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Utilization Care Manager Jobs (NOW HIRING)

The Clinical Manager at Select Health leads and supervises a team of Utilization Review and Care Management clinicians within an insurance and managed care environment. This role ensures delivery of ...

New

CARE MANAGER

Daly City, CA · On-site

$68 - $72/hr

The Case Manager RN is responsible for ensuring effective and efficient utilization of hospital resources and assisting patients in receiving appropriate, high quality post hospital care and service.

Overview The Case Manager RN is responsible for ensuring effective and efficient utilization of hospital resources and assisting patients in receiving appropriate, high quality post hospital care and ...

CARE MANAGER

Daly City, CA · On-site

$68/hr

Overview The Case Manager RN is responsible for ensuring effective and efficient utilization of hospital resources and assisting patients in receiving appropriate, high quality post hospital care and ...

Coordinate and manage care throughout the patient's acute inpatient illness; ensure continuity of services and appropriate utilization and management of resources. Demonstrate leadership abilities by ...

Job Summary Coordinate and manage care throughout the patient's acute inpatient illness; ensure continuity of services and appropriate utilization and management of resources. Demonstrate leadership ...

Coordinate and manage care throughout the patient's acute inpatient illness; ensure continuity of services and appropriate utilization and management of resources. Demonstrate leadership abilities by ...

Inpatient Care Manager II The Inpatient Care Manager II is critical for working with assigned ... utilization, care planning quality, and facilitates discharge planning on admission and concurrent ...

Coordinate and manage the care throughout the patient's acute inpatient illness; ensure continuity of services and appropriate utilization and management of resources. Demonstrate leadership ...

Coordinate and manage care throughout the patient's acute inpatient illness; ensure continuity of services and appropriate utilization and management of resources. Demonstrate leadership abilities by ...

Coordinate and manage care throughout the patient's acute inpatient illness; ensure continuity of services and appropriate utilization and management of resources. Demonstrate leadership abilities by ...

Coordinate and manage care throughout the patient's acute inpatient illness; ensure continuity of services and appropriate utilization and management of resources. Demonstrate leadership abilities by ...

Showing results 41-60

Utilization Care Manager information

See salary details

$39K

$91K

$167.5K

How much do utilization care manager jobs pay per year?

As of Aug 8, 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.

How does a utilization care manager 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 is a utilization care manager?

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.

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.

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 August 2026, with employment types broken down into 2% As Needed, 69% Full Time, 22% Part Time, and 7% 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.

REGISTERED NURSE CARE MANAGER UTILIZATION MANAGEMENT

St. Clair Hospital

Pittsburgh, PA • On-site

Full-time

Posted 8 days ago


St. Clair Health rating

6.8

Company rating: 6.8 out of 10

Based on 31 frontline employees who took The Breakroom Quiz

490th of 887 rated healthcare providers


Job description

Summary

Completes all aspects of Utilization Management for assigned patient population by evaluating appropriate status and physician orders for admission, observation, or outpatient at all points of entry to St. Clair Hospital, and ensures that appropriate orders are placed in the electronic medical record.

Minimum Qualifications

  1. Current licensure as a Registered Nurse in Pennsylvania.
  2. Five years of clinical experience as a Registered Nurse in an acute care setting.
  3. Two years of experience in Utilization Review.
  4. Highly effective communication skills.
  5. Ability to identify appropriate status and physician orders for the level of care the patient is or will be placed in.
  6. Ability to navigate electronic medical records and web-based applications.
  7. Possesses the ability to manage multiple tasks in a fast-paced environment.

Preferred Qualifications

  1. Bachelor's degree in nursing or health related field.
  2. Certification in Case Management.

What St. Clair Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom


St. Clair Health logo

About St. Clair Health

Sourced by ZipRecruiter

St. Clair Hospital is a highly honored, independent, 329 bed acute-care medical center that provides advanced, high quality health care to the residents of southwestern Pennsylvania. A member of the Mayo Clinic Care Network, St. Clair has 600 physicians and 2,500 employees. St. Clair Hospital is the largest employer in Pittsburgh’s South Hills. Providing virtually every health care service that residents may need throughout their lives, the Hospital is focused on continuously enhancing its services and technologies to ensure that the community’s health needs are met. The Hospital offers a comprehensive array of high-quality inpatient and outpatient services, including advanced cardiovascular services; specialized care for women and children; oncology services; orthopedics; emergency care; urgent care; and psychiatry and mental health services.

Industry

Health care and social assistance

Company size

1,001 - 5,000 Employees

Headquarters location

Pittsburgh, PA, US

Year founded

1954