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Utilization Manager Jobs in Arizona (NOW HIRING)

UHS

Utilization Review Manager

Phoenix, AZ

Responsibilities Utilization Review Manager (URM) Position: Full-Time Shift: Daytime For over 60 years, Calvary Healing Center has provided a full continuum of care, specializing in addiction ...

UHS

Utilization Review Manager

Phoenix, AZ · On-site

Responsibilities Utilization Review Manager (URM) Position: Full-Time Shift: Daytime For over 60 years, Calvary Healing Center has provided a full continuum of care, specializing in addiction ...

UHS

Utilization Review Manager

Phoenix, AZ · On-site

Responsibilities Utilization Review Manager (URM) Position: Full-Time Shift: Daytime For over 60 years, Calvary Healing Center has provided a full continuum of care, specializing in addiction ...

UHS

Utilization Review Manager

Phoenix, AZ

Responsibilities Utilization Review Manager (URM) Position: Full-Time Shift: Daytime For over 60 years, Calvary Healing Center has provided a full continuum of care, specializing in addiction ...

UHS

Utilization Review Coordinator

Scottsdale, AZ · On-site

The Utilization Management Coordinator reports to the Utilization Management Director. UM Coordinators provide an ongoing, systematic process for the assessment of the necessity and efficiency of the ...

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All JobsUtilization JobsUtilization Manager JobsUtilization Manager Jobs in Arizona

Utilization Manager information

See Arizona salary details

$36.3K

$84.8K

$156.1K

How much do utilization manager jobs pay per year?

As of Jul 15, 2026, the average yearly pay for utilization manager in Arizona is $84,812.00, according to ZipRecruiter salary data. Most workers in this role earn between $55,400.00 and $102,000.00 per year, depending on experience, location, and employer.

What does a utilization manager do?

A utilization manager oversees the allocation and efficient use of resources, such as staff and equipment, to meet organizational goals. They analyze data, monitor utilization rates, and ensure compliance with policies, often using tools like spreadsheets or specialized software. This role requires strong organizational and communication skills to optimize productivity and control costs.

What jobs pay 4000 a week without a degree?

Utilization Managers typically require a relevant background in healthcare, logistics, or operations, and their salaries usually do not reach $4,000 weekly without specialized experience or certifications. High-paying roles that can reach this level without a degree often include sales, real estate, or skilled trades like certain construction or technical jobs, which rely more on experience and skills than formal education.

What are the key skills and qualifications needed to thrive as a Utilization Manager, and why are they important?

To thrive as a Utilization Manager, you need a solid background in healthcare management, case review, and knowledge of insurance regulations, often supported by a degree in nursing, healthcare administration, or a related field. Familiarity with utilization management software, electronic health records (EHRs), and certification such as Certified Case Manager (CCM) are typically required. Strong analytical thinking, communication, and negotiation skills help Utilization Managers effectively coordinate care and collaborate with providers. These skills ensure appropriate resource use, regulatory compliance, and optimal patient outcomes within healthcare organizations.

What is the highest paying job in healthcare management?

The highest paying roles in healthcare management include Chief Executive Officers (CEOs) of hospitals and health systems, with salaries often exceeding $200,000 annually. Other high-paying positions include Chief Financial Officers (CFOs) and Chief Operating Officers (COOs), who oversee organizational strategy and operations, typically earning six-figure salaries. These roles require extensive experience, advanced degrees, and strong leadership skills.

What are some common challenges faced by Utilization Managers, and how can they be addressed?

Utilization Managers often face challenges such as balancing cost containment with patient care quality, navigating complex insurance policies, and managing high caseloads. To address these, effective communication with healthcare providers and payers is essential, as is staying current with regulatory requirements and best practices. Building strong relationships within interdisciplinary teams and leveraging data analytics tools can also help Utilization Managers make informed decisions and improve workflow efficiency.

What Is a Utilization Manager?

A utilization manager works in the insurance industry to analyze health care needs in medical cases and determine further patient care. In this career, your job duties include conducting interviews to determine what services you register for and cutting down on unnecessary costs. You may review medical records and compile documentation to improve care and report your findings. Skills in management, customer service, and health care services are vital in this career. Job experience in nursing is a benefit when applying for utilization manager positions. Additional qualifications include a bachelor’s degree and medical case management certificate.

What is the difference between Utilization Manager vs Utilization Coordinator?

AspectUtilization ManagerUtilization Coordinator
CertificationsOften requires healthcare or case management certificationsMay have similar certifications but less emphasis on management
Work EnvironmentTypically in healthcare organizations, overseeing utilization review processesSupports daily operations, assisting with case documentation and scheduling
Employer & Industry UsageCommon in healthcare, insurance, and managed care companiesFound in similar settings, often working under Utilization Managers

In summary, a Utilization Manager generally has broader responsibilities, overseeing utilization review and resource allocation, while a Utilization Coordinator focuses on supporting daily tasks and documentation. Both roles are integral in healthcare settings but differ in scope and level of responsibility.

Is being a MOA a good entry level job?

A Medical Office Assistant (MOA) role is often considered an entry-level position in healthcare, requiring basic administrative skills and knowledge of medical terminology. It provides experience in patient interaction, scheduling, and office management, which can serve as a stepping stone to more advanced healthcare roles. However, career advancement may require additional certifications or education.
More about Utilization Manager jobs
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What job categories do people searching Utilization Manager jobs in Arizona look for? The top searched job categories for Utilization Manager jobs in Arizona are:
What cities in Arizona are hiring for Utilization Manager jobs? Cities in Arizona with the most Utilization Manager job openings:
What are popular job titles related to Utilization Manager jobs in AZ? For Utilization Manager jobs in AZ, the most frequently searched job titles are:
Utilization Manager jobs near you

Yoeme Managed Care Utilization Manager

Pascua Yaqui Tribe, AZ

Tucson, AZ • On-site

Full-time

Medical, Retirement, PTO

Posted 15 days ago

Job description

Salary: Depends on Qualifications
Location : Tucson, AZ
Job Type: Full-Time
Job Number: 2026-00161
Department: MANAGED CARE
Division: YOEME HEALTH PLAN
Opening Date: 06/01/2026
Closing Date: 7/22/2026 11:59 PM Arizona
Job Summary
The Yoeme Managed Care Utilization Manager (YMCU) works with the Executive Director of Health to plan, organize, direct, coordinate, and lead personnel and work process of a multi-million program that serves the Tribal membership residing in Pima and Maricopa counties. Scope of responsibility includes assisting in managing the Commercial Health Self-Insurance Plan -Yoeme Woi Health Plan. The YMCU Manager will have knowledge and familiarity with the key elements of commercial insurance regulations, commercial eligibility, and producing Family Status Reports for Woi members. The incumbent evaluates the programmatic procedures and implements resource programs to assist with the overall program goals of providing a coordinated, comprehensive coordination of benefits. In addition, the incumbent performs the following duties serves as the Tribal Administrator of the Health-e-Arizona (HEA) site, administers hospital accessibility, ensures compliance with program policies and procedures, determines the use of external providers, conducting performance evaluations.
Principle Duties and Responsibilities
  1. Provide research, analysis, and recommendations to Health Department Executives which include but are not limited to identifying service improvement procedures, organizational improvements to promote efficiency of service delivery, effective cost control measures, provide recommendations for positive outcomes.
  2. Assist in managing the Commercial Health Self-Insurance Plan - Yoeme Woi Health Plan, in commercial eligibility and producing Family Status Reports for Woi members.
  3. Assist in providing coordination and communication management and guidance across health care service systems to include Inpatient / Outpatient, Specialty services, Pharmacy, CHEF, and special health projects/initiatives.
  4. Serves as the Tribal Administrator for the Health-e-Arizona (HEA) site.
  5. Assist in Hospital / Clinical Coordination and Discharge planning with Nursing and Clinic Coordinators.
  6. Assist in Prior Authorization review with the Specialty Clinic Coordinator outside of YHP members.
  7. Assist in developing and maintaining sound administrative policies and management protocols including budgets, cost determination, fee setting and collection structure, and financial reports.
  8. Performs under minimal supervision with accountability for specific goals/objectives.
  9. Works with the Executive Director, Deputy Director, Medical Director, and others to develop performance improvement targets for the organization's quality, service, and efficiency.
  10. Provides leadership with recommendations for implementing changes targeted at contract policy improvement. Measures and evaluates attainment of results.
  11. Supervise staff to include prioritizing and assigning work, conducting performance evaluations, ensuring staff are trained and employees follow policies and procedures, maintaining a healthy and safe working environment, and making hiring, termination, and disciplinary recommendations.
  12. Responsible for the daily oversight of the referral department.
  13. Ensure adequate staffing to meet production and quality standards of the program.
  14. Monitor ambulatory data, inquiries from eligibility providers, intermediaries, tribal members, and complex issues.
  15. Monitor communication with provider business offices daily; manage workload distributions for Utilization Review Specialists (URS) and contractor letters.
  16. Review and issue formal response letters to contractors about program member additions, deletions, and changes, send out notifications of member disenrollment, and review the FI pend report.
  17. Assign Health Record Numbers (HRN) to newborns/new program enrollees, sign denial letters for YHP and send Urgent Care letters to members.
  18. Post payments for "I" type purchase orders payable by the Yoeme Health Plan Finance Office and payments for EOBRS that did not process through FI download.
  19. Generate ad hoc reports from RPMS and CHSMIS as required, generate an open document list sent to providers, and access RPMS and RIC modules.
  20. Process and coordinate medical referrals for the Phoenix Indian Medical Center (PIMC) and the Pima County El Rio Health Center, provide healthcare for tribal members in Maricopa and Pima County by scheduling appointments, generating purchase orders, and explaining procedures.
  21. Review medical referrals and claims with assigned committee members; determine medical need, the priority of the request, eligibility, and payer and provide authorization of payment.
  22. Act as an advocate for patients; performs liaison and case management activities between patients and healthcare providers; provides patient education about eligibility, diagnosis, and insurance.
  23. Work closely with the Native American Liaison for AHCCCS ensuring equal treatment for our tribal members.
  24. Monitor contractors to ensure they follow the contract in providing health services to tribal members.
  25. Participate in discharge planning for patients to ensure appropriate services are in place and that the client is being discharged to an appropriate level of care.
  26. Perform other duties of a similar nature or level as requested by the supervisor or director.

Required Knowledge, Skills, and Abilities
Knowledge of:
  • Knowledge of commercial contracting for Self-Insurance Plan -Yoeme Woi Plan
  • Knowledge of Blue Cross Blue Shield Health Network
  • Knowledge of managing Tribal Health Programs
  • Indian Health Service Programs, policies and procedures.
  • Community health resources;
  • Medical terminology;
  • Customer service principles;
  • Assess the necessity and urgency of requests for medical services to be provided to members to determine payment for the service.
  • Monitor and report abnormal trends/variations in healthcare patterns;
  • Promote excellence and professionalism in healthcare quality;
  • ICD-9, ICD-10 and CPT coding guidelines.
  • Resource and Patient Management System (RPMS) or similar patient information tracking system;
  • Provide clinical review for all requests for home health and physical therapy, making appropriate assessments for approving payment for the service;
  • Maintain a professional approach with confidentiality;
  • Yaqui culture, customs, resources, and traditions, and/or a willingness to learn.

Skills and Abilities:
  • Identify issues and able to provide resolutions;
  • Remain resourceful and calm in emergencies;
  • Monitor and report abnormal trends/variations in healthcare patterns;
  • Promote excellence and professionalism in healthcare quality;
  • Provide clinical review for all requests for home health and physical therapy, making appropriate assessments for approving payment for the service;
  • Maintain a professional approach with confidentiality;
  • Operating a variety of office equipment, including a computer and related software applications;
  • Effective communication and interpersonal skills as applied to interaction with co-workers, supervisor, management, Council members, and the general public. Ability to sufficiently exchange or convey information and receive verbal and written work instructions.

Education, Certifications and Experience Required
Bachelor's degree in public or business administration, or a related field; plus two (2) years of Utilization Review (UR) experience; with a minimum of two (2) years of supervisory experience, or an equivalent combination of education and experience and experience to successfully perform the essential duties of the job such as those listed.
Special Requirements:
  • Must possess and maintain a valid Arizona Driver's License
  • This position will require the incumbent to work non-traditional hours, nights, and weekends.
  • Must have a current Level 1 Arizona Clearance Card or be able to obtain the Level 1 Arizona Clearance Card within ninety (90) days of hire. Failure to maintain a current Level 1 Clearance Card will result in removal from this position.

The Pascua Yaqui Tribe provides 22 days of Paid Time Off which increases with years of service and 15 paid Holidays per year. We offer a comprehensive healthcare benefit package that surpasses or rivals the biggest organizations in Tucson. We encourage you to stay healthy by providing an onsite Wellness Center. Additionally, the Tribe offers a 401(k) Plan with a generous match in which you're immediately vested along with a profit sharing plan after one year of employment. Sworn police and and fire employees are eligible to make Pre-Tax and After-Tax contirbutions to the Arizona Public Safety Personnel Retirement Systems ("PSPRS").
01
Do you have a Bachelor's Degree in Public Administration, Business Administration, or in a related field?
  • Yes
  • No

02
Do you have two (2) years of Utilization Review (UR) experience?
  • Yes
  • No

03
Do you have a minimum of two (2) years of supervisory experience?
  • Yes
  • No

04
Do you have an equivalent combination of education, training, and relevant experience that demonstrates the ability to successfully perform the responsibilities of the position?
  • Yes
  • No

05
Do you have a current valid Driver's license?
  • Yes
  • No

06
Do you currently have a valid Level 1 Arizona Clearance Card, or are you able to obtain one within ninety (90) days of hire? (Please note: failure to maintain a current Level 1 Clearance Card will result in termination.)
  • Yes
  • No

07
Are you aware that this position will require you to work non-traditional hours, nights, and weekends?
  • Yes
  • No

Required Question

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