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Utilization Care Manager Jobs (NOW HIRING)

The Care Manager, as part of the interdisciplinary team, assess, plans, advocates, and coordinates ... Utilization Management experience, preferred Licensure: • Current License in the state of ...

The Care Manager, as part of the interdisciplinary team, assess, plans, advocates, and coordinates ... Utilization Management experience, preferred Licensure: • Current License in the state of ...

The Care Manager, as part of the interdisciplinary team, assess, plans, advocates, and coordinates ... Utilization Management experience, preferred Licensure: • Current License in the state of ...

The Care Manager, as part of the interdisciplinary team, assess, plans, advocates, and coordinates ... Utilization Management experience, preferred Licensure: • Current License in the state of ...

The Care Manager, as part of the interdisciplinary team, assess, plans, advocates, and coordinates ... Utilization Management experience, preferred Licensure: • Current License in the state of ...

The Care Manager, as part of the interdisciplinary team, assess, plans, advocates, and coordinates ... Utilization Management experience, preferred Licensure: • Current License in the state of ...

The Care Manager, as part of the interdisciplinary team, assess, plans, advocates, and coordinates ... Utilization Management experience, preferred Licensure: • Current License in the state of ...

The Care Manager, as part of the interdisciplinary team, assess, plans, advocates, and coordinates ... Utilization Management experience, preferred Licensure: • Current License in the state of ...

The Care Manager, as part of the interdisciplinary team, assess, plans, advocates, and coordinates ... Utilization Management experience, preferred Licensure: • Current License in the state of ...

Manager, Data Analytics

Long Beach, CA · On-site +1

$79K - $172K/yr

Performs research and analysis of complex Clinical Data - Utilization & Care Management Data. Evaluates, writes, and presents reports and makes recommendations based on relevant findings. Uses ...

Utilization Management * Provides an Important Message notice and choice on Medicare patients as ... Care Coordination, Collaboration, and Transition Planning * Collaborates with social workers for ...

Utilization Management * Provides an Important Message notice and choice on Medicare patients as appropriate. * Identifies and reports process improvement opportunities by capturing delays in care by ...

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Utilization Care Manager information

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$39K

$91K

$167.5K

How much do utilization care manager jobs pay per year?

As of Jul 13, 2026, the average yearly pay for utilization care manager 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 utilization manager do?

A utilization care manager evaluates healthcare services to ensure they are necessary, appropriate, and cost-effective. They review patient cases, coordinate with healthcare providers, and use medical records and guidelines to optimize resource use and improve patient outcomes.

How does a Utilization Care Manager typically collaborate with medical and administrative teams to ensure effective patient care?

Utilization Care Managers work closely with physicians, nursing staff, and administrative teams to review patient cases, determine medical necessity, and coordinate appropriate care plans. They frequently participate in interdisciplinary meetings, communicate with insurance providers regarding authorizations, and ensure compliance with regulatory guidelines. This collaborative approach helps to optimize resource utilization, improve patient outcomes, and support smooth transitions of care. Being proactive in communication and documentation is key to success in this role.

What are Utilization Care Managers?

Utilization Care Managers are healthcare professionals responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They work to ensure that patients receive the right care at the right time, while also helping healthcare organizations manage costs and comply with regulations. Utilization Care Managers often review patient cases, coordinate with medical staff, and interact with insurance companies to authorize or deny services. Their goal is to optimize healthcare delivery, reduce unnecessary procedures, and improve patient outcomes.

Is being a MOA a good entry level job?

A Medical Office Assistant (MOA) role is often considered an entry-level position in healthcare, requiring basic administrative and clinical skills. It provides experience in patient communication, medical records, and office procedures, which can serve as a foundation for advanced healthcare roles. However, career growth may require additional certifications or training.

What jobs pay 4000 a week without a degree?

Utilization Care Managers typically do not earn $4,000 weekly without specialized experience or certifications. High-paying roles that can reach this level without a degree often include skilled trades such as commercial pilots, real estate brokers, or sales managers, which may require licensing or extensive experience. Most jobs paying this amount without a degree involve specialized skills, certifications, or significant experience in the field.

What are the key skills and qualifications needed to thrive as a Utilization Care Manager, and why are they important?

To thrive as a Utilization Care Manager, you need a background in healthcare, typically as a registered nurse or social worker, with expertise in care coordination and utilization review. Familiarity with utilization management software, medical necessity guidelines (such as Milliman or InterQual), and knowledge of insurance regulations are important. Strong analytical thinking, attention to detail, and effective communication skills help you advocate for patients while working with healthcare teams and payers. These skills ensure appropriate resource use, quality patient outcomes, and compliance with regulatory standards.

What is the difference between Utilization Care Manager vs Utilization Review Nurse?

AspectUtilization Care ManagerUtilization Review Nurse
CredentialsRN, case management certificationRN, certification in utilization review
Work EnvironmentHealthcare facilities, insurance companiesHospitals, insurance companies, outpatient clinics
Primary FocusCoordinating patient care, managing resourcesReviewing medical necessity, approving treatments

Utilization Care Managers focus on coordinating patient care and managing resources, while Utilization Review Nurses primarily evaluate medical necessity for treatments. Both roles require nursing credentials and work within healthcare or insurance settings, but their core responsibilities differ in scope and focus.

What is the highest paying healthcare administration job?

In healthcare administration, executive roles such as Chief Executive Officer (CEO), Chief Operating Officer (COO), and Chief Financial Officer (CFO) tend to have the highest salaries, often exceeding six figures annually. These positions require extensive experience, leadership skills, and often advanced degrees like an MBA or healthcare administration certification.
More about Utilization Care Manager jobs
What cities are hiring for Utilization Care Manager jobs? Cities with the most Utilization Care Manager job openings:
What states have the most Utilization Care Manager jobs? States with the most job openings for Utilization Care Manager jobs include:
Infographic showing various Utilization Care Manager job openings in the United States as of July 2026, with employment types broken down into 2% As Needed, 70% Full Time, 22% Part Time, and 6% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $91,011 per year, or $43.8 per hour.
Behavioral Health Utilization Care Manager

Behavioral Health Utilization Care Manager

CENTRAL FLORIDA BEHAVIORAL HEALTH NETWORK INC

Tampa, FL • Hybrid

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 13 days ago


Job description

Licensed Behavioral Health Utilization Care Manager

Come Put your Experience to Use and Work with Great People!

Central Florida’s Behavioral Health Network, Inc. (CFBHN) is one of the leading behavioral health managing entities in the state of Florida, covering 14 counties.  Contracted with the Department of Children and Family, we provide oversite to providers in central Florida who serve in the mental health and substance abuse field in all types of settings, including school and community settings.  We have been in business for more than 25 years, are well respected in the field, and are located in a convenient location near Brandon just off the Selman Expressway, not far from downtown!

The Behavioral Health Utilization Care Manager is responsible for assuring that the system of care is accessible, effective, efficient and appropriate for individuals and families seeking services.

One of the best things about working at CFBHN is that the company truly cares about its employees, and it shows in the length of time our employees stay with us. Many of our staff have been here ten years or more. We offer a great paid time off program that includes paid vacation days, paid sick days, paid personal days and a paid volunteer day! Our health and dental benefits are 100% employer paid for telehealth. We offer a great 401k plan along with a profit-sharing plan to help you prepare for your future. This is a great hybrid role which is mostly work from home. We provide your laptop, cell phone, monitor, and other supplies you may need.

Responsibilities:

Essential Job Functions

  • Review, analyze, trend and report utilization/care coordination data of individuals receiving behavioral health services.
  • Identify, recommend, and assist in implementing programmatic and system changes designed to further develop and improve system of care through acute care meetings, care coordination, etc.
  • Provide training and technical assistance related to utilization management/care coordination.
  • Assure compliance with provider and CFBHN contractual requirements, managing entity accreditation requirements, annual audit requirements and laws, regulations and rules that govern the provision of behavioral health services
  • Participate in and/or chair CFBHN Utilization Management Committee and other associated CFBHN meetings
  • Exceptional skills in utilization data analysis
  • Understanding of different funding sources for behavioral health care (Medicaid, commercial insurance) as well as state and federal funding
  • In-depth understanding of system of care principles and values
  • Knowledge of federal and state regulations related to the provision of mental health and substance services
  • Knowledge of the principles and practices of collaborative quality improvement processes
  • Ability to manage multiple tasks and prioritize meeting deadlines
  • Knowledge of Microsoft Office suite as applicable to the position
  • Ability to travel as required by the position

Qualifications:

Required Education/Experience

  • Master’s degree in social work, mental health counseling or marriage and family counseling.
  • Behavioral health license LMHC, LCSW, LMFT required
  • Two years’ experience in utilization management that includes oversight of admissions, census, discharges, and budget.

We offer:

  • Health & dental (100% paid for employee)
  • Vision benefits (deeply discounted pricing)
  • Hybrid role
  • Life Insurance ($10,000 policy, 100% paid)
  • 401k (after 90 days)
  • 401k Matching up to 4%
  • AD&D policy (100% employer paid)
  • Telehealth
  • AFLAC available
  • 12 paid vacation days, 12 paid sick days
  • Two paid personal days and one paid volunteer day
  • Nine paid holidays
  • Employee assistance program
  • And more great benefits!

Send your resume now!