ZipRecruiter

Log In

1

Manager Utilization Management Jobs in Rosedale, MD

MedStar Health

Director Case Management

Columbia, MD · On-site

The Director of Case Management (DCM) oversees case management activities that may include behavioral health utilization management and care management functions and serves as a liaison to government ...

Global Alliant Inc

Clinical Analyst

Baltimore, MD · Remote

Utilization Management / Utilization Review / Prior Authorization * Clinical or healthcare educational background * ICD-10, CPT, HCPCS * Claims, denials, billing or medical-necessity review

Global Alliant Inc

Clinical Analyst

Baltimore, MD · On-site

Utilization Management / Utilization Review / Prior Authorization * Clinical or healthcare educational background * ICD-10, CPT, HCPCS * Claims, denials, billing or medical-necessity review

Global Alliant Inc

Clinical Analyst

Baltimore, MD · Remote

Utilization Management / Utilization Review / Prior Authorization * Clinical or healthcare educational background * ICD-10, CPT, HCPCS * Claims, denials, billing or medical-necessity review

previous page

Showing results 41-60

All JobsUtilization Management JobsManager Utilization Management JobsManager Utilization Management Jobs in Rosedale, MD

Manager Utilization Management information

See Rosedale, MD salary details

$37.4K

$87.3K

$160.7K

How much do manager utilization management jobs pay per year?

As of Aug 17, 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 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 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 August 2026, with employment types broken down into 84% Full Time, and 16% Contract. Highlights an 100% In-person job distribution, with an average salary of $87,292 per year, or $42 per hour.

Utilization Review Nurse - Managed Care

Johns Hopkins Healthcare

Hanover, MD • On-site

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 12 days ago

Johns Hopkins Medicine rating

7.6

Company rating: 7.6 out of 10

Based on 229 frontline employees who took The Breakroom Quiz

189th of 887 rated healthcare providers

Job description

Excel. Empower. Advance. Shine. Belong. Explore. Flourish. Champion.
Make It Happen At Hopkins!
Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine, one of the premier health delivery, academic, and research institutions in the United States. JHHP is a $2.5B business serving over 400,000 lives with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHP has become a leader in provider-sponsored health plans and is poised for future growth.
About this position:
Work Monday - Friday, the core business hours are 8:00 AM - 5:00 PM
As a Utilization Review Registered Nurse for Johns Hopkins Health Plans, you have the opportunity to use your clinical, managed care, utilization review, and verbal/written communication skills to make a difference in our members' lives. Your in-depth knowledge of the appropriate levels of care makes you a valuable resource to our members when they are in need.
What you'll do:
  • Monitor the appropriateness of care received by plan members in a variety of settings
  • Evaluate member benefits and medical criteria to determine authorization of services
  • Communicate authorization and/or denial of covered services with all parties involved
  • Initiate discharge planning of members

What awaits you:
  • Work-life balance - This is a remote role! Candidates in the following approved states will be given priority: MD, DC, VA, PA, DE, FL
  • Medical, Dental, and Vision Insurance.
  • 403B Savings Plan w/employer contribution.
  • Paid Time off & Paid holidays.
  • Employee and Dependent Tuition assistance benefits.
  • Health and wellness programs and MORE!

What you'll bring:
  • Understanding of managed care delivery systems and utilization management
  • Knowledge and expertise in utilizing various criteria sets (i.e. InterQual)
  • Ability to negotiate and resolve conflicts with external customers.
  • Unencumbered Registered Nurse (RN) license in Maryland (or Compact state)
  • 3+ years' experience as an acute care RN
  • 1+ years' experience in Managed Care/Utilization Review is required

Many organizations talk about transforming the future of healthcare, at Johns Hopkins Health Plans, we are setting the pace for change within the healthcare industry. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for our members and the communities we serve. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home.
Salary Range: Minimum 39.64/hour - Maximum 61.45/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority.
The Hospital reserves the right to modify employee schedules as needed.
We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices.
Johns Hopkins Health System and its affiliates are drug-free workplace employers.
Johns Hopkins Health System and its affiliates are an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.

What Johns Hopkins Medicine employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply