ZipRecruiter

Log In

1

Manager Utilization Management Jobs in Seattle, WA

Briljent

Clinical Domain Project Manager (PBM)

Seattle, WA · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Assigned projects span drug coverage administration, Preferred Drug List (PDL) management, prior authorization, utilization management, drug utilization review, clinical criteria configuration, and ...

Briljent

Clinical Domain Project Manager (PBM)

Seattle, WA · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Assigned projects span drug coverage administration, Preferred Drug List (PDL) management, prior authorization, utilization management, drug utilization review, clinical criteria configuration, and ...

Intermedia Group

Manager - Case Management RN

Everett, WA · On-site

$141K - $223K/yr

... utilization management, social work services, and pre-admission case management. * The Manager acts as a liaison between patients and families, department staff, physicians and the healthcare team ...

Briljent

Clinical Domain Project Manager (PBM)

Seattle, WA · On-site

$110 - $140/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Assigned projects span drug coverage administration, Preferred Drug List (PDL) management, prior authorization, utilization management, drug utilization review, clinical criteria configuration, and ...

LIFECENTER NORTHWEST

Organ Utilization Coordinator

Bellevue, WA · On-site

$36.50 - $52.94/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

GENERAL SUMMARY The Organ Utilization Coordinator (OUC) is accountable for the allocation of organs ... This includes managing allocation processes for transplantation and research, scheduling surgical ...

LifeCenter Northwest

Organ Utilization Coordinator

Bellevue, WA · On-site

$36.50 - $52.94/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

GENERAL SUMMARY The Organ Utilization Coordinator (OUC) is accountable for the allocation of organs ... This includes managing allocation processes for transplantation and research, scheduling surgical ...

LifeCenter Northwest

Organ Utilization Coordinator

Bellevue, WA · On-site

$36.50 - $52.94/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... Organ Utilization Coordinator (OUC) is accountable for the allocation of organs recovered from ... This includes managing allocation processes for transplantation and research, scheduling surgical ...

Pharmacy Careers

Formulary Management Pharmacist

Seattle, WA · On-site

$66.25 - $79.75/hr

Provide clinical support for utilization management, prior-authorization criteria, and step-therapy guidelines. What You'll Bring * Education: PharmD or Bachelor of Pharmacy. * Licensure: Active U.S ...

New

MultiCare Health System

Manager Case Management

Tacoma, WA

$154K - $213K/yr

  • Medical

  • Dental

  • Life

  • Retirement

  • PTO

Navigate and collaborate with utilization management team to ensure proper billing and reimbursement * Monitor patient progress and provide education and support to patients and their families to ...

Uw

Portfolio Manager (Fred Hutch / UW Medicine)

Seattle, WA · Hybrid

  • Medical

  • Life

  • Retirement

  • PTO

Develop and maintain project plans, schedules, and other project management documents * Support the operational departments to improve associated systems REQUIREMENTS * Bachelor's degree in a health ...

previous page

Showing results 41-60

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

Manager Utilization Management information

See Seattle, WA salary details

$44.4K

$103.6K

$190.6K

How much do manager utilization management jobs pay per year?

As of Aug 19, 2026, the average yearly pay for manager utilization management in Seattle, WA is $103,573.00, according to ZipRecruiter salary data. Most workers in this role earn between $67,700.00 and $124,600.00 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 the most commonly searched types of Utilization Management jobs in Seattle, WA?

The most popular types of Utilization Management jobs in Seattle, WA are:

What are popular job titles related to Manager Utilization Management jobs in Seattle, WA?

For Manager Utilization Management jobs in Seattle, WA, the most frequently searched job titles are:

What job categories do people searching Manager Utilization Management jobs in Seattle, WA look for?

The top searched job categories for Manager Utilization Management jobs in Seattle, WA are:

What cities near Seattle, WA are hiring for Manager Utilization Management jobs?

Cities near Seattle, WA with the most Manager Utilization Management job openings:

Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Seattle, WA as of August 2026, with employment types broken down into 85% Full Time, and 15% Contract. Highlights an 100% In-person job distribution, with an average salary of $103,573 per year, or $49.8 per hour.

Pharmacy Technician On Site Iwakuni, Japan

Arcetyp LLC

Seattle, WA • On-site

$20 - $24.25/hr

Full-time

Posted 15 days ago

Job description

Arcetyp LLC is a growing small business that provides a broad range of consulting services to US Federal Government, US Military, and Commercial clients. Services include Management & IT Consulting, Program & Project Management, and Professional & Admin Services.
We accept direct hire candidates only, W2 employee hires. We do not accept 1099 independent consultants. We do not accept staffing firms. We do not accept corp-to-corp (C2C) candidates. We can't sponsor H1B.
Arcetyp LLC is looking for a Pharmacy Technician to support the Government in Japan. This will be an on-site, in-office position with one position located in Iwakuni, Japan.
POSITION DUTIES:
  • The Pharmacy Technician will assist in developing and refi ning referral management (RM) to support medical management initiatives at the military treatment facility (MTF).

ESSENTIAL JOB FUNCTIONS
  • Assess, monitor and evaluate and assist in processing referrals for authorization. The contractor shall
    review specialty care referrals for clinical appropriateness, covered benefit, and administrative and
    medical completeness following MTF, DHA, BUMED guidelines and TRICARE policy.
  • The HCW shall input and retrieve patient information for each referral, through the use of various
    computer systems include Electronic Health Record (EHR), Defense Enrollment Eligibility Reporting
    System (DEERS) and other work programs that are in use in the Referral Management Center.
  • Refer to a physician advisor for clinical review if the HCW and physician cannot reach an agreement
    on the processing of a referral within one business days. Timelines shall be monitored through
    computer reporting systems such as Electronic Health Record and TRICARE Reports.
  • Elevate referrals to the medical manager, utilization nurse, and physician advisor for higher level of
    review when there is uncertainty in medical necessity and covered benefit. All referrals for routine
    continental US care will be elevated to the medical manager and director of medical services.
  • Communicate between physician reviewer and the requesting provider in regard to preauthorization.
  • Submit monthly, quarterly, and yearly utilization reports using Electronic Health Record and TRICARE
    Reports. The HCW will report on referral trends, patterns or incidents of under- and/ over- utilization
    of resources, network leakage, purchased care costs, network care recapture, continuity of care, and
    customer satisfaction for all beneficiaries. The HCW will discuss patterns and trends with MTF
    providers and the Directorate of Healthcare Business leadership to educate and improve processes.
    The HCW shall present these reports to all medical staff with recommendations for efficient use of
    resources.
  • Evaluate monthly through prospective, concurrent, retrospective review, focused reviews, clinical
    pathways and clinical practice guidelines for performance outcomes of clinical care. The HCW will
    review ten defer to network consults per month to determine consult outcome and if clinical practice
    guidelines were met. If not met, the HCW will develop and implement a plan of action for consult
    management to ensure clinical practice guidelines are met.
  • Identify and communicate all adverse trends and referral management discrepancies in a written
    report via the chain of command and effectively communicate both verbally and in writing with the
    requesting physician(s) for clarification and correction. The report is to be submitted when
    trend/discrepancies identified.
  • Manage the referral processing center for all beneficiary categories (Active Duty, Active Duty Family
    Members, Retirees, and their family member, survivors, Department of Defense Civilians, Contractors)
    of patient clinical referrals and care authorizations to health care specialists in either the direct care
    or purchased care systems.
  • Provide departmental, directorate, and command performance improvement processes
    commensurate with this position. The HCW will be responsible for participating in monthly education
    programs, quality assurance functions and process action teams to improve the operations of the
    referral management center.
  • Referral management services will be performed in a managed care environment. The RN referral
    manager shall adhere to clinical practice guidelines, DHA policies, BUMED Referral Management
    Guidelines; Referral Management policies; TRICARE policies and procedures; and ICD and DRG codes.
  • The contractor shall participate in monthly in-service training for healthcare
    practitioners and administrative staff on subjects of referral management and utilization management
    services.
  • Provide the MTF with a report on internal referral management bi-weekly using approved tools and
    electronic health record. This report will be disseminated to the medical staff and directorate of
    healthcare business leadership. The RN referral management will manage discrepancies and
    collaborate with clinic managers to ensure access to clinical care is delivered according to BUDMED,
    TRICARE, and DHA policies.
  • Provide education and training on the referral management process, specialty referral guidelines, and
    related policies to beneficiaries, providers, and host nation partners.

NECESSARY SKILLS AND KNOWLEDGE:
  • Maintain a level of productivity comparable with that of other individuals performing similar services.
    Adhere to and comply with the Department of the Navy, Bureau of Medicine and Surgery, and local
    instructions and notices in effect during the term of the contract.
  • Practice aseptic techniques as necessary; comply with infection control guidelines to include the
    proper handling, storage, and disposal of infectious wastes, and the use of universal precautions to
    prevent the spread of infection.
  • Function with an awareness and application of safety procedures.
  • Apply an awareness of legal issues in all aspects of patient care and strive to manage situations in a
    reduced risk manner.
  • Exercise awareness and sensitivity to patient/significant others' rights, as identified within the MTF.
  • Maintain an awareness of responsibility and accountability for own professional practice.
  • Maintain DoD email account as directed by government supervisor.
  • Exercise appropriate delegation of tasks and duties in the direction and coordination of health care
    team members, patient care, and clinic activities.
  • Each HCW providing service under this contract or resultant task orders shall undergo an orientation
    and shall complete mandatory Navy and DoD on-line training as required.
  • Be able to comply with all applicable Federal, State, and local laws, Department of Defense,
    Department of Navy, Bureau of Medicine and Surgery, and MTF instructions and policies.
  • Proficiency in Microsoft Office software applications including Word, Excel, Access, PowerPoint, and
    Outlook.

MINIMUM QUALIFICATIONS:
  • Possess and maintain a current certification and registration by the Pharmacy Technician Certification
    Board (PTCB).
  • HCW shall be in good standing, and under no restrictions, with the state licensure board in any state
    in which a license is held or has been held within the last 10 years.
  • HCW shall be in good standing and under no sanction or suspension by the Federal Government.
  • Possess and maintain current certification in either the American Heart Association BLS for Healthcare
  • Providers or American Heart Association Healthcare Provider Course.
  • Able to read, write, speak, and understand the English language fluently and maintain good
    communication skills with patients and other health care personnel.
  • Ability to pass all background/suitability checks.
  • A valid driver's license and ability to travel locally as needed.
  • Ability to work some night, weekend, and holiday shifts.

PREFERRED QUALIFICATIONS:
  • A thorough understanding of the military lifestyle and experience working with military family
    members.
  • Working knowledge of relevant military, state, federal, and local laws and resources.
  • Highly developed written, oral, and presentation communication skills.

Min. Citizenship Status Required: U.S Citizenship.
LOCATION: Iwakuni, Japan
COMPENSATION: Pay and benefits information for this position will be provided to interested candidates that apply. Arcetyp offers a package of compensation and benefits to full-time salaried employees.
Arcetyp is an Equal Opportunity Employer and we highly value diversity of our workforce. We accept resumes from all interested parties and consider applicants for all positions without regard to race, color, religion, sex, national origin, age, marital status, sexual preference, personal appearance, family responsibility, the presence of a non-job-related medical condition or physical disability, matriculation, political affiliation, veteran status, or any other legally protected status.
Arcetyp logo

About Arcetyp

Sourced by ZipRecruiter

Industry

Business management consulting

Company size

1 - 10 Employees

Headquarters location

Fairfax, VA, US

Year founded

2017

View All Arcetyp Jobs

Apply