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Utilization Management Ii Jobs (NOW HIRING)

HealthONE

Utilization Management Nurse

Dalton, GA · On-site

Job Title Utilization Management Nurse The Utilization Management Nurse performs comprehensive ... Other duties as may be assigned Qualifications * 3 years Clinical experience preferred * 1-2 years ...

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Utilization Management Ii information

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$39K

$89.5K

$163K

How much do utilization management ii jobs pay per year?

As of Aug 16, 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?

AspectUtilization Management IiUtilization Management Specialist
CredentialsTypically requires a healthcare-related certification (e.g., RN, CPC)Often requires similar healthcare certifications or experience
Work EnvironmentHealthcare insurance companies, hospitals, or managed care organizationsInsurance companies, healthcare providers, or case management teams
Employer & Industry UsageCommonly used in health insurance and managed care settingsUsed 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?

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 a Utilization Management II 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.
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What job categories do people searching Utilization Management Ii jobs look for?

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Utilization Management Ii jobs near you
Infographic showing various Utilization Management Ii job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 14% Part Time, and 3% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $89,483 per year, or $43 per hour.

UTILIZATION MANAGEMENT CLINICIAN

Muskegon County

Muskegon, MI • On-site

Other

Posted 4 days ago

Job description

Utilization Management/Utilization Review Tasks

An employee in this class, under general direction, performs Utilization Management/Utilization Review tasks to ensure delivery of medically necessary services related to mental health, substance use disorder, and/or intellectual/developmentally disabled consumers. These services will be at the correct frequency and duration to meet consumer goals and alleviate symptoms.

Required Minimum Entrance Qualifications

1. Must hold a master's degree from an accredited college or university with a major in Social Work, Clinical Psychology, Counseling, Marriage and Family Therapy or closely related field AND be fully licensed by the State of Michigan in their relevant field within 90 days of hire. 2. Have one (1) year of previous experience working with persons with developmental disabilities, mental illness and/or serious emotional disturbance; please note, internships count as work experience if they are documented in the Work Experience section of the employment application. 3. Must have reliable transportation that may have to be used to carry out job duties of this classification. Preferred but not Required 1. Be certified as a CADC, CAADC, or be on a Development Plan with MCBAP. 2. Bilingual candidates highly desired. 3. Lived experiences with mental illness/developmental disabilities/substance use disorders valued. 4. Individuals in Recovery and individuals with experience in Armed Services valued.

Physical Conditions / Work Location

PHYSICAL ACTIVITIES An employee in this class generally performs sedentary work requiring the occasional lifting of objects weighing thirty-five (35) pounds or less. ENVIRONMENTAL CONDITIONS A Utilization Management Clinician generally works at the various HealthWest program locations; however, travel to locations within the County may be required.

Additional Information

The purpose of this recruitment is to establish an eligible list from which to fill present and future vacancies in this classification in the County system. For each opening, the Department Head has her/his choice of the candidates who meet the required minimum entrance qualifications. This list remains in effect for three months unless exhausted or extended.

MUSKEON COUNTY IS AN EQUAL OPPORTUNITY EMPLOYER MUSKEGON COUNTY HAS ADOPTED A VETERANS PREFERENCE POLICY THAT RECOGNIZES QUALIFYING MILITARY SERVICE

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