We are currently seeking an Utilization Management Coordinator position for Riveredge Hospital ... A minimum of 2-3 years supervisory experience. * Thoroughly understands the management of UM data ...
We are currently seeking an Utilization Management Coordinator position for Riveredge Hospital ... A minimum of 2-3 years supervisory experience. * Thoroughly understands the management of UM data ...
... utilization management excellence. RN Utilization Lead under the general supervision of the ... Re gistered nurse (RN) with current Florida license with a minimum of two (2) years experience ...
... utilization management excellence. RN Utilization Lead under the general supervision of the ... Re gistered nurse (RN) with current Florida license with a minimum of two (2) years experience ...
... utilization management excellence. RN Utilization Lead under the general supervision of the ... Re gistered nurse (RN) with current Florida license with a minimum of two (2) years experience ...
... utilization management excellence. RN Utilization Lead under the general supervision of the ... Re gistered nurse (RN) with current Florida license with a minimum of two (2) years experience ...
Utilization Management Nurse
Los Angeles, CA · On-site
$60 - $75/hr
As a Utilization Management Nurse on the team, you will be responsible for reviewing patient files ... Expectations: 1. Completes orientation according to expected standards. 2. Works with close ...
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Utilization Management Nurse
Los Angeles, CA · On-site
$60 - $75/hr
As a Utilization Management Nurse on the team, you will be responsible for reviewing patient files ... Expectations: 1. Completes orientation according to expected standards. 2. Works with close ...
RN - Utilization Management
Franklin, NH · On-site
Minimum 2-3 years of acute care hospital nursing experience required. * Prior experience in Utilization Management, Case Management, or Care Coordination preferred. * Strong knowledge of InterQual ...
RN - Utilization Management
Franklin, NH · On-site
Minimum 2-3 years of acute care hospital nursing experience required. * Prior experience in Utilization Management, Case Management, or Care Coordination preferred. * Strong knowledge of InterQual ...
Utilization Management Coordinator II
$26.92 - $33.65/hr
Job Overview This Coordinator II of Utilization Management is responsible for providing support to the Medical Management department to ensure the timeliness of outpatient or inpatient referral ...
Utilization Management Coordinator II
$26.92 - $33.65/hr
Job Overview This Coordinator II of Utilization Management is responsible for providing support to the Medical Management department to ensure the timeliness of outpatient or inpatient referral ...
The Utilization Management Nurse is responsible for the monitoring patient plan of care for timely ... We deliver care across six states through two freestanding children's hospitals - Nemours Children ...
The Utilization Management Nurse is responsible for the monitoring patient plan of care for timely ... We deliver care across six states through two freestanding children's hospitals - Nemours Children ...
Utilization Management Coordinator II
Montebello, CA · On-site
$26.92 - $33.65/hr
Job Overview This Coordinator II of Utilization Management is responsible for providing support to the Medical Management department to ensure the timeliness of outpatient or inpatient referral ...
Utilization Management Coordinator II
Montebello, CA · On-site
$26.92 - $33.65/hr
Job Overview This Coordinator II of Utilization Management is responsible for providing support to the Medical Management department to ensure the timeliness of outpatient or inpatient referral ...
... 2. Regulatory & Compliance Oversight * Ensure compliance with federal, state, and payer ... Certification in Case Management and/or Utilization Management preferred. WORK SHIFT: Days (United ...
... 2. Regulatory & Compliance Oversight * Ensure compliance with federal, state, and payer ... Certification in Case Management and/or Utilization Management preferred. WORK SHIFT: Days (United ...
Utilization Management Representative II Utilization Management Representative II Location: This role requires associates to work from the posted locations full-time, enabling consistent face-to-face ...
Utilization Management Representative II Utilization Management Representative II Location: This role requires associates to work from the posted locations full-time, enabling consistent face-to-face ...
Bachelor's degree in Nursing preferred. 2+ years of clinical nursing experience. * Payor Utilization Management: 3 years recommended experience * Proficiency with Microsoft Office applications ...
Bachelor's degree in Nursing preferred. 2+ years of clinical nursing experience. * Payor Utilization Management: 3 years recommended experience * Proficiency with Microsoft Office applications ...
Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years clinical nursing experience * 2+ years care management / utilization management experience * MCG experience ...
Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years clinical nursing experience * 2+ years care management / utilization management experience * MCG experience ...
Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years clinical nursing experience * 2+ years care management / utilization management experience * MCG experience ...
Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years clinical nursing experience * 2+ years care management / utilization management experience * MCG experience ...
Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years clinical nursing experience * 2+ years care management / utilization management experience * MCG experience ...
Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years clinical nursing experience * 2+ years care management / utilization management experience * MCG experience ...
Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years clinical nursing experience * 2+ years care management / utilization management experience * MCG experience ...
Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years clinical nursing experience * 2+ years care management / utilization management experience * MCG experience ...
Bachelor's degree in Nursing preferred. 2+ years of clinical nursing experience. * Payor Utilization Management: 3 years recommended experience * Proficiency with Microsoft Office applications ...
Bachelor's degree in Nursing preferred. 2+ years of clinical nursing experience. * Payor Utilization Management: 3 years recommended experience * Proficiency with Microsoft Office applications ...
Utilization Management Representative II Utilization Management Representative II Location: This role requires associates to work from the posted locations full-time, enabling consistent face-to-face ...
Utilization Management Representative II Utilization Management Representative II Location: This role requires associates to work from the posted locations full-time, enabling consistent face-to-face ...
Physician Supervisor, Utilization Management
Manhattan, NY · On-site
$174K - $374K/yr
At least 2 years experience providing Utilization Management services to a Medicare and/or Medicaid line of business Excellent verbal and written communication skills A current, clinical ...
Physician Supervisor, Utilization Management
Manhattan, NY · On-site
$174K - $374K/yr
At least 2 years experience providing Utilization Management services to a Medicare and/or Medicaid line of business Excellent verbal and written communication skills A current, clinical ...
Must have at least 2 years of experience in 2 of the 3 skill sets to be forwarded to the manager; MTLC, Clinical and Utilization. The UMP team consist of 7 people. Must be comfortable working in a ...
Must have at least 2 years of experience in 2 of the 3 skill sets to be forwarded to the manager; MTLC, Clinical and Utilization. The UMP team consist of 7 people. Must be comfortable working in a ...
Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years clinical nursing experience * 2+ years care management / utilization management experience * MCG experience ...
Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years clinical nursing experience * 2+ years care management / utilization management experience * MCG experience ...
Utilization Management Ii information
See salary details
$39K - $50.3K
15% of jobs
$50.3K - $61.5K
8% of jobs
$63.2K is the 25th percentile. Wages below this are outliers.
$61.5K - $72.8K
15% of jobs
The median wage is $79.9K / yr.
$72.8K - $84.1K
20% of jobs
$84.1K - $95.4K
11% of jobs
$101K is the 75th percentile. Wages above this are outliers.
$95.4K - $106.6K
13% of jobs
$106.6K - $117.9K
5% of jobs
$117.9K - $129.2K
3% of jobs
$129.2K - $140.5K
4% of jobs
$140.5K - $151.7K
3% of jobs
$151.7K - $163K
3% of jobs
$39K
$89.5K
$163K
How much do utilization management ii jobs pay per year?
As of Jul 6, 2026, the average yearly pay for utilization management ii in the United States is $89,483.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,500.00 and $104,500.00 per year, depending on experience, location, and employer.
What is the difference between Utilization Management Ii vs Utilization Management Specialist?
| Aspect | Utilization Management Ii | Utilization Management Specialist |
|---|---|---|
| Credentials | Typically requires a healthcare-related certification (e.g., RN, CPC) | Often requires similar healthcare certifications or experience |
| Work Environment | Healthcare insurance companies, hospitals, or managed care organizations | Insurance companies, healthcare providers, or case management teams |
| Employer & Industry Usage | Commonly used in health insurance and managed care settings | Used across insurance, healthcare, and case management sectors |
Utilization Management Ii and Utilization Management Specialist roles share similar credentials and work environments, often within healthcare insurance or managed care organizations. The main difference lies in the level of responsibility, with the Utilization Management Ii typically handling more complex cases or reviews, while the Specialist may focus on routine assessments.
What is a Utilization Management II role?
A Utilization Management II (UM II) professional is responsible for reviewing and evaluating the medical necessity, appropriateness, and efficiency of healthcare services, procedures, and facilities. This role typically involves working with healthcare providers, insurance companies, and patients to ensure that care provided aligns with established guidelines and policies. UM II professionals may conduct case reviews, process authorization requests, and help prevent unnecessary medical costs. They often have clinical backgrounds and use their expertise to make informed decisions about patient care. The 'II' designation usually indicates intermediate experience or responsibility level, often requiring prior experience in utilization management or a related field.
How does the Utilization Management II role typically collaborate with healthcare providers and internal teams to make care decisions?
In a Utilization Management II position, you will frequently interact with healthcare providers to review clinical documentation and determine the medical necessity of proposed treatments or services. Collaboration with internal teams such as case managers, medical directors, and claims specialists is also essential to ensure care decisions align with organizational policies and regulatory guidelines. This role often involves participating in interdisciplinary meetings, discussing complex cases, and providing feedback to improve processes. Strong communication and negotiation skills are key, as you'll serve as a liaison between providers, members, and the health plan.
What are the key skills and qualifications needed to thrive as a Utilization Management II, and why are they important?
To thrive as a Utilization Management II, you need a strong background in healthcare management, clinical review, and knowledge of medical terminology, often supported by a nursing or healthcare degree and relevant licensure. Familiarity with utilization review software, electronic health records (EHRs), and industry-standard coding systems like ICD-10 and CPT is typically required. Strong analytical thinking, communication, and negotiation skills help professionals collaborate effectively with providers and payers. These competencies are vital for ensuring appropriate care utilization, regulatory compliance, and cost management within healthcare organizations.
More about Utilization Management Ii jobs
What job categories do people searching Utilization Management Ii jobs look for? The top searched job categories for Utilization Management Ii jobs are:
- Full Time Weekend Utilization Review
- Director Of Utilization Review
- Remote Dental Utilization Management
- Optum Utilization Review Nurse
- Utilization Review Nurse Consultant
- Anthem Utilization Review Nurse
- Temporary Medical Utilization Review Physician
- Utilization Review Nurse Lvn
- Medical Utilization Review Physician
- Internship Rn Utilization Review Nurse
Universal Health Services rating
6.8
Based on 250 frontline employees who took The Breakroom Quiz
483rd of 877 rated healthcare providers
Job description
Responsibilities
Qualifications
Shape the future of behavioral health care throughout the Forest Park community by joining our extraordinary team at Riveredge Hospital. Bring your compassion, expertise, enthusiasm, and passion for quality to a place that cultivates wellness and inspires hope.
We are currently seeking an Utilization Management Coordinator position for Riveredge Hospital. Simply apply to the posting and discuss your interests with the hiring manager if you are selected to come in for an interview.
The Utilization Management Coordinator position oversees the daily activities of the Utilization Management staff including but not limited to assigning and scheduling; reviewing and approving documentation and reports; advising and mentoring UM staff; and overseeing operational procedures involving work processes, forms, and billing. Assists with hiring, coaching, and counseling staff and compliance with internal policies and outside governmental and regulatory agencies. Conducts the Utilization Management Committee meetings, staff meetings, in-services, and participates in performance improvement teams.
Qualifications
- Must have a Bachelor’s degree, Master’s degree preferred.
- Must have an appropriate background in the mental health field to organize and achieve quality performance with a focus on securing reimbursement for the organization.
- Possess an in depth knowledge of funding sources and government reimbursement protocols.
- A minimum of 2-3 years supervisory experience.
- Thoroughly understands the management of UM data obtained from admission, concurrent reviews and appeals utilizing the Severity of Illness/Intensity of Service Criteria.
- Has knowledge of JC, CMS, Illinois Mental Health Code Act, and all other relevant state and federal regulatory standards.
- Possesses strong verbal and written communication skills.
- Must have a Bachelor’s degree, Master’s degree preferred.
- Must have an appropriate background in the mental health field to organize and achieve quality performance with a focus on securing reimbursement for the organization.
- Possess an in depth knowledge of funding sources and government reimbursement protocols.
- A minimum of 2-3 years supervisory experience.
- Thoroughly understands the management of UM data obtained from admission, concurrent reviews and appeals utilizing the Severity of Illness/Intensity of Service Criteria.
- Has knowledge of JC, CMS, Illinois Mental Health Code Act, and all other relevant state and federal regulatory standards.
- Possesses strong verbal and written communication skills.
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About Universal Health Services
Sourced by ZipRecruiter
Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
King of Prussia, PA, US