Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high ...
Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high ...
Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high ...
Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high ...
Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high ...
Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high ...
Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high ...
Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high ...
Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high ...
Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high ...
Responsible for leading governance, audit readiness, training, policy and procedure management, corrective action oversight, and performance improvement across Physical Health Utilization Management ...
Responsible for leading governance, audit readiness, training, policy and procedure management, corrective action oversight, and performance improvement across Physical Health Utilization Management ...
Medical Management - Senior Manager Clinical Governance and Performance 145-2056
Tulsa, OK ยท On-site
Responsible for leading governance, audit readiness, training, policy and procedure management, corrective action oversight, and performance improvement across Physical Health Utilization Management ...
Medical Management - Senior Manager Clinical Governance and Performance 145-2056
Tulsa, OK ยท On-site
Responsible for leading governance, audit readiness, training, policy and procedure management, corrective action oversight, and performance improvement across Physical Health Utilization Management ...
Clinical Pharmacy - Managed Care Clinical Pharmacist
Tulsa, OK ยท On-site
$102K - $122K/yr
The Utilization Management Clinical Pharmacist is responsible for playing a critical role in optimizing medication use, improving member outcomes, and ensuring regulatory compliance. This position ...
Clinical Pharmacy - Managed Care Clinical Pharmacist
Tulsa, OK ยท On-site
$102K - $122K/yr
The Utilization Management Clinical Pharmacist is responsible for playing a critical role in optimizing medication use, improving member outcomes, and ensuring regulatory compliance. This position ...
Clinical Pharmacy - Managed Care Clinical Pharmacist 146-2005
Tulsa, OK ยท On-site
$108K - $129K/yr
The Utilization Management Clinical Pharmacist is responsible for playing a critical role in optimizing medication use, improving member outcomes, and ensuring regulatory compliance. This position ...
Clinical Pharmacy - Managed Care Clinical Pharmacist 146-2005
Tulsa, OK ยท On-site
$108K - $129K/yr
The Utilization Management Clinical Pharmacist is responsible for playing a critical role in optimizing medication use, improving member outcomes, and ensuring regulatory compliance. This position ...
Hospital Case Manager
Tulsa, OK ยท On-site
Responsible for all case management activities assignedm, including case management and utilization management * The Case Manager provides concise management of patients hospitalization from pre ...
Hospital Case Manager
Tulsa, OK ยท On-site
Responsible for all case management activities assignedm, including case management and utilization management * The Case Manager provides concise management of patients hospitalization from pre ...
Formulary Management Pharmacist
Tulsa, OK ยท On-site
$50.50 - $60.75/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
Formulary Management Pharmacist
Tulsa, OK ยท On-site
$50.50 - $60.75/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
The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ... Maintains current knowledge of managed care requirements and accurately interprets these ...
The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ... Maintains current knowledge of managed care requirements and accurately interprets these ...
Utilization Review Specialist
Tulsa, OK ยท On-site
The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ... Maintains current knowledge of managed care requirements and accurately interprets these ...
Utilization Review Specialist
Tulsa, OK ยท On-site
The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ... Maintains current knowledge of managed care requirements and accurately interprets these ...
Case Manager II - PRN Days
Broken Arrow, OK ยท On-site
$19 - $25/hr
Enhances the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integration of functions of case management, utilization review and ...
Case Manager II - PRN Days
Broken Arrow, OK ยท On-site
$19 - $25/hr
Enhances the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integration of functions of case management, utilization review and ...
JOB SUMMARY The Utilization Review (UR) has a well-developed knowledge and skills in the areas of ... The UR effectively and efficiently manages a diverse workload in a fast-paced, rapidly changing ...
New
JOB SUMMARY The Utilization Review (UR) has a well-developed knowledge and skills in the areas of ... The UR effectively and efficiently manages a diverse workload in a fast-paced, rapidly changing ...
New
Drug Utilization Review Pharmacist - Ensure Safe and Effective Use of Medications A confidential managed care organization is seeking a skilled Drug Utilization Review (DUR) Pharmacist to support ...
Drug Utilization Review Pharmacist - Ensure Safe and Effective Use of Medications A confidential managed care organization is seeking a skilled Drug Utilization Review (DUR) Pharmacist to support ...
JOB SUMMARY The Utilization Review (UR) has a well-developed knowledge and skills in the areas of ... The UR effectively and efficiently manages a diverse workload in a fast-paced, rapidly changing ...
JOB SUMMARY The Utilization Review (UR) has a well-developed knowledge and skills in the areas of ... The UR effectively and efficiently manages a diverse workload in a fast-paced, rapidly changing ...
Collaborates with case management, utilization review, and operational teams after patient identification to support transition planning and care coordination. Identifies and addresses pre-enrollment ...
Collaborates with case management, utilization review, and operational teams after patient identification to support transition planning and care coordination. Identifies and addresses pre-enrollment ...
Oracle PMO - Manager
Tulsa, OK ยท On-site
$99K - $232K/yr
... utilization of business applications. As a Manager, you will enhance your leadership style by motivating, developing, and inspiring others to deliver quality. You are responsible for coaching ...
Oracle PMO - Manager
Tulsa, OK ยท On-site
$99K - $232K/yr
... utilization of business applications. As a Manager, you will enhance your leadership style by motivating, developing, and inspiring others to deliver quality. You are responsible for coaching ...
Measure changes in quality, efficiency, productivity, utilization, cost, and performance * Compare ... Collaborate with BI, Machine Learning, Data Engineering, Finance, PMO, CQI, and operational teams
Measure changes in quality, efficiency, productivity, utilization, cost, and performance * Compare ... Collaborate with BI, Machine Learning, Data Engineering, Finance, PMO, CQI, and operational teams
Manager Utilization Management information
See Tulsa, OK salary details
$35.6K - $46.3K
9% of jobs
$54.2K is the 25th percentile. Wages below this are outliers.
$46.3K - $57K
22% of jobs
$57K - $67.6K
11% of jobs
The median wage is $74.2K / yr.
$67.6K - $78.3K
14% of jobs
$78.3K - $89K
12% of jobs
$95.6K is the 75th percentile. Wages above this are outliers.
$89K - $99.6K
13% of jobs
$99.6K - $110.3K
13% of jobs
$110.3K - $121K
5% of jobs
$121K - $131.6K
2% of jobs
$131.6K - $142.3K
0% of jobs
$142.3K - $153K
0% of jobs
$35.6K
$83.1K
$153K
How much do manager utilization management jobs pay per year?
What are the key skills and qualifications needed to thrive as a manager utilization management?
What is the difference between Manager Utilization Management vs Utilization Review Nurse?
| Aspect | Manager Utilization Management | Utilization Review Nurse |
|---|---|---|
| Credentials | RN, often with management or utilization review certifications | RN, with certifications in utilization review or case management |
| Work Environment | Supervises teams, manages policies, oversees utilization review processes | Performs patient chart reviews, assesses medical necessity, collaborates with providers |
| Employer & Industry | Hospitals, insurance companies, healthcare organizations | Hospitals, insurance companies, healthcare organizations |
| Search & Comparison Intent | Yes | Yes |
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 utilization management, and how can they effectively address them?
What does a manager utilization management do?
What are the most commonly searched types of Utilization Management jobs in Tulsa, OK?
The most popular types of Utilization Management jobs in Tulsa, OK are:
What are popular job titles related to Manager Utilization Management jobs in Tulsa, OK?
For Manager Utilization Management jobs in Tulsa, OK, the most frequently searched job titles are:
What job categories do people searching Manager Utilization Management jobs in Tulsa, OK look for?
The top searched job categories for Manager Utilization Management jobs in Tulsa, OK are:
What cities near Tulsa, OK are hiring for Manager Utilization Management jobs?
Cities near Tulsa, OK with the most Manager Utilization Management job openings:

Other
Re-posted 23 days ago
Job description
Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk members, and other members identified with at risk or high utilization needs. Functions as an active team member of the Utilization Management Team.
KEY RESPONSIBILITIES:
- Performs utilization review of outpatient and ancillary services as well as inpatient and post-acute services when indicated.
- Determines medical necessity and appropriateness of services using clinical review criteria.
- Accurately documents all review determinations and contacts providers and members according to established timeframes.
- Appropriately identifies and refers cases that do not meet established clinical criteria to the Medical Director.
- Appropriately identifies and refers quality issues to Medical Management leadership.
- Appropriately identifies potential cases for Care Management programs.
- Collaborates with physicians and other providers to facilitate provision of services throughout the health care continuum.
- Performs accurate data entry.
- Communicates appropriate information to other staff members as necessary/required.
- Participates in continuing education initiatives.
- Collaborates with other departments as needed.
- Performs other duties as assigned.
- Knowledge of managed care and associated group benefit plans.
- Possess strong oral and written communication skills.
- Ability to reason logically and to use good judgment when interpreting materials or situations.
- Knowledge of community- based resources.
- Must have excellent organizational skills and be able to perform multiple tasks.
- Proficient in Microsoft applications.
- Excellent time management and documentation skills.
- Successful completion of Health Care Sanctions background check.
- Graduation from accredited School of Nursing.
- Current, active, unrestrictive license to practice as a Registered Nurse in the State of Oklahoma.
- Three years of acute care experience preferred.
- Two years of experience working with population health preferred.
- Previous discharge planning or case management experience preferred.
- Managed care experience a plus.
CommunityCare is an equal opportunity at will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation or national origin