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Utilization Management Jobs in Baltimore, MD (NOW HIRING)

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Utilization Management information

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$38.8K

$88.9K

$162K

How much do utilization management jobs pay per year?

As of Aug 9, 2026, the average yearly pay for utilization management in Baltimore, MD is $88,913.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,100.00 and $103,800.00 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 Baltimore, MD? The most popular types of Utilization Management jobs in Baltimore, MD are:
What are popular job titles related to Utilization Management jobs in Baltimore, MD? For Utilization Management jobs in Baltimore, MD, the most frequently searched job titles are:
What job categories do people searching Utilization Management jobs in Baltimore, MD look for? The top searched job categories for Utilization Management jobs in Baltimore, MD are:
What cities near Baltimore, MD are hiring for Utilization Management jobs? Cities near Baltimore, MD with the most Utilization Management job openings:
Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Baltimore, MD as of August 2026, with employment types broken down into 93% Full Time, and 7% Contract. Highlights an 89% In-person, and 11% Remote job distribution, with an average salary of $88,913 per year, or $42.7 per hour.

Utilization Management Coordinator

System One

Baltimore, MD • Remote

Contractor

Medical, Dental, Vision, Life, Retirement

Re-posted 2 days ago

Job description

UTILIZATION MANAGEMENT COORDINATOR

Location: Remote — client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected extension possible) Schedule: 40 hours/week — must include a weekend day Pay (W2): USD 24.70/H

JOB OVERVIEW

In this role, you’ll support Utilization Management (UM) clinical teams by handling non-clinical administrative work tied to pre-service authorization, utilization review support, care coordination workflows, and quality-of-care processes. You’ll help manage authorization intake, documentation, and provider/member support—while working in a fast-paced environment where schedule flexibility (including weekends) is required.

WHAT YOU’LL DO

  • Provide member/provider administrative support such as benefit verification, authorization creation/management, claims inquiries, and case documentation.

  • Review incoming authorization requests for initial determination and/or triage items for clinical review and resolution.

  • Support day-to-day coordination for the department, including answering/responding to phone calls, taking messages, and responding to basic inquiries.

  • Research information and assist with issue resolution and operational problem-solving.

  • Assist with reporting, data tracking, and organizing/disseminating information (including Continuity of Care processes and tracking Peer-to-Peer reviews).

REQUIRED QUALIFICATIONS

  • High School Diploma (or equivalent)

  • 3+ years of experience in healthcare claims/service areas and/or healthcare office/administrative support

  • Ability to work effectively within a multidisciplinary team (internal and external partners)

  • Strong communication, organization, and customer service skills

  • Strong attention to detail with sound judgment and decision-making

  • Comfortable with web-based tools and Microsoft Office (Word, Excel, PowerPoint)

NICE TO HAVE

  • Knowledge of CPT and ICD-10 coding / medical terminology used in managed care

  • Experience in a managed care environment (health plan / UM support)

  • Phone-heavy/customer support experience

  • Experience with Medicaid/Medicare (government programs)

  • Exposure to tools such as Facets, Guiding Care, and/or NICE CXone

System One, and its subsidiaries including Joulé and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.

System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.

#M-M2 #LI-

Ref: #851-Rockville-S1