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Utilization Management Jobs in Alabama (NOW HIRING)

Highmark Health

Senior Pharmacist - Strategy

Montgomery, AL

$57.50 - $69.25/hr

Formulary & Utilization Management Strategy & Development: May lead Highmark's evidence-based medicine drug evaluation program supporting Highmark's formulary and utilization management (UM) and/or ...

Baptistfirst

Case Manager PRN

Prattville, AL · On-site

The RN - Case Management will be utilized as either Utilization Management or as Discharge Planning. The Case Manager tasked with discharge planning shall coordinate care of an assigned caseload of ...

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Utilization Management information

See Alabama salary details

$35.3K

$81.1K

$147.7K

How much do utilization management jobs pay per year?

As of Jun 8, 2026, the average yearly pay for utilization management in Alabama is $81,106.00, according to ZipRecruiter salary data. Most workers in this role earn between $58,500.00 and $94,700.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Utilization Management position, and why are they important?

To thrive in Utilization Management, you need a strong understanding of healthcare procedures, insurance guidelines, and case review processes, usually backed by a clinical background such as RN, LPN, or allied health certification. Familiarity with medical management software, electronic health records (EHR), and utilization review tools like InterQual or MCG is often required. Excellent analytical thinking, attention to detail, and effective communication skills greatly enhance performance in this role. These competencies enable accurate assessment of medical necessity, ensure regulatory compliance, and support efficient, collaborative workflows between providers, insurers, and patients.

What is a Utilization Management job?

A Utilization Management (UM) job involves evaluating medical services to ensure they are necessary, cost-effective, and compliant with healthcare guidelines. Professionals in this field review patient care plans, authorize treatments, and collaborate with healthcare providers to optimize resource use. They work for insurance companies, hospitals, or healthcare organizations to balance quality care with cost control. Strong analytical skills and knowledge of medical policies are essential in this role.

What are the typical daily responsibilities of a Utilization Management professional?

As a Utilization Management professional, your day-to-day duties typically include reviewing patient admissions, authorizing ongoing treatment or procedures, assessing medical necessity, and ensuring services comply with insurance policies and industry guidelines. You will frequently collaborate with physicians, nurses, and insurance representatives to facilitate timely and appropriate care decisions while managing cost and quality. Documentation and communication play key roles as you help bridge the gap between clinical teams and payers. This role is often fast-paced, requires decisive action, and provides opportunities to have a direct impact on patient outcomes and organizational efficiency.

What are the most commonly searched types of Utilization Management jobs in Alabama? The most popular types of Utilization Management jobs in Alabama are:
What are popular job titles related to Utilization Management jobs in Alabama? For Utilization Management jobs in Alabama, the most frequently searched job titles are:
What job categories do people searching Utilization Management jobs in Alabama look for? The top searched job categories for Utilization Management jobs in Alabama are:
What cities in Alabama are hiring for Utilization Management jobs? Cities in Alabama with the most Utilization Management job openings:
Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Alabama as of May 2026, with employment types broken down into 92% Full Time, and 8% Part Time. Highlights an 100% In-person job distribution, with an average salary of $81,106 per year, or $39 per hour.
Utilization Management Physician

Utilization Management Physician

NaphCare

Birmingham, AL • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 28 days ago

NaphCare rating

5.9

Company rating: 5.9 out of 10

Based on 47 frontline employees who took The Breakroom Quiz

748th of 869 rated healthcare providers

Job description

Overview
NaphCare is hiring a Utilization Management Physician to join our team at our Corporate Office in Birmingham, AL.
The Utilization Management Physician will provide a streamlined, efficient, and consistent approach to the quality of patient care while supplementing onsite resources to prioritizing continuity of care, ensuring accuracy and follow through of care plans related to offsite patient encounters that focus on site resource availability and appropriate utilization.
Responsibilities
Responsibilities
  • Review of offsite/specialty Returns, hospital returns (inpatient or observation status), and ER returns. Completing detailed review of records to make sure all consultant recommendations are reviewed and implemented, along with submitting follow up consult visits as recommended.
  • Site Maintenance to review facility queues. This is to ensure timely follow up in signing off orders and reordering medications. Sharing educational needs that are identified for providers and nursing to education department for follow up/training.
  • Review diabetic acuity reports, medical priority dashboard, and Coumadin patients charts to ensure plan of care, orders, appointments, etc. are appropriate and being monitored/followed by site or corporate provider.
  • Use knowledge and expertise to ensure that processes and systems are followed appropriately according to policies and procedures, company performance, and accreditation standards. Support peer review process per NCCHC standards.
  • Use all functions and applications of TechCare® relevant to the position with no supervision.
  • Communicate effectively with clients, peers, and employees at all levels within the organization. Maintain clear lines of communication throughout issue-resolution processes.
  • Demonstrate personal performance based on professional practice standards, relevant statutes, rules and regulations, and organizational criteria.
  • Demonstrate professionalism by using objectivity, maintaining self-control when under pressure, separating professional from personal issues, displaying emotional maturity, maintaining a high degree of integrity, and promoting a positive work environment by setting an example.
  • Participate when indicated in all monthly, quarterly, and annual meetings as assigned and required in accordance with contract compliance.
  • Relay critical information to the next level of management that may have a negative impact on client and/or vendor relations or patient care.

Qualifications
Qualifications
  • Must have:
    • A current unrestricted license as a Physician in the state of employment
    • Hold a current DEA registration
    • Have a valid CPR card. (BLS required)
  • A minimum of 2-years experience in primary care with correctional healthcare preferred
  • Must possess strong written communication and verbal skills and have strong computer skills

Working Conditions:
  • Long periods of sitting at a desk performing light physical work, including working at a computer terminal.
  • Talking and listening to communicate ideas or requirements to individual team members.
  • Visual acuity to perform an activity such as: preparing data; viewing a computer terminal; extensive reading.

Why Join NaphCare?
NaphCare is one of the largest providers of healthcare services to correctional facilities throughout the US and we are growing. If you have never considered a career in correctional healthcare, now may be the time. In addition to competitive salaries and generous employee benefits, we strongly support career advancement within the company.
NaphCare Benefits for Full-Time Employees Include:
  • Health, dental & vision insurance that starts day one!
  • Prescriptions free of charge through our health plan, beginning day one!
  • Lowest Cost Benefits!
  • Employee Assistance Program (EAP) services
  • 401K and Roth with company contribution that starts day one!
  • Tuition Assistance
  • Referral bonuses
  • Term life insurance at no cost to the employee
  • Generous paid time off & paid holidays
  • Free continuing education and CMEs

If you would like to speak with me to learn more about this position and NaphCare, apply directly to the position to initiate the application process, and we'll be in touch.
Equal Opportunity Employer: disability/veteran
Follow Us: Instagram | Facebook | LinkedIn | Advancing Correctional Healthcare | NaphCare
The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with a job.

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About NaphCare

Sourced by ZipRecruiter

NaphCare partners with correctional facilities to provide proactive, patient-focused healthcare. We recognize that we serve a unique and diverse patient population, and our onsite teams take pride in bringing excellence in care to a population in great need. Be part of a world-class team of professionals who are revolutionizing correctional healthcare. NaphCare offers competitive compensation! Our full-time teammates have a top-notch benefits package, which includes medical, dental, vision, FREE prescriptions, flexible spending account, company-paid life and AD&D insurance with voluntary life and AD&D options, ST & LT disability, 401(k) company contribution, 20 days Paid Time Off, paid holidays, tuition assistance, employee referral bonuses, etc.

Industry

Health care and social assistance

Company size

1,001 - 5,000 Employees

Headquarters location

Birmingham, AL, US

Year founded

1989

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