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Utilization Management Team Lead Jobs (NOW HIRING)

Centene

Supervisor, Utilization Management

$75K - $135K/yr

Supervises day-to-day activities of utilization management team. Key Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future.

New

Humana

Utilization Management Nurse

Reporting to the Manager, Utilization Management Nursing, the Part C Grievance & Appeals (G&A ... The Weekend Team Lead will serve as a resource for associates, provide real-time guidance, identify ...

Wellpath

Director Utilization Mgmt

Lemoyne, PA · On-site

Lead UM process improvements, facilitate patient care goals, and utilize data research to reduce ... One (1) year of experience in utilization management is required. * Excellent communication and ...

ProgenyHealth LLC

Utilization Management Supervisor

Job Type Full-time Description Job Role The Utilization Management Supervisor will primarily be ... Experience in a team lead or supervisory role managing nursing staff is desired. * Three or more ...

New

Intus, Inc

Utilization Management Manager

Key Responsibilities Team Leadership & Performance Management (approximately 75% of time) • Hold ... lead ongoing quality assurance (QA) and inter-rater reliability activities; identify variance in ...

24-MAG LLC

Utilization Review Specialist

Manhattan, NY · Remote

$80/hr

... management, team lead, supervisor, or operational oversight roleStrong clinical background with ... authorization, utilization management, clinical review, nursing, healthcare operations, payer ...

Humana

Manager, Utilization Management Nursing

Minimum 2 years of team lead and/or project lead experience * Minimum 2 years progressive clinical ... Utilization management * Prior experience within discharge planning, case management * Health Plan ...

Wellpath

Director Utilization Mgmt

Lemoyne, PA · On-site

$199K - $249K/yr

Autonomy in a warm team environment * Growth and training Perks and Benefits In addition to ... Lead UM process improvements, facilitate patient care goals, and utilize data research to reduce ...

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Utilization Management Team Lead information

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$10

$25

$72

How much do utilization management team lead jobs pay per hour?

As of Sep 5, 2026, the average hourly pay for utilization management team lead in the United States is $25.73, according to ZipRecruiter salary data. Most workers in this role earn between $15.38 and $24.04 per hour, depending on experience, location, and employer.

What does a utilization management team lead do?

A Utilization Management Team Lead oversees a team responsible for reviewing and evaluating the necessity, appropriateness, and efficiency of healthcare services and treatments. They coordinate daily operations, provide guidance to utilization review staff, and ensure compliance with regulatory guidelines and organizational policies. The Team Lead also communicates with healthcare providers, resolves escalated cases, and monitors performance metrics to optimize resource use and patient outcomes.

What are the key skills and qualifications needed to thrive as a utilization management team lead, and why are they important?

To thrive as a Utilization Management Team Lead, you need a background in healthcare, strong knowledge of utilization review processes, and typically a degree in nursing or a related field with relevant licensure or certification. Familiarity with case management software, medical coding systems, and payer guidelines is essential for effective oversight. Strong leadership, critical thinking, and communication skills are vital for guiding teams and collaborating with various stakeholders. These skills ensure compliance, efficient care coordination, and optimal resource utilization within healthcare organizations.

What are some common challenges faced by a utilization management team lead, and how can they be addressed?

A Utilization Management Team Lead often faces challenges such as balancing workflow efficiencies with regulatory requirements, managing diverse team member skillsets, and ensuring timely case reviews. Addressing these challenges involves fostering clear communication, providing regular training, and implementing effective performance tracking systems. Additionally, collaborating closely with clinical staff and other departments helps ensure consistent application of best practices and supports continuous quality improvement.

What is the difference between Utilization Management Team Lead vs Utilization Review Nurse?

AspectUtilization Management Team LeadUtilization Review Nurse
CredentialsRN license, certifications in utilization management or case managementRN license, certifications in utilization review or case management
Work EnvironmentSupervisory role overseeing review teams, administrative tasksPerforming reviews, assessing patient records, direct communication with providers
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, insurance companies, healthcare organizations
Search & Comparison IntentLeadership, team management, utilization review processesReview procedures, case assessments, clinical decision-making

The Utilization Management Team Lead typically oversees review teams and manages utilization review processes, requiring leadership skills and certifications. In contrast, the Utilization Review Nurse focuses on conducting clinical reviews and assessments directly related to patient care. Both roles share similar credentials and work environments but differ mainly in scope and responsibilities.

More about Utilization Management Team Lead jobs

What job categories do people searching Utilization Management Team Lead jobs look for?

The top searched job categories for Utilization Management Team Lead jobs are:

Utilization Management Team Lead jobs near you
Infographic showing various Utilization Management Team Lead job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 20% Part Time, and 3% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $53,524 per year, or $25.7 per hour.

Supervisor, Utilization Management

Centene

Remote

$75K - $135K/yr

Full-time

Medical, Retirement, PTO

Posted 3 days ago

New

Centene rating

8.4

Company rating: 8.4 out of 10

Based on 406 frontline employees who took The Breakroom Quiz

12th of 898 rated healthcare providers

Job description

Position Purpose:

Supervises Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team.

Key Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.

Applicants for this role have the flexibility to work remotely within the continental United States.

  • Monitors and tracks UM resources to ensure adherence to performance, compliance, quality, and efficiency standards
  • Collaborates with utilization management team to resolve complex care member issues
  • Maintains knowledge of regulations, accreditation standards, and industry best practices related to utilization management
  • Works with utilization management team and senior management to identify opportunities for process and quality improvements within utilization management
  • Educates and provides resources for utilization management team on key initiatives and to facilitate on-going communication between utilization management team, members, and providers
  • Monitors prior authorization, concurrent review, and/or retrospective clinical review nurses and ensures compliance with applicable guidelines, policies, and procedures
  • Works with the senior management to develop and implement UM policies, procedures, and guidelines that ensure appropriate and effective utilization of healthcare services
  • Evaluates utilization management team performance and provides feedback regarding performance, goals, and career milestones
  • Provides coaching and guidance to utilization management team to ensure adherence to quality and performance standards
  • Assists with onboarding, hiring, and training utilization management team members
  • Leads and champions change within scope of responsibility
  • Performs other duties as assigned
  • Complies with all policies and standards

Education/Experience: Requires Graduate of an Accredited School Nursing or Bachelor's degree and 4+ years of related experience.


Knowledge of utilization management principles preferred.
License/Certification:

  • RN - Registered Nurse - State Licensure and/or Compact State Licensure required
Pay Range: $75,300.00 - $135,400.00 per year

At Centene, we connect people to the care they need to live healthier lives - and the work you do here makes that impact real every day. You'll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It's work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.


Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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