Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Nurse Practitioner / Physician Assistant - Urology
$102K - $132K/yr
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Nurse Practitioner / Physician Assistant - Urology
$102K - $132K/yr
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
PRN Nurse Practitioner - Wound Care
$104K - $143K/yr
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
PRN Nurse Practitioner - Wound Care
$104K - $143K/yr
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Establishment of quality assurance programs Establishment of utilization management programs Selection of management information systems Development of patient education services Development of ...
Establishment of quality assurance programs Establishment of utilization management programs Selection of management information systems Development of patient education services Development of ...
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
PRN Nurse Practitioner - Wound Care
$94K - $130K/yr
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
PRN Nurse Practitioner - Wound Care
$94K - $130K/yr
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Nurse Practitioner / Physician Assistant - Urology
$102K - $132K/yr
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Nurse Practitioner / Physician Assistant - Urology
$102K - $132K/yr
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Nurse Practitioner / Physician Assistant - ENT - Patewood
Greenville, SC · On-site
$102K - $132K/yr
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Nurse Practitioner / Physician Assistant - ENT - Patewood
Greenville, SC · On-site
$102K - $132K/yr
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Nurse Practitioner / Physician Assistant - Neurosurgery - Greenville
Greenville, SC · On-site
$102K - $132K/yr
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Nurse Practitioner / Physician Assistant - Neurosurgery - Greenville
Greenville, SC · On-site
$102K - $132K/yr
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
PRN Nurse Practitioner - Wound Care
Laurens, SC · On-site
$94K - $130K/yr
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
PRN Nurse Practitioner - Wound Care
Laurens, SC · On-site
$94K - $130K/yr
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
PRN Nurse Practitioner - Wound Care
$104K - $143K/yr
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
PRN Nurse Practitioner - Wound Care
$104K - $143K/yr
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Nurse Practitioner- Laurens Family Medicine and Skilled Nursing Facilities - Laurens
Laurens, SC · On-site
$94K - $119K/yr
Establishment of quality assurance programs Establishment of utilization management programs Selection of management information systems Development of patient education services Development of ...
Nurse Practitioner- Laurens Family Medicine and Skilled Nursing Facilities - Laurens
Laurens, SC · On-site
$94K - $119K/yr
Establishment of quality assurance programs Establishment of utilization management programs Selection of management information systems Development of patient education services Development of ...
Nurse Practitioner / Physician Assistant - ENT - Powdersville
Powdersville, SC · On-site
$97K - $125K/yr
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Nurse Practitioner / Physician Assistant - ENT - Powdersville
Powdersville, SC · On-site
$97K - $125K/yr
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Establishment of quality assurance programs Establishment of Utilization Management programs Selection of management information systems Development of patient education surveys Development of ...
Utilization Management information
See Greer, SC salary details
$37.5K - $48.3K
15% of jobs
$48.3K - $59.2K
8% of jobs
$60.7K is the 25th percentile. Wages below this are outliers.
$59.2K - $70K
15% of jobs
The median wage is $76.9K / yr.
$70K - $80.9K
20% of jobs
$80.9K - $91.7K
11% of jobs
$97.1K is the 75th percentile. Wages above this are outliers.
$91.7K - $102.5K
13% of jobs
$102.5K - $113.4K
5% of jobs
$113.4K - $124.2K
3% of jobs
$124.2K - $135K
4% of jobs
$135K - $145.9K
3% of jobs
$145.9K - $156.7K
3% of jobs
$37.5K
$86K
$156.7K
How much do utilization management jobs pay per year?
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.

Full-time
Re-posted 25 days ago
Prisma Health rating
7.1
Based on 345 frontline employees who took The Breakroom Quiz
374th of 886 rated healthcare providers
Job description
Job Summary
Provides assistant surgical services in the operating room as well as other selected medical services under the direction of the surgeon.
Accountabilities
- Provides general surgical assistant services in operating room.10%
- Assists surgeon with prepping and until completion of procedure.15%
- Removes drains, tubes and catheters.10%
- Closes incisions.15%
- Assists with patient office visits and assumes call when assigned.10%
- Performs all charting, summaries, correspondence, and required paperwork for purposes of documenting care and billing.10%
- Participates in physician educational programs provided by employer relative to capitated medicine and implications relative to physician practice patterns.5%
- Participates in:
Establishment of quality assurance programs
Establishment of Utilization Management programs
Selection of management information systems
Development of patient education surveys
Development of patient satisfaction surveys. 5% - Assists in the development of operational and capital budgets.5%
- Participates in operational assessments in search of revenue enhancement, expense reductions, consolidation efficiencies and billing opportunities.5%
- Assists in post-operative care of patients including daily rounds and wound assessments.10%
Supervisory/Management Responsibilities
- This is a non-management job that will report to a supervisor, manager, director or executive.
Minimum Requirements
- Master's Degree - Nursing; Nurse Practitioner Degree Emphasis or Program Certificate equivalent
- 1 year - Clinical experience
Required Certifications/Registrations/Licenses
- SC Nurse Practitioner
- CPR Certification - Required
In Lieu Of The Minimum Requirements Listed Above
- Completion of Nurse Practitioner Surgical Residency Program
Other Required Sills and Experience
- Patient Equip (Vitals, Suction, Defib)
- Surgical assistant skills
Work Shift
Day (United States of America)
Location
Greenville Memorial Med Campus
Facility
2107 Cardiothoracic Surgery
Department
21071000 Cardiothoracic Surgery-Practice Operations
Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.
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Pay
Benefits
Hours and flexibility
Workplace
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About Prisma Health
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Greenville, SC, US
Year founded
2017