The Utilization Management Assistant responsibilities include: * Participating on the Utilization Management Team (UMT), serving as a Utilization Management liaison with managed care organizations ...
The Utilization Management Assistant responsibilities include: * Participating on the Utilization Management Team (UMT), serving as a Utilization Management liaison with managed care organizations ...
Utilization Management Representative I Utilization Management Representative I Location : This role enables associates to work virtually full-time, except for required in-person training sessions ...
Utilization Management Representative I Utilization Management Representative I Location : This role enables associates to work virtually full-time, except for required in-person training sessions ...
Utilization Management Representative I Location : This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and ...
Utilization Management Representative I Location : This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and ...
General Purpose of Job To act as a liaison between the Case Management Organizations (CMOs), the Department of Children & Families (DCF) and specialty and/or community providers to facilitate ...
New
General Purpose of Job To act as a liaison between the Case Management Organizations (CMOs), the Department of Children & Families (DCF) and specialty and/or community providers to facilitate ...
New
Under the general supervision of the Utilization Management Manager and in accordance with established policies, professional guidelines, and CMS Conditions of Participation for Utilization Review ...
Under the general supervision of the Utilization Management Manager and in accordance with established policies, professional guidelines, and CMS Conditions of Participation for Utilization Review ...
Wound Care Utilization Management RN
$39.34 - $56.20/hr
Wound Care Utilization Management RN Wound Care Utilization Management RN Virtual : This role enables associates to workvirtually full-time, except for required in-person training sessions, providing ...
Wound Care Utilization Management RN
$39.34 - $56.20/hr
Wound Care Utilization Management RN Wound Care Utilization Management RN Virtual : This role enables associates to workvirtually full-time, except for required in-person training sessions, providing ...
PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize ... Act as liaison between managed care organizations and the facility professional clinical staff.
PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize ... Act as liaison between managed care organizations and the facility professional clinical staff.
Utilization Review RN Team Lead
Pinellas Park, FL · On-site
$81K - $122K/yr
Job Type Full-time Description The Utilization Review (UR) Nurse Team Lead provides clinical and ... This role provides day-to-day oversight of workflow management, quality assurance, staff ...
Utilization Review RN Team Lead
Pinellas Park, FL · On-site
$81K - $122K/yr
Job Type Full-time Description The Utilization Review (UR) Nurse Team Lead provides clinical and ... This role provides day-to-day oversight of workflow management, quality assurance, staff ...
Utilization Review/Outpatient Care RN
Tampa, FL · On-site
$28 - $32/hr
Determines appropriate utilization management of services requested Qualifications What We Look For: * Clear and active RN license in state of FL * 2+ years of acute clinical/surgical position
Utilization Review/Outpatient Care RN
Tampa, FL · On-site
$28 - $32/hr
Determines appropriate utilization management of services requested Qualifications What We Look For: * Clear and active RN license in state of FL * 2+ years of acute clinical/surgical position
Staff Under the general supervision of the Utilization Management Manager and in accordance with established policies, professional guidelines, and CMS Conditions of Participation for Utilization ...
New
Staff Under the general supervision of the Utilization Management Manager and in accordance with established policies, professional guidelines, and CMS Conditions of Participation for Utilization ...
New
Utilization Specialist
Wesley Chapel, FL · On-site
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.
Utilization Specialist
Wesley Chapel, FL · On-site
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.
Utilization Specialist
Wesley Chapel, FL · On-site
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.
Utilization Specialist
Wesley Chapel, FL · On-site
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.
Utilization Reviewer 2
Tampa, FL · On-site
$59K - $76K/yr
The ideal candidate performs utilization review on workers' compensation related prospective ... Detail-oriented with strong organizational skills to manage multiple cases efficiently.
Utilization Reviewer 2
Tampa, FL · On-site
$59K - $76K/yr
The ideal candidate performs utilization review on workers' compensation related prospective ... Detail-oriented with strong organizational skills to manage multiple cases efficiently.
Utilization Reviewer 2
Tampa, FL · On-site
$59K - $76K/yr
The ideal candidate performs utilization review on workers' compensation related prospective ... Detail-oriented with strong organizational skills to manage multiple cases efficiently.
Utilization Reviewer 2
Tampa, FL · On-site
$59K - $76K/yr
The ideal candidate performs utilization review on workers' compensation related prospective ... Detail-oriented with strong organizational skills to manage multiple cases efficiently.
Hematologist-Oncologist Senior Medical Director of Utilization Management needed to join a practice in Tampa, FL. This position is with a group that is committed to providing quality services in ...
Hematologist-Oncologist Senior Medical Director of Utilization Management needed to join a practice in Tampa, FL. This position is with a group that is committed to providing quality services in ...
Utilization Reviewer 2
$59K - $76K/yr
The ideal candidate performs utilization review on workers' compensation related prospective ... Detail-oriented with strong organizational skills to manage multiple cases efficiently.
Utilization Reviewer 2
$59K - $76K/yr
The ideal candidate performs utilization review on workers' compensation related prospective ... Detail-oriented with strong organizational skills to manage multiple cases efficiently.
Utilization Management Rep I (contract)
Tampa, FL · Remote
$35K - $40K/yr
Managing incoming calls or incoming post services claims work. * Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior ...
Utilization Management Rep I (contract)
Tampa, FL · Remote
$35K - $40K/yr
Managing incoming calls or incoming post services claims work. * Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior ...
Underpinned by technology, data, analytics, AI, change management, talent and sustainability ... As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise ...
Underpinned by technology, data, analytics, AI, change management, talent and sustainability ... As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise ...
Managing denial and/or appeal escalations and communicating delays to the Director, Utilization Management Compliance. * Working closely with the Director, Utilization Management Compliance to ...
Managing denial and/or appeal escalations and communicating delays to the Director, Utilization Management Compliance. * Working closely with the Director, Utilization Management Compliance to ...
Utilization Management information
See New Port Richey, FL salary details
$34.7K - $44.8K
15% of jobs
$44.8K - $54.8K
8% of jobs
$56.3K is the 25th percentile. Wages below this are outliers.
$54.8K - $64.9K
15% of jobs
The median wage is $71.2K / yr.
$64.9K - $74.9K
20% of jobs
$74.9K - $84.9K
11% of jobs
$90K is the 75th percentile. Wages above this are outliers.
$84.9K - $95K
13% of jobs
$95K - $105K
5% of jobs
$105K - $115.1K
3% of jobs
$115.1K - $125.1K
4% of jobs
$125.1K - $135.1K
3% of jobs
$135.1K - $145.2K
3% of jobs
$34.7K
$79.7K
$145.2K
How much do utilization management jobs pay per year?
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 popular job titles related to Utilization Management jobs in New Port Richey, FL?
For Utilization Management jobs in New Port Richey, FL, the most frequently searched job titles are:
What job categories do people searching Utilization Management jobs in New Port Richey, FL look for?
The top searched job categories for Utilization Management jobs in New Port Richey, FL are:
What cities near New Port Richey, FL are hiring for Utilization Management jobs?
Cities near New Port Richey, FL with the most Utilization Management job openings:

Full-time
Medical, Dental, Vision, Retirement, PTO
Re-posted 24 days ago
BayCare Health System rating
7.5
Based on 401 frontline employees who took The Breakroom Quiz
235th of 887 rated healthcare providers
Job description
The Utilization Management Assistant responsibilities include:
- Participating on the Utilization Management Team (UMT), serving as a Utilization Management liaison with managed care organizations, collaborating with Medical Staff, Business Office, Medical Records and other hospital staff.
- Provides support services to the staff of the UM department.
- Provides assistance with coordination of case management services and various administrative duties.
Position details:
- Location: Hybrid - Morton Plant Hospital - Clearwater, FL
- Status: Full Time, 40 hours per week
- Schedule: Monday - Friday 8:00 AM - 4:30 PM
- Weekend Requirement: Every 3rd
- On Call: No
Education:
- Required High School Diploma or Equivalent
Experience:
- Required 2 years in Case Management
- Or 2 years in Medical Billing
- Or 2 years in Registration
Benefits:
- Benefits (Health, Dental, Vision)
- Paid time off
- Tuition reimbursement
- 401k match and additional yearly contribution
- Yearly performance appraisals and team award bonus
- Community discounts and more
Equal Opportunity Employer Veterans/Disabled
What BayCare Health System employees say
Pay
Benefits
Hours and flexibility
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About Baycare Health System
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Pinellas Park, FL, US
Year founded
1997