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Utilization Management Assistant Jobs in Florida

Acadia Healthcare

Utilization Specialist

Ocklawaha, FL

$20 - $24/hr

Act as liaison between managed care organizations and the facility professional clinical staff ... Initiate and complete the formal appeal process for denied admissions or continued stay. * Assist ...

Acadia Healthcare

Utilization Specialist

Ocklawaha, FL · On-site

$20 - $24/hr

Act as liaison between managed care organizations and the facility professional clinical staff ... Initiate and complete the formal appeal process for denied admissions or continued stay. * Assist ...

Banyan

Utilization Review Specialist

Pompano Beach, FL · On-site

$50K - $65K/yr

In this remote role, you'll manage a caseload of 50-75 patients, conducting admission and ... Identify and address over- and underutilization trends * Assist in resolving outstanding case ...

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Utilization Management Assistant information

See Florida salary details

$21.7K

$36.2K

$51.9K

How much do utilization management assistant jobs pay per year?

As of Aug 4, 2026, the average yearly pay for utilization management assistant in Florida is $36,166.00, according to ZipRecruiter salary data. Most workers in this role earn between $31,400.00 and $36,200.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a utilization management assistant?

To thrive as a Utilization Management Assistant, you need a solid understanding of healthcare processes, medical terminology, and administrative procedures, often supported by a high school diploma or associate's degree. Familiarity with electronic health records (EHR) systems, insurance verification tools, and Microsoft Office Suite is typically required. Strong organizational skills, attention to detail, and effective communication are crucial soft skills for managing documentation and collaborating with clinical teams. These skills ensure accurate data handling, efficient workflow, and compliance with healthcare regulations, all of which are vital for successful utilization management operations.

What skills do you need for utilization management assistant?

A utilization management assistant needs strong organizational skills, attention to detail, and knowledge of healthcare policies and insurance procedures. Good communication skills and proficiency with electronic health records (EHR) systems are also important for coordinating patient information and supporting case reviews.

What are some common challenges utilization management assistants face when working with insurance pre-authorizations?

Utilization Management Assistants often encounter challenges such as navigating complex insurance requirements, meeting tight deadlines for pre-authorization requests, and communicating effectively with both healthcare providers and insurance representatives. Staying organized and detail-oriented is essential to ensure all documentation is accurate and submitted promptly. Additionally, adapting to frequent changes in insurance policies and maintaining strong problem-solving skills are key to overcoming these obstacles.

What is a utilization management assistant?

A Utilization Management Assistant is a healthcare administrative professional who supports the utilization management team by handling clerical tasks, coordinating communications, and organizing patient documentation. They often help ensure that medical services are used efficiently and that insurance requirements are met by gathering information, processing authorizations, and maintaining records. This role is essential in facilitating collaboration between healthcare providers, insurance companies, and patients, ultimately helping to optimize the quality and cost-effectiveness of patient care.
What are the most commonly searched types of Utilization Management jobs in Florida? The most popular types of Utilization Management jobs in Florida are:
What cities in Florida are hiring for Utilization Management Assistant jobs? Cities in Florida with the most Utilization Management Assistant job openings:
Utilization Management Assistant jobs near you
Infographic showing various Utilization Management Assistant job openings in Florida as of July 2026, with employment types broken down into 1% As Needed, 76% Full Time, 20% Part Time, 1% Temporary, and 2% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution, with an average salary of $36,166 per year, or $17.4 per hour.

Utilization Management Physician (UMP) - Remote - Florida

ProTouch Staffing

Daytona Beach, FL

Other

Medical, Retirement, PTO

Re-posted 22 days ago

Job description

Utilization Management Physician (UMP) - Remote

Full-Time | 40 Hours Weekly

A leading healthcare organization is seeking an experienced Utilization Management Physician (UMP) for a full-time remote opportunity. This role is ideal for a physician with strong clinical judgment, managed care experience, and expertise in medical necessity review and evidence-based decision-making.

The position is primarily remote, with occasional on-site attendance required for meetings and committee participation in Daytona Beach, Florida.

Position Highlights

  • Remote full-time role

  • 40 hours per week

  • Bonus opportunity

  • Must be available via phone, email, and Microsoft Teams

  • On-site presence required periodically for meetings/committees

    • Location: Daytona Beach, FL

Key Responsibilities

  • Review and render determinations for:

    • Pre-authorization requests

    • Initial and concurrent clinical reviews

    • Post-service decisions, including claims and appeals

  • Apply medical necessity criteria using nationally recognized guidelines, including:

    • MCG (Milliman Care Guidelines)

    • InterQual

    • CMS (Medicare/Medicaid) standards

    • Internal protocols and coverage documents

  • Participate in annual review and updates of clinical criteria and scripts

  • Provide physician support and guidance to Utilization Management staff

  • Conduct peer-to-peer discussions with treating providers (phone or electronic)

  • Assist with provider education regarding treatment protocols and best practices

  • Participate in medical and utilization management committees as requested

Patient/Plan Focus

This role supports utilization review across multiple plan types, including:

  • Medicare

  • Medicaid

  • Commercial health plans

Requirements

  • MD or DO from an accredited medical school

  • Active, unrestricted Florida medical license

  • Board certification in primary specialty preferred

  • Minimum 3 years' experience as a Utilization Management Physician

  • 3-7 years of overall clinical experience

  • Knowledge of managed care health plan operations and benefits

  • Strong working knowledge of medical policy application and evidence-based criteria

  • Willingness to participate in audit/interrater reliability processes to ensure consistency


Compensation & Benefits


  • Annual bonus opportunity

  • 401(k) retirement plan

  • Health benefits for provider and eligible dependents

  • Malpractice insurance provided

  • Paid leave time

  • CME stipend

  • Licenses, fees, and dues reimbursement

  • Travel reimbursement

Location

Remote (Florida)
Occasional on-site meetings in Daytona Beach, FL

Protouch Staffing logo

About Protouch Staffing

Sourced by ZipRecruiter

Protouch Staffing, based in Plano, Texas, is a leading provider in the healthcare staffing industry. Established over 30 years ago, the company prides itself on delivering quality services in the fields of nursing, allied health, pharmaceuticals, healthcare IT, and more. Committed to building lasting relationships, Protouch Staffing continually exceeds client expectations by providing unparalleled service, superior patient care, and talented healthcare professionals.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Frisco, TX, US

Year founded

1989

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