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Utilization Management Jobs in Wisconsin (NOW HIRING)

Unitas

WI · On-site

$100 - $120/hr

The Clinical Pharmacist is responsible for the processing and documenting of Utilization Management (UM) requests (e.g. prior authorization, step therapy, formulary exceptions) for delegated products ...

Unitas

WI · On-site

$108K - $129K/yr

The Clinical Pharmacist is responsible for the processing and documenting of Utilization Management (UM) requests (e.g. prior authorization, step therapy, formulary exceptions) for delegated products ...

Sargent Electric

Solar Site Project Manager

De Pere, WI · On-site

$90 - $120/hr

Monitor proper utilization/management of Company-Owned and rented equipment. * Direct supervision of project site team including General Foreman, Yard Manager, Safety, QA/QC and other required site ...

Gainwell Technologies

WI · On-site

$80 - $95/hr

Participating in inter-rater reliability assessments and quality assurance auditors for multiple review types including Place of Service, Level of Care, Readmissions, Utilization Management and other ...

Sargent Electric

Solar Site Manager

De Pere, WI · On-site

$75 - $100/hr

Monitor proper utilization/management of Company‑Owned and rented equipment. * Direct supervision of project site team including General Foreman, Yard Manager, Safety, QA/QC and other required site ...

St. Luke's University Health Network

WI · On-site

$65 - $90/hr

Works as a team with other members of care management, including RN care managers, assistants, coordinators, utilization management staff, and director. * Facilitates communication among all ...

Elevance Health

Family Care-Service Coordinator

Sparta, WI · Hybrid

$18.50 - $24.50/hr

Submits utilization/authorization requests to utilization management with documentation supporting and aligning with the individual's care plan. * Responsible for reporting critical incidents to ...

Elevance Health

Family Care-Service Coordinator

Milwaukee, WI · Hybrid

$19.75 - $26/hr

Submits utilization/authorization requests to utilization management with documentation supporting and aligning with the individual's care plan. * Responsible for reporting critical incidents to ...

Elevance Health

Family Care-Service Coordinator

Waukesha, WI · Hybrid

$19.25 - $26/hr

Submits utilization/authorization requests to utilization management with documentation supporting and aligning with the individual's care plan. * Responsible for reporting critical incidents to ...

Elevance Health

Family Care-Service Coordinator

Monroe, WI · Hybrid

$18.75 - $25/hr

Submits utilization/authorization requests to utilization management with documentation supporting and aligning with the individual's care plan. * Responsible for reporting critical incidents to ...

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All JobsUtilization Management JobsUtilization Management Jobs in Wisconsin

Utilization Management information

See Wisconsin salary details

$39.4K

$90.3K

$164.5K

How much do utilization management jobs pay per year?

As of Sep 5, 2026, the average yearly pay for utilization management in Wisconsin is $90,320.00, according to ZipRecruiter salary data. Most workers in this role earn between $65,100.00 and $105,500.00 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 Wisconsin?

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

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

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

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

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

What cities in Wisconsin are hiring for Utilization Management jobs?

Cities in Wisconsin with the most Utilization Management job openings:

Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Wisconsin as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 14% Part Time, and 2% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $90,320 per year, or $43.4 per hour.

Clinical Review Pharmacist (REMOTE)

Unitas

WI • On-site

$100 - $120/hr

Other

Posted 18 days ago

Job description

UNITAS provides clinical staffing and consulting solutions, including contract staff augmentation, permanent talent recruiting, consulting, and clinical coaching. Our extensive experience includes Pharmacy Benefit Management, Long-Term Care, Retail Pharmacy, Hospital, and Leadership, enabling us to connect the best clinical talent with outstanding companies. We know clinicians because we are clinicians!

About the role
  • The Clinical Pharmacist is responsible for the processing and documenting of Utilization Management (UM) requests (e.g. prior authorization, step therapy, formulary exceptions) for delegated products and services. The work is detail-oriented, and candidates will be expected to provide sound clinical judgement and communication.
  • Positions are available in Medicare and Commercial lines of business.
What you’ll do
  • Responsible for the clinical evaluation and determination of client UM requests, which includes consideration of the denial language, as well as the appropriateness of the decision as it pertains to the clinical intent of the individual program criteria.
  • Accountable for direct consultation with health care providers concerning non-formulary and clinical product coverage issues.
  • Collaborate with team members to promote consistency of clinical decisions across the pharmacist team.
  • Other duties as assigned.
Qualifications
  • Doctor of Pharmacy (PharmD) or Bachelor of Science in Pharmacy degree.
  • Current pharmacist license in good standing at local State Board of Pharmacy.
  • Confident in making clinical decisions independently.
  • Ability to prioritize tasks and manage multiple projects simultaneously.
  • Motivated self-starter who does not require constant direction or feedback to drive results.
  • Flexibility to evolve in a dynamic working environment.
  • Proficient with learning new computer systems and using multiple monitors.
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