ZipRecruiter

Log In

1

Supervisor Utilization Management Jobs (NOW HIRING)

Welbehealth

Utilization Management RN

Los Angeles, CA

$99K - $131K/yr

By guiding this team, the Utilization Management RN Supervisor drives the continuous improvement of our care delivery processes. Essential Job Duties: * Direct oversight of day-to-day operations ...

WelbeHealth

Utilization Management RN

Los Angeles, CA

$99K - $131K/yr

By guiding this team, the Utilization Management RN Supervisor drives the continuous improvement of our care delivery processes. Essential Job Duties: * Direct oversight of day-to-day operations ...

WelbeHealth

Utilization Management RN

Los Angeles, CA · On-site

$99K - $131K/yr

By guiding this team, the Utilization Management RN Supervisor drives the continuous improvement of our care delivery processes. Essential Job Duties: * Direct oversight of day-to-day operations ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Oakland Park, FL · On-site

The Director supervises all Utilization Management activities, including conducting audits to assure medical necessity criteria is met and is clearly documented in the medical record, immediately ...

CorroHealth

Coordinator, Utilization Management

$19 - $20/hr

Title: Coordinator, Utilization Management Location: Remote (Within US Only) Required Schedule ... Additional functions and requirements may be assigned by supervisors as deemed appropriate.

next page

Showing results 1-20

All JobsSupervisor Utilization Management Jobs

Supervisor Utilization Management information

See salary details

$39K

$91K

$167.5K

How much do supervisor utilization management jobs pay per year?

As of Jun 25, 2026, the average yearly pay for supervisor 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 is a Supervisor Utilization Management job?

A Supervisor Utilization Management oversees the utilization review process to ensure healthcare services are used efficiently and appropriately. They manage a team of utilization review staff, monitor case reviews, and ensure compliance with policies and regulations. Their role includes coordinating with healthcare providers, optimizing resource use, and improving patient care outcomes.

What is the highest paying job in healthcare management?

In healthcare management, executive roles such as Chief Executive Officer (CEO), Chief Operating Officer (COO), and Chief Financial Officer (CFO) typically have the highest salaries. These positions require extensive experience, leadership skills, and often advanced degrees like an MBA or healthcare administration certification.

What jobs pay $2000 a day?

Jobs that can pay $2000 a day typically include high-level roles such as specialized surgeons, senior corporate executives, or certain consulting and investment banking positions. These roles often require advanced skills, extensive experience, and sometimes certifications, and they may involve long hours or high-pressure environments.

What are the key skills and qualifications needed to thrive in the Supervisor Utilization Management position, and why are they important?

To thrive as a Supervisor Utilization Management, you need in-depth knowledge of healthcare utilization review, case management, and compliance regulations, typically supported by a clinical background and relevant licensure or certification. Familiarity with utilization management software, claims processing systems, and data analysis tools such as Microsoft Excel or SQL is often required. Strong leadership, effective communication, and problem-solving abilities are critical soft skills for leading teams and collaborating with physicians and payers. These capabilities ensure efficient workflow management, regulatory adherence, and improved patient outcomes within healthcare organizations.

What degree do you need for utilization management?

A supervisor in utilization management typically needs at least a bachelor's degree in healthcare, nursing, health administration, or a related field. Some roles may require a master's degree or professional certifications such as Certified Managed Care Professional (CMCP) or Certified Professional in Healthcare Quality (CPHQ). Experience in healthcare or case management is also important for advancement.

What are the typical daily responsibilities of a Supervisor Utilization Management?

A Supervisor Utilization Management typically oversees a team of utilization review nurses or specialists, monitors case workloads, and ensures that medical necessity and regulatory standards are met during patient care reviews. On a daily basis, you might review complex cases, coordinate with physicians and insurance companies regarding care determinations, and implement departmental process improvements. Supervisors also provide staff training, audit case files for quality assurance, and manage departmental reporting and metrics. Collaborating with interdisciplinary teams and adapting to changing regulations are essential aspects of the role, offering variety and opportunities to influence patient care delivery.

Is utilization management a growing field?

Utilization management is a growing field within healthcare, driven by the need to control costs and improve patient outcomes. Demand for professionals in this area is increasing, especially as organizations seek certified managers with knowledge of healthcare policies and utilization review tools.
More about Supervisor Utilization Management jobs
What are the most commonly searched types of Supervisor Utilization Management jobs? The most popular types of Supervisor Utilization Management jobs are:
What states have the most Supervisor Utilization Management jobs? States with the most job openings for Supervisor Utilization Management jobs include:
What job categories do people searching Supervisor Utilization Management jobs look for? The top searched job categories for Supervisor Utilization Management jobs are:
Supervisor Utilization Management jobs near you
Supervisor, Prior Authorization Utilization Management

Supervisor, Prior Authorization Utilization Management

Medical Mutual of Ohio

Cleveland, OH • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 13 days ago

Medical Mutual of Ohio rating

9.4

Company rating: 9.4 out of 10

Based on 15 frontline employees who took The Breakroom Quiz

13th of 261 rated insurance

Job description

Medical Mutual employees must submit their applications through MySource.
This is a hybrid-remote role based out of the Brooklyn, OH office, with employees expected to work onsite on designated in-office days each week.
Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.
Job Summary:
Supervises prior authorization utilization review nurses ensuring they appropriately apply medical necessity guidelines in making authorization determinations for preservice procedures and surgeries, in collaboration with physician reviewers. Oversees processes to support evidence-based guidelines, Corporate Medical Policies and other decision support tools to ensure comprehensive cost-effective care for members.
Responsibilities:
  • Supervises daily operations of assigned Prior Authorization Nurse Reviewers. Ensures appropriate use of staff resources to facilitate accurate and timely utilization management decisions in collaboration with physician reviewers.
  • Supports staff onboarding, training, and professional development including maintenance of current knowledge of approved criteria and evidence-based practice to support the delivery of high quality, efficient utilization management authorization determinations
  • Ensures that staff appropriately gather the requisite data and information to enter authorizations and tracks and monitors the accuracy and timelines of data entered
  • Evaluates the quality of individual and group performance to ensure that that team is meeting departmental and organizational goals related to utilization, cost, quality and productivity targets.
  • Ensures compliance with company policy and procedure as well as state and federal rules and regulations and accreditation standards.
  • Assists management in coordinating facility system process with providers, partners, vendors, and subcontractors as necessary
  • Performs other duties as assigned

Qualifications:
Education and Experience:
  • Graduate of a registered nursing program approved by the Ohio State Nursing Board. Bachelor of Science in Nursing preferred.
  • 7 years progressive experience as a Nurse Reviewer in health insurance prior authorization or clinical appeals, or equivalent relevant RN experience in a clinical practice
  • Relevant experience leading teams or projects (formally or informally)

Professional Certification(s):
  • Registered Nurse with current State of Ohio unrestricted license.

Technical Skills and Knowledge:
  • Intermediate Microsoft Office skills and proficiency navigating windows and web-based systems.
  • Knowledge of medical terminology/coding managed care processes
  • Knowledge of and the ability to apply fundamental concepts related to HIPAA compliance and related regulations
  • Knowledge of disease continuums expected patient outcomes and community services available
  • Strong knowledge of clinical claim management including ICD 10, CPT and HCPCS code
  • Strong knowledge of health insurance benefits and network plan designs

Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:
A Great Place to Work:
  • We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset.
  • Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.
  • On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
  • Discounts at many places in and around town, just for being a Medical Mutual team member.
  • The opportunity to earn cash rewards for shopping with our customers.
  • Business casual attire, including jeans.

Excellent Benefits and Compensation:
  • Employee bonus program.
  • 401(k) with company match up to 4% and an additional company contribution.
  • Health Savings Account with a company matching contribution.
  • Excellent medical, dental, vision, life and disability insurance - insurance is what we do best, and we make affordable coverage for our team a priority.
  • Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
  • Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
  • After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.

An Investment in You:
  • Career development programs and classes.
  • Mentoring and coaching to help you advance in your career.
  • Tuition reimbursement up to $5,250 per year, the IRS maximum.
  • Diverse, inclusive and welcoming culture with Business Resource Groups.

About Medical Mutual:
Medical Mutual's status as a mutual company means we are owned by our policyholders, not stockholders, so we don't answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.
There's a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.
We're not just one of the largest health insurance companies based in Ohio, we're also the longest running. Founded in 1934, we're proud of our rich history with the communities where we live and work.
We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.
#LI-CS1 #LI-HYBRID
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

What Medical Mutual of Ohio employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply