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Manager Utilization Review Physical Therapist Jobs

Albanymed

Utilization Review Nurse

Albany, NY

$77K - $119K/yr

Care Management/Social Work Work Shift: Day (United States of America) Salary Range: $77,075.00 ... While performing utilization review identifies areas for clinical documentation improvement and ...

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Manager Utilization Review Physical Therapist information

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$91K

$167.5K

How much do manager utilization review physical therapist jobs pay per year?

As of Sep 6, 2026, the average yearly pay for manager utilization review physical therapist 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 does a manager utilization review physical therapist do?

A Manager Utilization Review Physical Therapist oversees the process of evaluating the medical necessity, appropriateness, and efficiency of physical therapy services provided to patients. They lead a team of utilization review specialists, ensuring that treatment plans comply with insurance guidelines and regulatory standards. Their role involves reviewing clinical documentation, communicating with healthcare providers and insurers, and implementing best practices to optimize patient outcomes while controlling costs. Additionally, they are responsible for training staff, maintaining compliance, and improving review processes.

What are the key skills and qualifications needed to thrive as a manager utilization review physical therapist?

To thrive as a Manager Utilization Review Physical Therapist, you need a valid physical therapy license, clinical expertise, and experience in utilization review or case management. Familiarity with healthcare coding systems (ICD-10, CPT), utilization management software, and compliance regulations such as Medicare guidelines is typically required. Strong leadership, analytical thinking, and effective communication are crucial soft skills for guiding teams and collaborating with diverse healthcare stakeholders. These abilities ensure appropriate care delivery, regulatory compliance, and efficient resource utilization within healthcare organizations.

What are some typical challenges faced by a manager utilization review physical therapist, and how can they be addressed?

A Manager Utilization Review Physical Therapist often faces challenges such as balancing administrative duties with clinical oversight, staying current with changing payer guidelines, and ensuring consistent communication between clinical staff and insurance providers. Addressing these challenges involves strong organizational skills, regular training on updated policies, and fostering a collaborative team environment. Utilizing technology to streamline documentation and review processes can also help manage workload efficiently while maintaining high-quality patient care.

What is the difference between Manager Utilization Review Physical Therapist vs Utilization Review Coordinator Physical Therapist?

AspectManager Utilization Review Physical TherapistUtilization Review Coordinator Physical Therapist
CertificationsLicensed Physical Therapist, possibly additional management certificationsLicensed Physical Therapist, certification in utilization review preferred
Work EnvironmentSupervises teams, manages review processes, strategic planningPerforms review assessments, coordinates case evaluations, administrative tasks
Employer & Industry UsageHospitals, insurance companies, healthcare organizationsInsurance companies, healthcare providers, case management firms

The Manager Utilization Review Physical Therapist typically oversees review teams and manages utilization review processes, focusing on strategic and administrative leadership. In contrast, the Utilization Review Coordinator Physical Therapist primarily conducts case reviews and assessments, supporting the review process without managerial responsibilities. Both roles require licensed physical therapists and knowledge of healthcare utilization, but their scope and responsibilities differ significantly.

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Cities with the most Manager Utilization Review Physical Therapist job openings:

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Manager Utilization Review Physical Therapist jobs near you
Infographic showing various Manager Utilization Review Physical Therapist job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 74% Full Time, 20% Part Time, 1% Temporary, 3% Contract, and 1% Nights. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution, with an average salary of $91,011 per year, or $43.8 per hour.

MANAGER OF UTILIZATION REVIEW

Southwest General

Hudson, OH • On-site

Full-time

Posted 5 days ago

Southwest General Health Center rating

6.9

Company rating: 6.9 out of 10

Based on 46 frontline employees who took The Breakroom Quiz

546th of 1,065 rated hospitals

Job description

  • POSITION INFORMATION
    • Position summary:
      • The Utilization Management (UM) RN Manager is responsible for the day-to-day leadership, operational oversight, and performance management of the Utilization Management nursing team. Reporting to the UM RN Director, the Manager translates department strategy, regulatory and payer requirements, approved clinical review criteria, and organizational priorities into consistent daily execution.
      • The role provides direct supervision, coaching, workflow management, clinical-operational support, and performance oversight for assigned UM staff. The Manager collaborates with physician advisors/medical directors, case management, clinical operations, revenue cycle, payer relations, quality, compliance, and other stakeholders to support timely, accurate, evidence-informed utilization management decisions and appropriate stewardship of healthcare resources.
  • MINIMUM QUALIFICATIONS
    • Education:
      • Bachelor of Science in Nursing (BSN) required, or equivalent qualification consistent with organizational policy.
      • Master's degree in Nursing, Healthcare Administration, Business Administration, Public Health, or a related field preferred.
    • Required length and type of experience:
      • Five or more years of progressive clinical nursing and/or utilization management experience preferred, including three or more years of experience in utilization management, utilization review, case management, managed care, or a closely related function.
      • Prior formal leadership experience required; two or more years of supervisory or management experience preferred.
    • Required licensure, certification or registry:
      • Current Ohio State Board of Nursing license required.
      • Certified Case Manager (CCM) certification preferred.
      • Accredited Case Manager (ACM) certification preferred.
    • Core Knowledge, Skills, and Competencies
      • Knowledge of utilization management and utilization review principles, including prospective, concurrent, and retrospective review.
      • Knowledge of medical necessity, patient status, level-of-care review, authorization processes, payer requirements, denial prevention, and escalation pathways.
      • Knowledge of evidence-based clinical review criteria and appropriate use of clinical decision-support tools.
      • Knowledge of regulatory and accreditation requirements affecting utilization management and clinical review.
      • Demonstrated ability in people leadership, coaching, performance management, conflict resolution, and change management.
      • Demonstrated ability to interpret operational analytics and KPIs, conduct root-cause analysis, and drive process improvement.
      • Demonstrated ability to communicate effectively across interdisciplinary teams, including nursing, physicians, physician advisors, payers, revenue cycle, and leadership.
      • Demonstrated application of professional nursing judgment, ethical practice, confidentiality, and appropriate stewardship of healthcare resources.

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