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Utilization Management Um Technician Jobs (NOW HIRING)

Toney Healthcare

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Supervisor, Utilization Management & Appeals

Tampa, FL · Remote

$50 - $60/hr

Supervise daily activities of UM and Appeals staff, including nurses. * Monitor workloads ... Competencies: * Utilization management oversight * Medical necessity * Clinical operations ...

Centene Management Company LLC

$102K - $190K/yr

... utilization management ... This is a remote opportunity supporting BH UM. Applicants must one of the following active clinical ...

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Utilization Management Um Technician information

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$39K

$89.5K

$163K

How much do utilization management um technician jobs pay per year?

As of Sep 11, 2026, the average yearly pay for utilization management um technician 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 UM Technician vs Utilization Review Nurse?

AspectUtilization Management UM TechnicianUtilization Review Nurse
CredentialsTypically requires a high school diploma or equivalent; some roles may prefer healthcare certificationsRegistered Nurse (RN) license required
Work EnvironmentOffice setting, healthcare insurance companies, or managed care organizationsHospitals, clinics, or insurance companies, often involving direct patient review
Job FocusData entry, initial review, and supporting utilization management processesClinical review, assessing medical necessity, and making patient care decisions

While both roles support utilization management, the UM Technician primarily handles administrative tasks and data processing, whereas the Utilization Review Nurse performs clinical assessments and reviews patient cases directly. The nurse role requires licensure and clinical expertise, making it more focused on patient care decisions, while the technician role emphasizes administrative support within the utilization management process.

What are popular job titles related to Utilization Management Um Technician jobs?

For Utilization Management Um Technician jobs, the most frequently searched job titles are:

Infographic showing various Utilization Management Um Technician job openings in the United States as of September 2026, with employment types broken down into 1% As Needed, 82% Full Time, 15% Part Time, and 2% Contract. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $89,483 per year, or $43 per hour.

UTILIZATION MANAGEMENT COORDINATOR II MSO

Burlingame, CA • On-site

NORTH EAST MEDICAL SERVICES
Health Care and Social Assistance • 51 - 200 employees
Learn more about NORTH EAST MEDICAL SERVICESexternal

$39.69 - $45.10/hr

Full-time

Medical, Dental, Vision, Retirement

Re-posted 8 days ago

Job description

The Utilization Management Coordinator II functions under the direct supervision of a physician or Registered Nurse performing utilization management (UM) and care coordination duties for the NEMS MSO. The UM Coordinator II will also provide basic training to the junior UM Coordinators.

ESSENTIAL JOB FUNCTIONS:

  • Responsible to review Referral Requests and Treatment Authorization Requests received daily; process and approve authorization requests according to the NEMS MSO Authorization Grid and established clinical guidelines.
  • Provide guidance to junior UM Coordinators during research of additional clinical guidelines from different sources for complex cases.
  • Responsible to lead the junior UM Coordinators to prepare and present complex cases to Medical Director for review and ensure follow up activities.
  • Responsible for reviewing the confirmed MD approval/modification/denial decision and notes for record tracking purposes.
  • Responsible to prepare UM Notice of Action (NOA) to provider and member for UM denial decision per AB1455 turn-around-time requirement.
  • Responsible for preparing UM statistical reports and submit to health plans per contract requirement.
  • Perform Care Coordination activities with members, families, specialists, and ancillary providers for authorized services.
  • Perform case investigation for member and/or provider complaints and appeals related to UM denials, and report findings to Health Plan.
  • Provide transition of care services to members who are discharged from the hospital.
  • Perform customer services for UM inquires to PCP, specialist, and members.
  • Stay current with DHCS regulations, Health Plan agreements, and Industry Standard guidelines applicable to healthcare programs.
  • Communicate with Health Plan for clarification about clinical guidelines for covered/uncovered benefits.
  • Communicate UM related information and updates to all members of the health care team, patients, and their families.
  • Follows the appropriate turnaround timeframe for decisions and notification of members and providers.
  • Performs other job duties as required by manager/supervisor.
     
  • BS/BA Degree in Health Science or General Education highly preferred.
  • Minimum of one year of experience in utilization management required.
  • Recent experience in a clinic or outpatient setting desirable; able to perform efficiently and appropriately in a busy environment.
  • Current Medical Assistant Certification or California Pharmacy Technician License or equivalent experience in a health care field is a plus.
  • Knowledge of medical terminology is a must
  • Strong communication, analytical, and problem-solving skills.
  • Knowledge of community resources and cultural needs.
  • Good organization and prioritization skills, outstanding in time management.

LANGUAGE:

  • Must be able to fluently speak, read and write English.
  • Fluent in Chinese (Cantonese and/or Mandarin) preferred.
  • Fluent in other languages is an asset.

STATUS:

  • This is an FLSA Non-exempt position.
  • This is not an OSHA high-risk position.
  • This is a full-time position. 

NEMS is proud to be an Equal Opportunity Employer welcoming diversity in our workforce. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

NEMS BENEFITS: Competitive benefits, including free medical, dental and vision insurance for employee, spouse and/or children; and company contribution to 401(k).
 

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