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Utilization Management Jobs in Oregon (NOW HIRING)

PacificSource

Utilization Management Clinician

Bend, OR · On-site

Provide utilization management (UM) services which promote quality, cost-effective outcomes by helping member populations achieve effective utilization of healthcare services. Facilitate outstanding ...

St. Tammany Parish Hospital

$85 - $110/hr

Experience in the field of Utilization Management activities highly preferred. Basic understanding of CPT-ICD-9 coding principles and DRG management preferred. Graduate of accredited school of ...

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Utilization Management information

See Oregon salary details

$41.2K

$94.6K

$172.3K

How much do utilization management jobs pay per year?

As of Sep 5, 2026, the average yearly pay for utilization management in Oregon is $94,609.00, according to ZipRecruiter salary data. Most workers in this role earn between $68,200.00 and $110,500.00 per year, depending on experience, location, and employer.

What is utilization management?

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 key skills and qualifications needed to thrive in utilization management, 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 degree is needed for utilization management?

Utilization management professionals typically need at least a bachelor's degree in healthcare, nursing, health administration, or a related field. Some roles may require a master's degree or professional certifications such as Certified Professional in Healthcare Quality (CPHQ) or Certified Case Manager (CCM). Experience in healthcare settings and knowledge of medical terminology and insurance processes are also important.

What are the most commonly searched types of Utilization Management jobs in Oregon?

The most popular types of Utilization Management jobs in Oregon are:

What are popular job titles related to Utilization Management jobs in Oregon?

For Utilization Management jobs in Oregon, the most frequently searched job titles are:

What job categories do people searching Utilization Management jobs in Oregon look for?

The top searched job categories for Utilization Management jobs in Oregon are:

What cities in Oregon are hiring for Utilization Management jobs?

Cities in Oregon with the most Utilization Management job openings:

Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Oregon as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 17% Part Time, 2% Contract, and 1% Nights. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $94,609 per year, or $45.5 per hour.

Utilization Management Clinician

PacificSource

Springfield, OR • On-site

$54 - $78/hr

Other

Medical

Re-posted 12 days ago

PacificSource rating

6.3

Company rating: 6.3 out of 10

Based on 12 frontline employees who took The Breakroom Quiz

287th of 315 rated insurance

Job description

Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person’s talents and strengths. Collaborate closely with physicians, nurses, social workers and a wide range of medical and non-medical professionals to coordinate delivery of healthcare services. Assess the member’s specific health plan benefits and the additional medical, community, or financial resources available. Provide utilization management (UM) services which promote quality, cost-effective outcomes by helping member populations achieve effective utilization of healthcare services. Facilitate outstanding member care using fiscally responsible strategies.

Essential Responsibilities
  • Collect and assess member information pertinent to member’s history, condition, and functional abilities in order to promote wellness, appropriate utilization, and cost-effective care and services.
  • Coordinate necessary resources to achieve member outcome goals and objectives.
  • Accurately document case notes and letters of explanation which may become part of legal records.
  • Perform concurrent review of members admitted to inpatient facilities, residential treatment centers, and partial hospitalization programs.
  • Maintain contact with the inpatient facility utilization review personnel to assure appropriateness of continued stay and level of care.
  • Identify cases that require discharge planning, including transfer to skilled nursing facilities, rehabilitation centers, residential, and outpatient to include behavioral health, home health, and hospice services while considering member co-morbid conditions.
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