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Utilization Management Jobs in Greer, SC (NOW HIRING)

Absolute Total Care

Medical Director

Simpsonville, SC · On-site +1

$225K - $428K/yr

Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. * Performs medical review activities pertaining to utilization review ...

Absolute Total Care

Medical Director

Greenville, SC · On-site +1

$225K - $428K/yr

Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. * Performs medical review activities pertaining to utilization review ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Simpsonville, SC · On-site

$51.25 - $62.25/hr

Prior managed care or utilization management experience preferred -- retail and hospital pharmacists with strong clinical and documentation skills are encouraged to apply. * Skills: Excellent ...

Prismahealth

PRN Nurse Practitioner - Wound Care

Greer, SC · On-site

$106K - $146K/yr

Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...

Prisma Health

PRN Nurse Practitioner - Wound Care

Greer, SC · On-site

$106K - $146K/yr

Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...

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All JobsUtilization Management JobsUtilization Management Jobs in Greer, SC

Utilization Management information

See Greer, SC salary details

$37.5K

$86K

$156.7K

How much do utilization management jobs pay per year?

As of Jul 17, 2026, the average yearly pay for utilization management in Greer, SC is $86,037.00, according to ZipRecruiter salary data. Most workers in this role earn between $62,000.00 and $100,500.00 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 Greer, SC? The most popular types of Utilization Management jobs in Greer, SC are:
What are popular job titles related to Utilization Management jobs in Greer, SC? For Utilization Management jobs in Greer, SC, the most frequently searched job titles are:
What job categories do people searching Utilization Management jobs in Greer, SC look for? The top searched job categories for Utilization Management jobs in Greer, SC are:
What cities near Greer, SC are hiring for Utilization Management jobs? Cities near Greer, SC with the most Utilization Management job openings:
Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Greer, SC as of July 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 1% Temporary, and 3% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $86,037 per year, or $41.4 per hour.
Supv-Case Management

Supv-Case Management

Spartanburg Regional Healthcare System

Spartanburg, SC • On-site

Full-time

Posted 17 days ago

Spartanburg Regional Healthcare System rating

6.7

Company rating: 6.7 out of 10

Based on 117 frontline employees who took The Breakroom Quiz

526th of 886 rated healthcare providers

Job description

Job Requirements

Position Summary

Under the direction of the Case Management Manager, the Supervisor performs duties related to personnel supervision, daily staffing and functioning of the Case Management department. Serves as a resource to immediately address barriers and issues related to Discharge Planning/Care Transitions and Utilization Management.

Demonstrates strong organizational and planning skills. Works collaboratively with managers, administration, and physicians. Maintains responsibility and accountability for the management of patients across the continuum of care by working collaboratively with health care providers to provide cost-effective, quality care. This position reports to the Manager of Case Management.

Minimum Requirements

Education           

  • Associate of Science in Nursing, Bachelor of Social Work

Experience        

  • 3-5 years in the field of Case Management, LBSW with 10 years of hospital case management experience

License/Registration/Certifications       

  • Current R.N. licensure in the state of SC or Current Social Work licensure in the state of SC

Preferred Requirements

Preferred Education      

  • BSN, MSW

Preferred Experience   

  • N/A

Preferred License/Registration/Certifications   

  • RN or LMSW

Core Job Responsibilities

  • Complies with established policies and procedures.
  • Remains competent in Case Management functions.
  • Assumes responsibility for monitoring and adjusting associate staffing levels to assure optimal patient care and cost-effective utilization of personnel.
  • Uses administrative and case management policies and procedures to guide and direct the supervision of case management staff. 
  • Promotes an environment which stimulates continuous improvement, employee growth, employee engagement and retention.
  • Applies counseling skills in supervision and motivation of personnel in accordance with SRHS personnel policies.
  • Complies with regulatory requirements of Utilization Review and Discharge Planning.
  • Responsible for the core functions of the Utilization Management plan.
  • Performs audits for regulatory compliance, denial management, and resource utilization. 
  • Responsible for assisting with and maintaining records of associate education, new employee orientation and onboarding, associate education and ongoing competencies.
  • Collaborates with internal and external partners.
  • Educates the interdisciplinary team regarding any changes to the CM process and/or regulatory requirements.
  • Negotiates timely decisions to expedite the discharge plan and ensure seamless transitions across the continuum of care.
  • Approves transportation, medications, durable medical equipment assistance or other items to meet patient needs.
  • Serves as a resource to the Case Management department.
  • Identifies and elevates unresolved issues to Case Management Leadership and/or Physician Advisor.
  • Coordinates and documents findings for length of stay rounds including but not limited to avoidable days and case review/consultation.
  • Collects, interprets, and evaluates Case Management data, as requested by Case Management Leadership.
  • Effectively represents the department and the facility. Participates on case management and hospital committees.
  • Maintains professional knowledge, demonstrates professional development, leads and attends associate meetings and educational offerings. Updates job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; and participating in professional organizations.
  • Other duties as assigned.

Employment Type: FULL_TIME

What Spartanburg Regional Healthcare System employees say

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Benefits

Hours and flexibility

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About Spartanburg Regional Healthcare System

Sourced by ZipRecruiter

Spartanburg Regional Healthcare System is a leader in the healthcare industry, located in Spartanburg, SC, US. As a comprehensive health system, it offers services encompassing everything from wellness, prevention, and care coordination to specific medical treatments for a wide range of diseases and health issues. Spartanburg Regional Healthcare System was founded in 1921 and has since developed a reputation for excellence and innovative care, growing to include six hospitals, 100 medical offices, 8,000 associates and more than 900 medical staff.

Industry

Recruiting and staffing services

Company size

5,001 - 10,000 Employees

Headquarters location

Spartanburg, SC, US

Year founded

1921

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