Utilization Management

*SRMC Care Management

*Full Time

*Part Time

 Receive 17% Weekday Nights, 26% Weekend Nights and 15% Weekend Day shift differentials

Compensation Disclaimer

Compensation for this role is based on a number of factors, including but not limited to experience, education, and other business and organizational considerations.

Care Management Department Descriptions:

Your application may be considered for any of the below programs. We will work with you to find the best fit.

Inpatient Care Management: Supports patient’s inpatient stay through care coordination, discharge planning and proactively discharging patient safely to the next level of care when medically ready. RN Case Managers have a 1:25-30 patient ratio and support all age groups from newborn to seniors. From birth to end of life needs. RN CM attend daily multidisciplinary rounds and work alongside providers, therapist, pharmacist on a daily basis. This work is done primarily in person.

· Most positions will be Monday- Friday from 8-430pm.

· Weekend and PRN availability

· There is required on-call for weekends (10 days/year)

· Holiday coverage (2 Holidays/year)

Outpatient Care Management: Supports patient needs in the outpatient clinic setting, that encompasses care plan facilitation, transition of care coordination between an acute care setting to the home. RN Case Manager (RNCM) will assist with referrals in the areas of Durable Medical Equipment (DME) support, Home Healthcare, Hospice, and any other care coordination needs that helps patients continue to stay at home and reduce readmission to the hospital.

 RN CM work collaboratively with primary and specialty care providers within clinic setting. Ratios vary depending on clinic site but can vary depending on whether it is a specialty clinic versus a primary care clinic.

· Primarily working on computer and phone, navigating multiple software systems/programs to send and receive referrals for patients.

  • Microsoft excel and word
  • Powerchart - Cerner/Oracle electronic medical record
  • electronic faxing/scanning system. 

· Clinic hours are normally 0800-1700.

· Position schedule primarily Monday- Friday from 0800-1630, with some flexibility.

· Primarily work in clinic setting with consideration for one work from home day after 6 months of employment and successful completion of competency requirements.

· No weekends or on-call work requirement.

· Clinics are closed on major holidays.

Utilization Management:

Supports the medical necessity appropriateness for all patients receiving treatment/services. This is supported by a chart review for the level of care and correcting billing aspects of care for our patients while they are hospitalized. They provide provider support, appeals and denials and work directly with insurance payors to recuperate payment for patient care. There is limited patient interaction.

· Primarily a remote work from home position once applicant has successfully completed the onsite orientation phase.

· Most positions are Monday-Friday 7-3:30, with additional weekend positions and prn availability. Scheduled Holiday rotations.

· Staff can be requested to attend in-person meetings, trainings or come into the work environment if any remote work issues arise.

Inpatient Care Management- SRMC Campus: Supports patient’s inpatient stay through care coordination, discharge planning and proactively discharging patient safely to the next level of care when medically ready. RN Case Managers are assigned to units and have a 1:25-30 patient ratio and support for all age groups. RN CM attends daily multidisciplinary rounds and works alongside Social Work case manager, case management assistants, providers, therapist, and pharmacist daily. This work is done primarily in person on their assigned unit/s.

· Most positions will be Monday- Friday from 8-430pm.

· Weekend and PRN availability

· There is required on-call for evenings and weekends (approximately 10 days/year)

· Holiday coverage (approximately 2 Holidays/year)

MINIMUM QUALIFICATIONS
EDUCATION:
Nursing program (nationally accredited) graduate
EXPERIENCE:
1 year directly related experience
CERTIFICATIONS:
RN MATRIX - Complete and maintain unit/clinic based required certifications and competencies as listed in the department expectations/and or the unit/clinic education matrix
LICENSES/CERTIFICATIONS:
CPR Certification for Healthcare/BLS Providers or for Professional Rescuers or must obtain within 30 calendar days of date of position
Licensed Registered Nurse (RN) in State of New Mexico or as allowed by reciprocal agreement by State of New Mexico
CAP III - Clinical Advancement Program Level III requirements satisfied
TESTING REQUIREMENTS:
Tuberculosis testing is completed upon hire and additionally as required
PREFERRED QUALIFICATIONS
PREFERRED EDUCATION:
Bachelor's Degree of Science in Nursing
PREFERRED EXPERIENCE:
Bilingual English/Spanish
Bilingual English/Keres, Tewa, Tiwa, Towa, Zuni, or Navajo

Sign-On Bonus Available

Relocation Assistance Available

Department: Registered Nurse

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