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Manager Utilization Management Jobs in Rosedale, MD

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Manager Utilization Management information

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$37.4K

$87.3K

$160.7K

How much do manager utilization management jobs pay per year?

As of May 30, 2026, the average yearly pay for manager utilization management in Rosedale, MD is $87,292.00, according to ZipRecruiter salary data. Most workers in this role earn between $57,100.00 and $105,000.00 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 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 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 popular job titles related to Manager Utilization Management jobs in Rosedale, MD? For Manager Utilization Management jobs in Rosedale, MD, the most frequently searched job titles are:
What job categories do people searching Manager Utilization Management jobs in Rosedale, MD look for? The top searched job categories for Manager Utilization Management jobs in Rosedale, MD are:
What cities near Rosedale, MD are hiring for Manager Utilization Management jobs? Cities near Rosedale, MD with the most Manager Utilization Management job openings:
Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Rosedale, MD as of May 2026, with employment types broken down into 81% Full Time, 15% Part Time, 1% Temporary, and 3% Contract. Highlights an 52% Physical, 6% Hybrid, and 42% Remote job distribution, with an average salary of $87,292 per year, or $42 per hour.
Utilization Management Coordinator

Utilization Management Coordinator

System One Holdings, LLC

Baltimore, MD • On-site

$24.67 - $25/hr

Full-time

Medical, Dental, Vision, Life, Retirement

This job post has expired today. Applications are no longer accepted.

Job description

Utilization Management Coordinator
Work setup: 100% Remote (must be able to work Eastern Time hours)
Schedule: Must be able to work weekends
Contract length: ~3 months
Pay: $24.50/HR
Role overview
This role supports a Utilization Management/Medical Management team by handling high-volume prior authorization administrative work and related documentation. The work is fax-only (no calls) and requires strong accuracy, speed, and comfort with medical terminology and authorization workflows.
What you'll do
  • Create and manage prior authorization requests (data entry + processing)
  • Review incoming authorization requests and triage for clinical review when needed
  • Document activity accurately and keep cases organized and up to date
  • Support the team with general coordination tasks and tracking/reporting as needed
  • Work in a high-volume environment with a minimum of 32+ faxes per day

Must-have qualifications (required)
  • 1+ year of experience as a Utilization Management Coordinator / Medical Management Coordinator (or very similar)
  • Hands-on experience with:
    • Prior authorization entry (most important)
    • Prior authorization processing
  • Strong medical terminology knowledge
  • Proven ability to keep up with high-volume throughput (32+ faxes/day minimum)
  • Excellent communication, organization, attention to detail, and ability to multitask
  • Own computer (required)
  • High School Diploma (or equivalent)

Nice-to-have / preferred
  • Guiding Care (highly preferred) - especially auth entry module experience building prior auths
  • FACETS (preferred) - used for eligibility verification/lookup
  • ICD-10 / diagnosis code familiarity
  • Two monitors for productivity

System One, and its subsidiaries including Joulé and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.
System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.
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