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Utilization Management Jobs in Wisconsin (NOW HIRING)

Bcbsa

$155K - $175K/yr

Analytics Team - Collaborate on drug trends and utilization data to inform clinical policy decisions, medical policy and formulary compliance, drug share shift and utilization management strategies

Naviant

Engagement Manager

Verona, WI · On-site

Demonstrates strong organizational skills and attention to detail across reporting, documentation, utilization management, and operational execution. Comfortable working within CRM and project ...

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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 Aug 11, 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 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 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 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 80% Full Time, and 20% Part Time. Highlights an 60% In-person, 20% Hybrid, and 20% Remote job distribution, with an average salary of $90,320 per year, or $43.4 per hour.

Case Manager - Inpatient Rehab

Select Medical Rehabilitation - Madison

Madison, WI • On-site

Per diem

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 2 days ago

Job description

Overview
Select Medical Madison Rehabilitation Hospital
*A joint venture with Select Medical & Hospital*
Madison, Wisconsin
Case Manager (RN, SW, RT, LPN)
M-F 8HR Shifts *As Needed Basis*
Why Join Us?
  • Start Strong: Extensive and thorough orientation program to ensure a smooth transition into our setting
  • Recharge & Refresh: Generous PTO and Paid Sick Time for full-time team members to maintain a healthy work-life balance
  • Your Health Matters: Comprehensive medical/RX, health, vision, employee assistance program (EAP) and dental plan offerings for full-time team members
  • Invest in Your Future: Company-matching 401(k) retirement plan, as well as life and disability protection for full-time team members
  • Your Impact Matters: Join a team of over 44,000 committed to providing exceptional patient care

Responsibilities
Position Summary
The Case Manager is responsible for the coordination of health care decisions by using a systematic approach to assure treatment plans that improve quality and outcomes, coordination of care across the continuum; promotion of cost-effective care within the allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and appropriate discharge plans. The Case Manager assesses the psychosocial needs of the patient and provides intervention as part of the discharge planning process.
The primary job functions in Case Management include:
  • Clinical Interventions/Discharge Planning
  • Care Planning Management
  • Fiscal Management
  • Payer/Referral Management

Qualifications
Minimum Qualifications
  • Current Licensure per sate guidelines in a clinical or related discipline OR a Bachelor's or Master's in health or human services discipline.

Previous Experience
  • Previous experience in Case Management and Discharge Planning preferred.
  • CCM Certification Preferred.

Additional Data
Equal Opportunity Employer/including Disabled/Veterans

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