Details: Under minimal supervision, provides medical and/or behavioral health utilization management for members of Medical Plan in accordance with the schedule of benefits and network criteria ...
Details: Under minimal supervision, provides medical and/or behavioral health utilization management for members of Medical Plan in accordance with the schedule of benefits and network criteria ...
Utilization Management RN
Aurora, CO · On-site +1
$38.91 - $60.31/hr
UCH Utilization Management Work Schedule: Full Time, 80.00 hours per pay period (2 weeks) Shift: Days Pay: $38.91 - $60.31 / hour. Pay is dependent on applicant's relevant experience This position is ...
Utilization Management RN
Aurora, CO · On-site +1
$38.91 - $60.31/hr
UCH Utilization Management Work Schedule: Full Time, 80.00 hours per pay period (2 weeks) Shift: Days Pay: $38.91 - $60.31 / hour. Pay is dependent on applicant's relevant experience This position is ...
Registered Nurse - Utilization Management Location: Buckley AFB & Peterson AFB, Colorado Military Health System Compensation: $1,600 - $1,800/week (based on experience) Contract Length: 1-year ...
Registered Nurse - Utilization Management Location: Buckley AFB & Peterson AFB, Colorado Military Health System Compensation: $1,600 - $1,800/week (based on experience) Contract Length: 1-year ...
Registered Nurse - Utilization Management Location: Buckley AFB & Peterson AFB, Colorado Military Health System Compensation: $1,600 - $1,800/week (based on experience) Contract Length: 1-year ...
Registered Nurse - Utilization Management Location: Buckley AFB & Peterson AFB, Colorado Military Health System Compensation: $1,600 - $1,800/week (based on experience) Contract Length: 1-year ...
The Utilization Management Coordinator possesses knowledge of Substance Use Disorders and diagnosis, as well as the ability to articulate those indicators professionally. The UM Coordinator manages ...
The Utilization Management Coordinator possesses knowledge of Substance Use Disorders and diagnosis, as well as the ability to articulate those indicators professionally. The UM Coordinator manages ...
RN Clinical Trainer, Utilization Management - Denver Health Medical Plan (Must Live in Colorado. ...
Denver, CO · On-site
We are recruiting for a mission-driven RN Clinical Trainer, Utilization Management - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement) to join our team! We're with you ...
RN Clinical Trainer, Utilization Management - Denver Health Medical Plan (Must Live in Colorado. ...
Denver, CO · On-site
We are recruiting for a mission-driven RN Clinical Trainer, Utilization Management - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement) to join our team! We're with you ...
Utilization Review Manager
Aspen, CO · Hybrid
As a Manager, Utilization Review, you will hire, evaluate, and supervise Utilization Review ... Liaison with regional management teams to discuss clinical issues and facilitate solutions to ...
Utilization Review Manager
Aspen, CO · Hybrid
As a Manager, Utilization Review, you will hire, evaluate, and supervise Utilization Review ... Liaison with regional management teams to discuss clinical issues and facilitate solutions to ...
Senior Director, Health Plan Utilization Management - Denver Health Medical Plan (Must Live in Co...
Denver, CO · On-site
$143K - $237K/yr
Job Summary The Senior Director of Health Plan Utilization Management is a senior leader for the Denver Health Medical Plan (DHMP) with responsibility for providing strategic and operational ...
Senior Director, Health Plan Utilization Management - Denver Health Medical Plan (Must Live in Co...
Denver, CO · On-site
$143K - $237K/yr
Job Summary The Senior Director of Health Plan Utilization Management is a senior leader for the Denver Health Medical Plan (DHMP) with responsibility for providing strategic and operational ...
Utilization Review Manager
Aspen, CO · On-site
$93K - $117K/yr
As a Manager, Utilization Review, you will hire, evaluate, and supervise Utilization Review ... Liaison with regional management teams to discuss clinical issues and facilitate solutions to ...
Utilization Review Manager
Aspen, CO · On-site
$93K - $117K/yr
As a Manager, Utilization Review, you will hire, evaluate, and supervise Utilization Review ... Liaison with regional management teams to discuss clinical issues and facilitate solutions to ...
Utilization Review Manager
Denver, CO · On-site +1
$93K - $117K/yr
As a Manager, Utilization Review, you will hire, evaluate, and supervise Utilization Review ... Liaison with regional management teams to discuss clinical issues and facilitate solutions to ...
Quick apply
Utilization Review Manager
Denver, CO · On-site +1
$93K - $117K/yr
As a Manager, Utilization Review, you will hire, evaluate, and supervise Utilization Review ... Liaison with regional management teams to discuss clinical issues and facilitate solutions to ...
RN Utilization Management Nurse (InPatient) - California HMO
Denver, CO · On-site
$41.38 - $69.02/hr
Anticipated End Date: 2026-07-10 Position Title: RN Utilization Management Nurse (InPatient) - California HMO RN Utilization Management Nurse (InPatient) - California HMO Virtual: This role enables ...
New
RN Utilization Management Nurse (InPatient) - California HMO
Denver, CO · On-site
$41.38 - $69.02/hr
Anticipated End Date: 2026-07-10 Position Title: RN Utilization Management Nurse (InPatient) - California HMO RN Utilization Management Nurse (InPatient) - California HMO Virtual: This role enables ...
New
This position is dual-role Utilization Management Advisor and supervisor. The Registered Nurse will assess, plan, implement, and evaluate care based on age-specific components while assuming the ...
This position is dual-role Utilization Management Advisor and supervisor. The Registered Nurse will assess, plan, implement, and evaluate care based on age-specific components while assuming the ...
Utilization Review Registered Nurse : On Site Position
Meeker, CO · On-site
$33.50 - $49/hr
Education and Experience: - Previous experience in managing staff and schedules required. - Active ... Utilization Review or Case Management preferred. - Strong knowledge of Medicare, Medicaid, and ...
Utilization Review Registered Nurse : On Site Position
Meeker, CO · On-site
$33.50 - $49/hr
Education and Experience: - Previous experience in managing staff and schedules required. - Active ... Utilization Review or Case Management preferred. - Strong knowledge of Medicare, Medicaid, and ...
Utilization Specialist - Fulltime
Westminster, CO · On-site
$28 - $34.13/hr
Act as liaison between managed care organizations and the facility professional clinical staff ... Gather and develop statistical and narrative information to report on utilization, non-certified ...
Utilization Specialist - Fulltime
Westminster, CO · On-site
$28 - $34.13/hr
Act as liaison between managed care organizations and the facility professional clinical staff ... Gather and develop statistical and narrative information to report on utilization, non-certified ...
Utilization Specialist - Fulltime
Westminster, CO · On-site
$28 - $34.13/hr
Act as liaison between managed care organizations and the facility professional clinical staff ... Gather and develop statistical and narrative information to report on utilization, non-certified ...
Utilization Specialist - Fulltime
Westminster, CO · On-site
$28 - $34.13/hr
Act as liaison between managed care organizations and the facility professional clinical staff ... Gather and develop statistical and narrative information to report on utilization, non-certified ...
Utilization Specialist - Fulltime
$28 - $34.13/hr
Act as liaison between managed care organizations and the facility professional clinical staff ... Gather and develop statistical and narrative information to report on utilization, non-certified ...
Utilization Specialist - Fulltime
$28 - $34.13/hr
Act as liaison between managed care organizations and the facility professional clinical staff ... Gather and develop statistical and narrative information to report on utilization, non-certified ...
RN Utilization Management Nurse (InPatient) - California HMO
$41.38 - $69.02/hr
RN Utilization Management Nurse (InPatient) - California HMO Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ...
New
RN Utilization Management Nurse (InPatient) - California HMO
$41.38 - $69.02/hr
RN Utilization Management Nurse (InPatient) - California HMO Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ...
New
Payer Utilization Management & Business Integration, Manager
Denver, CO · On-site
$99K - $232K/yr
Industry/Sector Health Services Specialism Operations Management Level Manager & Summary At PwC, our people in operations consulting specialise in providing consulting services on optimising ...
Payer Utilization Management & Business Integration, Manager
Denver, CO · On-site
$99K - $232K/yr
Industry/Sector Health Services Specialism Operations Management Level Manager & Summary At PwC, our people in operations consulting specialise in providing consulting services on optimising ...
Underpinned by technology, data, analytics, AI, change management, talent and sustainability ... As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise ...
Underpinned by technology, data, analytics, AI, change management, talent and sustainability ... As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise ...
Nurse II at FT. Logan
Denver, CO · On-site
$46.45 - $55.74/hr
Maintains primary clinical oversight and daily operational responsibility for the hospital's Utilization Management (UM) and clinical documentation integrity programs. * Manages the full lifecycle of ...
Nurse II at FT. Logan
Denver, CO · On-site
$46.45 - $55.74/hr
Maintains primary clinical oversight and daily operational responsibility for the hospital's Utilization Management (UM) and clinical documentation integrity programs. * Manages the full lifecycle of ...
Utilization Management information
See Colorado salary details
$41K - $52.9K
15% of jobs
$52.9K - $64.7K
8% of jobs
$66.4K is the 25th percentile. Wages below this are outliers.
$64.7K - $76.6K
15% of jobs
The median wage is $84.1K / yr.
$76.6K - $88.4K
20% of jobs
$88.4K - $100.3K
11% of jobs
$106.2K is the 75th percentile. Wages above this are outliers.
$100.3K - $112.1K
13% of jobs
$112.1K - $124K
5% of jobs
$124K - $135.8K
3% of jobs
$135.8K - $147.7K
4% of jobs
$147.7K - $159.5K
3% of jobs
$159.5K - $171.4K
3% of jobs
$41K
$94.1K
$171.4K
How much do utilization management jobs pay per year?
What jobs pay 4000 a week without a degree?
What jobs pay $2000 a day?
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 is the least stressful healthcare job?
What does utilization management do?
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.

Full-time
Medical, Life
Posted 13 days ago
Job description
Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.
Details:
Under minimal supervision, provides medical and/or behavioral health utilization management for members of Medical Plan in accordance with the schedule of benefits and network criteria defined by the Plan's various lines of business and Center of Medicare & Medicaid Services ("CMS") regulatory requirements. Completes clinical review to determine whether a request can be approved using nationally recognized criteria such as InterQual or MCG, or requires additional review by the Plan's Medical Director.
MINIMUM QUALIFICATIONS:
Education:
Bachelor's degree in Nursing. A combination of education and experience may be substituted for the B.S.N. requirement.
Experience:
Typically, three years of medical utilization management experience working with a health insurance plan, hospital, skilled nursing facility, or surgical center. Managed Care experience is highly preferred.
Responsibilities:
Facility seeks 2 F/T RN Case Managers for excellent contract working in Managed Care department.
Must have BSN, 3 years' experience in medical utilization management, and experience working with a health insurance plan.
Managed Care experience is preferred however hospital experience is also considered.
Seeking highly skilled individual with experience with InterQual and MCG.
Provides medical and/or behavioral health utilization management for members of facility medical plan in accordance with the schedule of benefits and network criteria defined by the Plans various lines of business and Center of Medicare & Medicaid Services.
Regards,
Riya Khem
Life Science Recruiter
Integrated Resources, Inc.
IT Life Sciences Allied Healthcare CRO
(Direct) 732-844-8721 | (W) 732-549-2030 x 311 | (F) 732-549-5549
"INC 5000's FASTEST GROWING, PRIVATELY HELD COMPANIES" (8th Year in a Row)
About Integrated Resources
Sourced by ZipRecruiter
Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.
Industry
Recruiting and staffing services
Company size
51 - 200 Employees
Headquarters location
Edison, NJ, US
Year founded
1996