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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 Jul 6, 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 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 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 June 2026, with employment types broken down into 96% Full Time, and 4% Contract. Highlights an 83% In-person, 4% Hybrid, and 13% Remote job distribution, with an average salary of $94,609 per year, or $45.5 per hour.
Utilization Management Program Manager-RN

Utilization Management Program Manager-RN

Samaritan Health Services

Corvallis, OR • Remote

Other

Posted 9 days ago

Samaritan Health Services rating

7.4

Company rating: 7.4 out of 10

Based on 64 frontline employees who took The Breakroom Quiz

256th of 877 rated healthcare providers

Job description

  • Samaritan Health Plans (SHP) provides health insurance options to Samaritan employees, community employers, and Medicare and Medicaid members. SHP operates a portfolio of health plan products under several different legal structures: InterCommunityHealth Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans. 

    As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.

    This is a remote position in which we are able to employ in the following states: Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin

    Our ideal candidate will have the following experience:

    •  
    • Health plan utilization management 
    • Medicare and Medicaid rules and regulations and health plan benefit structure and policy.
    • Data analysis to include reporting results and developing improvement plans
    • Quality Management experience in a healthcare setting
  • JOB SUMMARY/PURPOSE
    • Executes program(s) that meet the needs of the organization, employees and/or customers. Plans, initiates, oversees execution of all elements for assigned program(s). Leads the development, implementation and management of assigned program(s) and associated projects. Oversees process from planning to completion. Works with multiple internal teams, vendors, clients. Responsible for explaining, training, and mentoring the entire organization on the program. Collaborates with SHS system experts to ensure focus, alignment, and best practices for the program.
  •  
  • EXPERIENCE/EDUCATION/QUALIFICATIONS
    • Current unencumbered Oregon RN License required within 90 days of hire. BSN preferred. Master's degree in a related field preferred.
    • One (1) year clinical nursing experience plus four (4) years health plan utilization management experience required.
    • Experience or training in the following required:
      • Health care delivery systems and/or managed care patients.
      • Computer applications including electronic documentation (e.g., MS Office, EPIC, Clinical Care Advanced).
    • Experience in the following preferred: 
      • Team leadership.
      • Case management.
      • Medicare and Medicaid rules and regulations and health plan benefit structure and policy.
  • KNOWLEDGE/SKILLS/ABILITIES
    • Leadership - Inspires, motivates, and guides others toward accomplishing goals. Achieves desired results through effective people management.
    • Conflict resolution - Influences others to build consensus and gain cooperation. Proactively resolves conflicts in a positive and constructive manner.
    • Critical thinking – Identifies complex problems. Involves key parties, gathers pertinent data and considers various options in decision making process. Develops, evaluates and implements effective solutions.
    • Communication and team building – Lead effectively with excellent verbal and written communication. Delegates and initiates/manage cross-functional teams and multi-disciplinary projects.
  • PHYSICAL DEMANDS

    • Rarely
      (1 - 10% of the time)

      Occasionally
      (11 - 33% of the time)

      Frequently
      (34 - 66% of the time)

      Continually
      (67 – 100% of the time)

      CLIMB - STAIRS

      LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs

      LIFT (Knee to chest: 24"-54") 0 – 20 Lbs

      LIFT (Waist to Eye: up to 54") 0 - 20 Lbs

      CARRY 1-handed, 0 - 20 pounds

      BEND FORWARD at waist

      KNEEL (on knees)

      STAND

      WALK – LEVEL SURFACE

      ROTATE TRUNK Standing

      REACH - Upward

      PUSH (0 - 20 pounds force)

      PULL (0 - 20 pounds force)

      SIT

      CARRY 2-handed, 0 - 20 pounds

      ROTATE TRUNK Sitting

      REACH - Forward

      MANUAL DEXTERITY Hands/wrists

      FINGER DEXTERITY

      PINCH Fingers

      GRASP Hand/Fist

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