The Manager, Utilization Review is responsible for overseeing the daily operations of the Utilization Review for one of our clients and leading a team of Utilization Review Nurses. This role involves ...
The Manager, Utilization Review is responsible for overseeing the daily operations of the Utilization Review for one of our clients and leading a team of Utilization Review Nurses. This role involves ...
As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise clients on network strategy, provider capacity,utilizationtrends, access challenges, and market ...
As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise clients on network strategy, provider capacity,utilizationtrends, access challenges, and market ...
As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise clients on network strategy, provider capacity,utilizationtrends, access challenges, and market ...
As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise clients on network strategy, provider capacity,utilizationtrends, access challenges, and market ...
Job Purpose: - The Utilization Review Manager - RN at LIFESTREAM BEHAVIORAL CENTER is responsible for overseeing the utilization review process to ensure that patient care services are delivered ...
Job Purpose: - The Utilization Review Manager - RN at LIFESTREAM BEHAVIORAL CENTER is responsible for overseeing the utilization review process to ensure that patient care services are delivered ...
The manager is looking for 3 years of Inpatient Medical experience, 3 years of Utilization experience, Concurrent Review experience and HMO exp. Training will be 3 - 4 weeks long that will include ...
The manager is looking for 3 years of Inpatient Medical experience, 3 years of Utilization experience, Concurrent Review experience and HMO exp. Training will be 3 - 4 weeks long that will include ...
Utilization Review Manager (On-site) (279)
Leesburg, FL · On-site
$34.05/hr
Job Purpose: - The Utilization Review Manager - RN at LIFESTREAM BEHAVIORAL CENTER is responsible for overseeing the utilization review process to ensure that patient care services are delivered ...
Utilization Review Manager (On-site) (279)
Leesburg, FL · On-site
$34.05/hr
Job Purpose: - The Utilization Review Manager - RN at LIFESTREAM BEHAVIORAL CENTER is responsible for overseeing the utilization review process to ensure that patient care services are delivered ...
Responsibilities The Utilization Review Director is responsible for directing and overseeing the Utilization Management Department. This includes the implementation of case management scenarios ...
Responsibilities The Utilization Review Director is responsible for directing and overseeing the Utilization Management Department. This includes the implementation of case management scenarios ...
Utilization Management Physician (UMP) Remote | Full-Time | Florida Compensation: $240,000 base + bonus Schedule: 40 hours/week Work Model: Remote (on-site meetings in Daytona Beach, FL ) Overview ...
Quick apply
Utilization Management Physician (UMP) Remote | Full-Time | Florida Compensation: $240,000 base + bonus Schedule: 40 hours/week Work Model: Remote (on-site meetings in Daytona Beach, FL ) Overview ...
Coordinates with healthcare providers to ensure compliance with utilization management guidelines. * Supports the optimization of treatment plans to promote effective patient care and appropriate ...
Coordinates with healthcare providers to ensure compliance with utilization management guidelines. * Supports the optimization of treatment plans to promote effective patient care and appropriate ...
Coordinates with healthcare providers to ensure compliance with utilization management guidelines. * Supports the optimization of treatment plans to promote effective patient care and appropriate ...
Coordinates with healthcare providers to ensure compliance with utilization management guidelines. * Supports the optimization of treatment plans to promote effective patient care and appropriate ...
Overview Make an impact by supporting the right care at the right time through utilization management excellence. Work Style: Onsite Location: Leesburg, FL FTE: PRN (.10 FTE) ⏰ Schedule: Variable ...
Overview Make an impact by supporting the right care at the right time through utilization management excellence. Work Style: Onsite Location: Leesburg, FL FTE: PRN (.10 FTE) ⏰ Schedule: Variable ...
Overview Make an impact by supporting the right care at the right time through utilization management excellence. Work Style: Onsite Location: Gainesville, FL FTE: Part-Time (.6 FTE) ⏰ Schedule:
Overview Make an impact by supporting the right care at the right time through utilization management excellence. Work Style: Onsite Location: Gainesville, FL FTE: Part-Time (.6 FTE) ⏰ Schedule:
Overview Make an impact by supporting the right care at the right time through utilization management excellence. ???? Work Style: Onsite ???? Location: Leesburg, FL ???? FTE: PRN (.10 FTE) ⏰ ...
Overview Make an impact by supporting the right care at the right time through utilization management excellence. ???? Work Style: Onsite ???? Location: Leesburg, FL ???? FTE: PRN (.10 FTE) ⏰ ...
Overview Make an impact by supporting the right care at the right time through utilization management excellence. ???? Work Style: Onsite ???? Location: Gainesville, FL ???? FTE: Part-Time (.6 FTE ...
Overview Make an impact by supporting the right care at the right time through utilization management excellence. ???? Work Style: Onsite ???? Location: Gainesville, FL ???? FTE: Part-Time (.6 FTE ...
Involves coordinating with healthcare providers to maintain compliance with utilization management guidelines and optimizing treatment plans for effective patient care and resource utilization.
Involves coordinating with healthcare providers to maintain compliance with utilization management guidelines and optimizing treatment plans for effective patient care and resource utilization.
Collaborates with healthcare providers to ensure compliance with utilization management guidelines. * Supports optimization of treatment plans to promote effective patient care and appropriate ...
Collaborates with healthcare providers to ensure compliance with utilization management guidelines. * Supports optimization of treatment plans to promote effective patient care and appropriate ...
Collaborates with healthcare providers to ensure compliance with utilization management guidelines. * Supports optimization of treatment plans to promote effective patient care and appropriate ...
Collaborates with healthcare providers to ensure compliance with utilization management guidelines. * Supports optimization of treatment plans to promote effective patient care and appropriate ...
Involves coordinating with healthcare providers to maintain compliance with utilization management guidelines and optimizing treatment plans for effective patient care and resource utilization.
Involves coordinating with healthcare providers to maintain compliance with utilization management guidelines and optimizing treatment plans for effective patient care and resource utilization.
We are seeking a Utilization Management Coordinator to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida ...
Quick apply
We are seeking a Utilization Management Coordinator to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida ...
The ISNP Utilization Management Nurse is supervised by a Utilization Management Supervisor and is responsible for evaluating a member's clinical condition through the review of medical records ...
The ISNP Utilization Management Nurse is supervised by a Utilization Management Supervisor and is responsible for evaluating a member's clinical condition through the review of medical records ...
Utilization Manager information
See Florida salary details
$29.1K - $37.9K
9% of jobs
$44.3K is the 25th percentile. Wages below this are outliers.
$37.9K - $46.6K
22% of jobs
$46.6K - $55.3K
11% of jobs
The median wage is $60.7K / yr.
$55.3K - $64.1K
14% of jobs
$64.1K - $72.8K
12% of jobs
$78.2K is the 75th percentile. Wages above this are outliers.
$72.8K - $81.5K
13% of jobs
$81.5K - $90.3K
13% of jobs
$90.3K - $99K
5% of jobs
$99K - $107.7K
2% of jobs
$107.7K - $116.4K
0% of jobs
$116.4K - $125.2K
0% of jobs
$29.1K
$68K
$125.2K
How much do utilization manager jobs pay per year?
What does a utilization manager do?
What jobs pay 4000 a week without a degree?
What are the key skills and qualifications needed to thrive as a Utilization Manager, and why are they important?
What is the highest paying job in healthcare management?
What are some common challenges faced by Utilization Managers, and how can they be addressed?
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?
| Aspect | Utilization Manager | Utilization Coordinator |
|---|---|---|
| Certifications | Often requires healthcare or case management certifications | May have similar certifications but less emphasis on management |
| Work Environment | Typically in healthcare organizations, overseeing utilization review processes | Supports daily operations, assisting with case documentation and scheduling |
| Employer & Industry Usage | Common in healthcare, insurance, and managed care companies | Found 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?
- Remote Utilization Management
- Cvs Health Utilization Management Remote
- Healthcare Revenue Cycle Manager
- Night Utilization Review Nurse
- Freelance Physician Case Reviewer
- Utilization Management Nurse
- Pre Service Review Nurse
- Hospice Rn
- Independent Contractor Remote Utilization Management Nurse
- Entry Level Utilization Management Nurse
- Live In Cigna Utilization Review Nurse
- Supervisor Utilization Review Remote
- Director Optum Utilization Review
- Tcm Nurse
- Remote Supervisor Utilization Management
- Night Shift Medical Utilization Review Physician
- Assistant Remote Utilization Review
- Full Time Cigna Utilization Review
- Lpn Utilization Management
- Overnight Dental Utilization Management

Full-time
Posted 13 days ago
Job description
The Manager, Utilization Review is responsible for overseeing the daily operations of the Utilization Review for one of our clients and leading a team of Utilization Review Nurses. This role involves ensuring efficient care coordination, managing healthcare costs, and maintaining high-quality patient care standards. The Manager, Utilization Review will collaborate with various healthcare professionals to improve patient outcomes and streamline care processes.
Key Responsibilities:
1. Leadership and Team Management:
• Supervise and mentor a team of Utilization Review Nurses, providing guidance and support to ensure excellent performance.
• Foster a collaborative and cohesive work environment within the department.
• Conduct regular staff meetings, performance evaluations, and staff development activities.
2. Care Coordination and Oversight:
• Oversee the development and implementation of individualized care plans for patients.
• Collaborate with the healthcare team to ensure coordinated and efficient patient care across different healthcare settings.
• Monitor and assess the appropriateness of care plans and resource utilization.
3. Quality Improvement:
• Implement and monitor quality improvement initiatives to enhance patient outcomes and compliance with healthcare regulations.
• Analyze data and metrics to identify areas for improvement in care coordination processes.
4. Budget Management:
• Manage the department's budget and resource allocation efficiently while maintaining high-quality patient care.
• Collaborate with finance and administrative teams to optimize resource utilization.
5. Staff Development:
• Provide ongoing training and education to Utilization Review Nurses to keep them updated on best practices and regulatory changes.
• Encourage professional growth and development within the department.
6. Patient Advocacy:
• Serve as a patient advocate, ensuring that patients' needs and preferences are addressed throughout their healthcare journey.
• Participate in complex case reviews and offer guidance on challenging patient cases.
7. Documentation and Compliance:
• Ensure accurate and timely documentation of patient records, care plans, and progress notes in accordance with regulatory standards.
Qualifications:
• Current RN (Registered Nurse) license. Compact or Multi-State License strongly preferred.
• Bachelor's degree in Nursing (BSN) required Masters (MSN) preferred.
• Previous experience in case management or care coordination, with at least 2 years in a leadership role.
• Strong clinical assessment and critical thinking skills.
• Excellent communication and interpersonal skills.
• Knowledge of healthcare regulations, insurance processes, and quality improvement methodologies.
• Proficiency in electronic health records (EHR) and healthcare software.
• Dedication to patient-centered care and a commitment to ethical practice.
If you are an experienced and visionary nurse leader who is passionate about improving patient care and outcomes, we invite you to apply for the Utilization Review Nurse Manager position. Join our team and lead the way in optimizing patient care. Apply today!
Health Business Solutions (HBiz) is an Equal Opportunity Employer. We are committed to providing equal employment opportunities to all employees and applicants without regard to race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, or any other status protected by applicable federal, state, or local law.
HBiz complies with all applicable employment laws for remote and multi-state hiring and provides reasonable accommodations as required by law.
About Health Business Solutions
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
51 - 200 Employees
Headquarters location
Cooper City, FL, US
Year founded
2002