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Utilization Management Assistant Jobs (NOW HIRING)

WVU Medicine

Clinical Utilization Management Pharmacist

$121.30K - $144.80K/yr

Serve as a clinical pharmacy preceptor for residents and rotational pharmacy students as needed. 13. Assist in creation of training materials for utilization management operational processes as ...

Peak Health

Clinical Utilization Management Pharmacist

$121.30K - $144.80K/yr

Serve as a clinical pharmacy preceptor for residents and rotational pharmacy students as needed. 13. Assist in creation of training materials for utilization management operational processes as ...

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$29K

$48.4K

$69.5K

How much do utilization management assistant jobs pay per year?

As of Jun 3, 2026, the average yearly pay for utilization management assistant in the United States is $48,396.00, according to ZipRecruiter salary data. Most workers in this role earn between $42,000.00 and $48,500.00 per year, depending on experience, location, and employer.

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

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 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 cities are hiring for Utilization Management Assistant jobs? Cities with the most Utilization Management Assistant job openings:
What are the most commonly searched types of Utilization Management jobs? The most popular types of Utilization Management jobs are:
What states have the most Utilization Management Assistant jobs? States with the most job openings for Utilization Management Assistant jobs include:
Utilization Management Assistant jobs near you
Infographic showing various Utilization Management Assistant job openings in the United States as of May 2026, with employment types broken down into 83% Full Time, 15% Part Time, and 2% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $48,396 per year, or $23.3 per hour.
Director of Utilization Management

Director of Utilization Management

PARTNERSHIP FOR STRONG FAMILIES INC

Gainesville, FL • On-site

Full-time

Posted 10 days ago

Job description

The Director of Utilization Management is responsible for overseeing service authorizations and the Certified Behavioral Health Assessment (CBHA) process, ensuring that services for children are producing desired outcomes and are achieving permanency and for managing a team of individuals who serve to make direct connections between the needs of the community's children and families and the providers that meet those needs. This position is also responsible for the continuous quality improvement and data analytics associated with the Utilization Management (UM) units and may serve in other such capacities outside of these units. This position reports directly to the Vice President of Information Technology and Utilization Management.

ESSENTIAL JOB FUNCTIONS

  • Provides direct supervision of professional and administrative positions assigned to the Utilization Management Department.
  • Analyzes and reports Utilization Management data for use in budget analyses, staffing and service allocation considerations, quality improvement, and performance measure analyses.
  • Tracks, manages, and reports on department spending, based on the annually approved departmental budget, which includes collaborating with the Finance Department to review spending and allocations.
  • Assists with developing specifications and system operation, efficiencies, and maintenance for data capturing systems used within the Utilization Management Department.
  • Leads the Quality Improvement process within UM, providing input and observations to management staff and the Quality Operations units regarding behavioral health provider performance.
  • Reviews utilization of behavioral health and supportive services provided in in-home and outpatient settings to ensure the maximization of resources.
  • Provides oversight and support for staff processing and reviewing CBHA materials.
  • Reviews and approves invoices for payment ensuring appropriate use of state, federal, and other funding sources, appropriate coding, and cost allocations are utilized to facilitate maximization of resources.
  • Interacts with community agencies to assist children with returning home or achieving permanency.
  • Oversees and directs training relevant to UM including provider and service array with case management, Department of Child & Families (DCF), and other stakeholders.
  • Knows and understands the processes to be followed in relation to complaints by employees regarding harassment and/or retaliation. Fairly and consistently applies all human resource policies as it relates to subordinate staff.
  • Provides documentation to the Vice President of IT in matters of hiring and discipline but lacks the ability to unilaterally hire and terminate.
  • Displays understanding of, and sensitivity to, service population's cultural and socioeconomic characteristics.
  • Performs other related job duties as assigned.

Education and Experience:

Bachelor's degree in related human services or human behavioral field or equivalent; Master's degree in the like preferred; and four (4) years of relevant experience in child welfare, behavioral health, or related field, to include two (2) years in a supervisory capacity; some experience in a Utilization Management function; or an equivalent combination of education and experience.

Special Qualifications:

Certified as a Child Protection Professional preferred.

Licensed Mental Health Professional preferred.

Possession of a valid, State of Florida driver's license to operate the motor vehicle operated. Requirement exists at the time of hire and as a condition of continued employment.

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