ZipRecruiter

Log In

1

Manager Utilization Management Jobs (NOW HIRING)

Bryan Health

Utilization Management Manager

Lincoln, NE · On-site

Leads and shapes the Utilization Management (UM) Strategy for Bryan Medical Center (BMC) while providing management oversight in implementing, directing, and monitoring the Utilization Management ...

New

SIHO Insurance Services, Inc.

Be Seen First

Utilization Management Nurse

Columbus, IN · On-site

Manager of Utilization Management Brief Description of Duties: This position is reserved for a licensed Registered Nurse who will perform the Utilization Management (UM) services for SIHO (and ...

next page

Showing results 1-20

All JobsUtilization Management JobsManager Utilization Management Jobs

Manager Utilization Management information

See salary details

$39K

$91K

$167.5K

How much do manager utilization management jobs pay per year?

As of Jun 18, 2026, the average yearly pay for manager utilization management in the United States is $91,011.00, according to ZipRecruiter salary data. Most workers in this role earn between $59,500.00 and $109,500.00 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.
More about Manager Utilization Management jobs
What cities are hiring for Manager Utilization Management jobs? Cities with the most Manager Utilization Management job openings:
What are the most commonly searched types of Utilization Management jobs? The most popular types of Utilization Management jobs are:
What states have the most Manager Utilization Management jobs? States with the most job openings for Manager Utilization Management jobs include:
What job categories do people searching Manager Utilization Management jobs look for? The top searched job categories for Manager Utilization Management jobs are:
Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in the United States as of June 2026, with employment types broken down into 1% As Needed, 96% Full Time, 1% Part Time, and 2% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $91,011 per year, or $43.8 per hour.

Senior Manager, Utilization Management

1199 Seiu National Benefit Fund

Manhattan, NY • On-site

$125K - $156K/yr

Full-time

Posted 8 days ago

Job description

Requisition #:
7475
# of openings:
1
Employment Type:
Full time
Position Status:
Permanent
Category:
Non-Bargaining
Workplace Arrangement:
Hybrid
Fund:
1199SEIU National Benefit Fund
Job Classification:
Exempt
Responsibilities
• Effectively manage the daily operations, workflow, and supervise clinical and non-clinical staff to provide support for the utilization management, benefits and service coordination and appeal process).
• Assist in developing strategic plan by partnering with Director/Assistant Director and Fund management to identify opportunities that have direct impact on clinical and financial outcomes.
• Access and analyze all processes on an ongoing basis to determine their effectiveness, eliminate inefficiencies, and make recommendations to senior management to improve workflow, operations, and staff performance.
• Coordinate activities between clinical programs, communication, and report requirements to maintain operational efficiencies and to be in compliance with the Department of Labor (DOL), Summary Plan Description (SPD) departmental protocols and clinical policies and procedures.
• Interact and collaborate with other departments in troubleshooting, problem solving, and exchanging information in conjunction with maintaining effective communication with providers and members.
• Participate in interdepartmental committees/meetings.
• Lead internal audits for designated unit
• Develop and maintain ongoing quality insurance process
• Responsible for staff development, clinical orientation, ongoing education, and training programs to meet the changing needs of the Department.
• Continually assess clinical staff performance against internal and external departmental and industry standards.
• Perform additional duties and projects as assigned by managed
Qualifications
• Bachelor's Degree in Nursing, Business or Health Care Administration or equivalent years of work experience required; plus
• Current New York State of Registered Nurse (RN) license required
• Minimum six (6) years work experience in Utilization/Case Management/Appeals Programs within a managed care organization, to include a minimum of three (3) years progressive leadership and management experience
• Experience working with Milliman guidelines or other regulatory protocols, claims processing, medical coding and interpreting provider contracts
• Ability to make critical business clinical decisions independently.
• Ability to work with automated Prior Authorization system
• Intermediate level of Microsoft Office suite applications
• Strong critical thinking and analytical skills with effective troubleshooting and problem-solving abilities
• Excellent time management and project management skills
• Effective verbal and written communication skills
• Ability to prioritize and be detail-oriented, multi-task and must strive in fast-paced environment

Apply