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Utilization Management Jobs in Milwaukee, WI (NOW HIRING)

Network Health

Claims Analyst II

Brookfield, WI · On-site +1

Keeps current on group contracts specifics, provider discounts, percentages and per diems, enrollee certificates and agreements, authorizations and other utilization management policies, etc.

Network Health, Inc

Claims Analyst II

Brookfield, WI · On-site +1

Keeps current on group contracts specifics, provider discounts, percentages and per diems, enrollee certificates and agreements, authorizations and other utilization management policies, etc.

Directsupply

Senior Director, Product Management

Milwaukee, WI · On-site

$229K - $240K/yr

In the Senior Director, Product Management - Spend Management position, you'll define and lead the ... Proven ability to scale a SaaS platform with measurable adoption and feature utilization goals ...

Edgeless Beauty Group

CRM Manager

Milwaukee, WI · On-site

$66K/yr

Support promotional campaigns, membership programs, admissions initiatives, and sales efforts through effective system utilization. * Provide technical support and troubleshooting for CRM and POS ...

FIS

Senior Manager, Product Management - ATM

Milwaukee, WI · On-site

$124K - $164K/yr

Utilization rates * Customer satisfaction * Recommend corrective actions and optimization ... P&L management and revenue growth accountability * Cross-functional leadership across technology ...

TEKsystems

Claims Analyst- Must Live In WI

Milwaukee, WI · Remote

$19.25/hr

Keeps current on group contracts specifics, provider discounts, percentages and per diems, enrollee certificates and agreements, authorizations and other utilization management policies, etc. Reviews ...

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Showing results 41-60

All JobsUtilization Management JobsUtilization Management Jobs in Milwaukee, WI

Utilization Management information

See Milwaukee, WI salary details

$38.4K

$88.2K

$160.6K

How much do utilization management jobs pay per year?

As of Aug 27, 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 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 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 degree is needed for utilization management?

Utilization management professionals typically need at least a bachelor's degree in healthcare, nursing, health administration, or a related field. Some roles may require a master's degree or professional certifications such as Certified Professional in Healthcare Quality (CPHQ) or Certified Case Manager (CCM). Experience in healthcare settings and knowledge of medical terminology and insurance processes are also important.

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 98% Full Time, and 2% Part Time. Highlights an 93% In-person, and 7% Remote job distribution, with an average salary of $88,162 per year, or $42.4 per hour.

Registerd Nurse (RN) Care Manager WP

Advocate Aurora Health

Milwaukee, WI • On-site

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 2 hours ago

Advocate Aurora Health rating

7.6

Company rating: 7.6 out of 10

Based on 781 frontline employees who took The Breakroom Quiz

190th of 894 rated healthcare providers

Job description

Department:
11210 Aurora St. Lukes Medical Center - Social Services
Status:
Full time
Benefits Eligible:
Yes
Hours Per Week:
40
Schedule Details/Additional Information:
Available schedules
I
WP ED RN CM coverage - leader is open to 36 hour (FRI/SAT/SUN 07-1900
or (2) 12H shifts (Sat, Sun) from 07:00-19:00 + 2 additional 8H shifts during the week = 40 hours a week
one weekend off a quarter and one holiday a year
Pay Range:
$38.20 - $57.30
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
Available schedules
WP ED RN CM coverage - leader is open to 36 hour (FRI/SAT/SUN 07-1900
or (2) 12H shifts (Sat, Sun) from 07:00-19:00 + 2 additional 8H shifts during the week = 40 hours a week
one weekend off a quarter and one holiday a year
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.
Ready to Take the Next Step:
Apply Now!
Our Commitment to You:
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including:
Compensation
  • Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
  • Premium pay such as shift, on call, and more based on a teammate's job
  • Incentive pay for select positions
  • Opportunity for annual increases based on performance
Benefits and more
  • Paid Time Off programs
  • Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
  • Flexible Spending Accounts for eligible health care and dependent care expenses
  • Family benefits such as adoption assistance and paid parental leave
  • Defined contribution retirement plans with employer match and other financial wellness programs
  • Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.
About Advocate Health
Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation's largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.

What Advocate Aurora Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Advocate Health logo

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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