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Utilization Management Jobs in Milwaukee, WI (NOW HIRING)

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Utilization Management information

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$38.4K

$88.2K

$160.6K

How much do utilization management jobs pay per year?

As of Aug 6, 2026, the average yearly pay for utilization management in Milwaukee, WI is $88,162.00, according to ZipRecruiter salary data. Most workers in this role earn between $63,500.00 and $103,000.00 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 Milwaukee, WI? The most popular types of Utilization Management jobs in Milwaukee, WI are:
What are popular job titles related to Utilization Management jobs in Milwaukee, WI? For Utilization Management jobs in Milwaukee, WI, the most frequently searched job titles are:
What job categories do people searching Utilization Management jobs in Milwaukee, WI look for? The top searched job categories for Utilization Management jobs in Milwaukee, WI are:
What cities near Milwaukee, WI are hiring for Utilization Management jobs? Cities near Milwaukee, WI with the most Utilization Management job openings:
Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Milwaukee, WI as of August 2026, with employment types broken down into 97% Full Time, and 3% Part Time. Highlights an 92% In-person, and 8% Remote job distribution, with an average salary of $88,162 per year, or $42.4 per hour.

Registered Nurse (RN) Case Manager

Advocate Health

Milwaukee, WI • On-site

Other

Re-posted 27 days ago

Advocate Aurora Health rating

7.6

Company rating: 7.6 out of 10

Based on 775 frontline employees who took The Breakroom Quiz

188th of 887 rated healthcare providers

Job description

Registered Nurse (RN) – RN Case Manager inpatient St Lukes

Where You Will Work:

Milwaukee, WI, United States Centrally located in the south side of Milwaukee
Help patients transition safely through their hospital stay. Partner with patients, families, and the care team to assess needs, coordinate services, plan discharges, and support utilization management.

We’re Looking For:

License/Registration/Certification: Registered Nurse License issued by the state in which the Team Member practices.
Level of Education: Bachelor’s Degree in Nursing
Years of Experience: 2 years of clinical nursing experience

What You’ll Do:

  • Conduct comprehensive assessments and create timely care plans & interventions

  • Collaborate and negotiate with patients/families and the multidisciplinary team to meet goals and preferences

  • Provide continuity of care and discharge planning aligned with regulatory standards

  • Coordinate smooth transfers and handoffs across units and settings

  • Deliver case management services (healthcare access, finances, housing, family dynamics, illness adjustment) using community resources

  • Initiate internal/external referrals; document discharge planning and UM activities accurately and on time

  • Perform concurrent/retrospective reviews using approved criteria

  • Partner closely with Social Work and support staff to implement safe, effective plans of care

  • Identify and remove barriers to discharge; expedite care delivery and report care coordination/UM outcomes

  • Collaborate with managers, physicians, medical directors, and physician advisors on status, progression of care, and regulatory compliance

  • Complete UM activities (payer updates, data collection, denials coordination, avoidable delay management); deliver CMS notices within required timeframes

  • Build relationships with community agencies; collaborate with Ambulatory Care Management/Continuing Health

  • Educate staff on admission status, acute care criteria, UM, care coordination, discharge planning, and regulatory requirements

  • Provide age-appropriate care per departmental standards

About This Location:

Aurora St. Luke’s Medical Center is a 938-bed, quaternary acute care
community hospital that provides advanced health care expertise.
The organization offers leading edge oncology, cardiovascular and
neurology therapies for primarily adult patients. Nursing professional
governance is a particular organizational strength, with over 40 years
of experience in clinical nurse shared decision making. Aurora St.
Luke’s has been recognized for Nursing Excellence by the American
Nurses Credentialing Center Magnet Recognition Program® since
2001, most recently celebrating our 6th consecutive designation in
February 2024.

Be the Nurse Who Redefines Care.
At Advocate Health, being a nurse means more than delivering exceptional clinical care—it means leading with purpose, compassion, and boldness. As part of our One Advocate Nurse community, you’ll join a unified team committed to lifting others up, embracing innovation, and creating inclusive spaces where everyone can thrive. You’ll be empowered to think boldly, collaborate with humility, and drive change through fearless curiosity. Whether you're at the bedside, in the community, or advancing care through research and education, you’ll help shape the future of health—because here, we’re redefining care for you, for us, for all.
Your feedback matters . Every nurse’s voice is vital in shaping our culture and improving care. We value your insights and experiences because they help us grow stronger together.

Ready to Take the Next Step:
Apply Now!

What Advocate Aurora Health employees say

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About Advocate Health

Sourced by ZipRecruiter

Advocate Healthcare, based in Oak Lawn, Illinois, United States, is a leading figure in the health care industry. Accessible via their official website, 'advocatehealth.com', this organization provides a wide variety of medical services and treatment options. Founded in 1995 through a merger of Evangelical Health Systems Corporation and Lutheran General HealthSystem, Advocate Healthcare has grown exponentially over the years. Now, it operates more than 400 sites of care, including 12 hospitals that encompass 11 acute care hospitals, the state’s largest integrated children’s network, five Level I trauma centers, and three Level II trauma centers. Upholding their values of equality, compassion, excellence, partnership and stewardship, Advocate Healthcare's mission is centered on building lifelong relationships with patients by delivering the best health outcomes and highest level of service through an integrated approach to care and wellness.

Industry

Hospitals and health care and social assistance

Company size

10,000+ Employees

Headquarters location

Charlotte, NC, US

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