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Utilization Care Manager Jobs (NOW HIRING)

DCH Health System

Rehab Care Manager /RN

Northport, AL · On-site

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

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$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:
What job categories do people searching Utilization Care Manager jobs look for? The top searched job categories for Utilization Care Manager jobs are:
Utilization Care Manager jobs near you
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.
Utilization Review Care Manager (RN)- Care Management

Utilization Review Care Manager (RN)- Care Management

Cookeville Regional Medical Center

Cookeville, TN • On-site

Other

Re-posted 9 days ago

Cookeville Regional Medical Center rating

6.8

Company rating: 6.8 out of 10

Based on 36 frontline employees who took The Breakroom Quiz

579th of 1,020 rated hospitals

Job description

The Utilization Review Care Manager is responsible for the direction, management and monitoring of activities related to Quality and Process Improvement, Case Management, Clinical Pathway Development, discharge planning for the Pathways System for Case Management . Other duties as assigned.
Education: Associates or Bachelors Degree in Nursing required. State RN License required.
Experience: Three to five years of health care management. A previous background in Case Management/Utilization Review. Knowledge of accepted Nursing procedures in designated patient populations as acquired through 5 years of clinical experience.
Knowledge of accounting, management and statistical principals. Knowledge and understanding of computer programs. . Demonstrates physical capabilities with pressure to meet deadlines and expectations.

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