As a Network Performance/Utilization Manager , your primary responsibilities may include: * Advise clients on network strategy, provider capacity, utilization trends, access challenges, and market ...
As a Network Performance/Utilization Manager , your primary responsibilities may include: * Advise clients on network strategy, provider capacity, utilization trends, access challenges, and market ...
The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments serves a key role in coordinating the department's interdisciplinary effort to assess and promote ...
The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments serves a key role in coordinating the department's interdisciplinary effort to assess and promote ...
The Utilization Review (UR) Assistant supports utilization management activities and serves as the central coordinator for postacute prior authorizations (PAs) for skilled nursing, swing bed, CAH ...
The Utilization Review (UR) Assistant supports utilization management activities and serves as the central coordinator for postacute prior authorizations (PAs) for skilled nursing, swing bed, CAH ...
The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments serves a key role in coordinating the department's interdisciplinary effort to assess and promote ...
The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments serves a key role in coordinating the department's interdisciplinary effort to assess and promote ...
The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments serves a key role in coordinating the department's interdisciplinary effort to assess and promote ...
The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments serves a key role in coordinating the department's interdisciplinary effort to assess and promote ...
The Utilization Review (UR) Assistant supports utilization management activities and serves as the central coordinator for postacute prior authorizations (PAs) for skilled nursing, swing bed, CAH ...
The Utilization Review (UR) Assistant supports utilization management activities and serves as the central coordinator for postacute prior authorizations (PAs) for skilled nursing, swing bed, CAH ...
The Utilization Review (UR) Assistant supports utilization management activities and serves as the central coordinator for postacute prior authorizations (PAs) for skilled nursing, swing bed, CAH ...
The Utilization Review (UR) Assistant supports utilization management activities and serves as the central coordinator for postacute prior authorizations (PAs) for skilled nursing, swing bed, CAH ...
The Utilization Review (UR) Assistant supports utilization management activities and serves as the central coordinator for postacute prior authorizations (PAs) for skilled nursing, swing bed, CAH ...
The Utilization Review (UR) Assistant supports utilization management activities and serves as the central coordinator for postacute prior authorizations (PAs) for skilled nursing, swing bed, CAH ...
The Utilization Review (UR) Assistant supports utilization management activities and serves as the central coordinator for postacute prior authorizations (PAs) for skilled nursing, swing bed, CAH ...
The Utilization Review (UR) Assistant supports utilization management activities and serves as the central coordinator for postacute prior authorizations (PAs) for skilled nursing, swing bed, CAH ...
The Utilization Review (UR) Assistant supports utilization management activities and serves as the central coordinator for postacute prior authorizations (PAs) for skilled nursing, swing bed, CAH ...
The Utilization Review (UR) Assistant supports utilization management activities and serves as the central coordinator for postacute prior authorizations (PAs) for skilled nursing, swing bed, CAH ...
Utilization Management CNA
Dubuque, IA · On-site
Utilization Management Assistant Location : Onsite in Dubuque, IA. Also accepting remote applicants. Are you passionate about patient care and thrive in a fast-paced, professional environment? We are ...
Utilization Management CNA
Dubuque, IA · On-site
Utilization Management Assistant Location : Onsite in Dubuque, IA. Also accepting remote applicants. Are you passionate about patient care and thrive in a fast-paced, professional environment? We are ...
Overview We are looking for a full-time Utilization Specialist for our new Methodist Jennie ... Act as liaison between managed care organizations and the facility professional clinical staff.
Overview We are looking for a full-time Utilization Specialist for our new Methodist Jennie ... Act as liaison between managed care organizations and the facility professional clinical staff.
Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Iowa City, IA · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Iowa City, IA · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Des Moines, IA · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Des Moines, IA · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Sioux City, IA · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Sioux City, IA · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Davenport, IA · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Davenport, IA · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Cedar Rapids, IA · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Cedar Rapids, IA · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
This role has direct management responsibility for all inpatient unit staff and ensures the ... Utilization Review & Care Management: · Oversee the utilization review (UR) and care management ...
Quick apply
This role has direct management responsibility for all inpatient unit staff and ensures the ... Utilization Review & Care Management: · Oversee the utilization review (UR) and care management ...
This role has direct management responsibility for all inpatient unit staff and ensures the ... Utilization Review & Care Management: · Oversee the utilization review (UR) and care management ...
Quick apply
This role has direct management responsibility for all inpatient unit staff and ensures the ... Utilization Review & Care Management: · Oversee the utilization review (UR) and care management ...
Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Davenport, IA · Remote
$29.05 - $67.97/hr
... utilization management and long-term services and supports (LTSS) issues. • Identifies and reports quality of care issues. • Assists with complex claim review including diagnosis-related group ...
Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Davenport, IA · Remote
$29.05 - $67.97/hr
... utilization management and long-term services and supports (LTSS) issues. • Identifies and reports quality of care issues. • Assists with complex claim review including diagnosis-related group ...
Utilization Manager information
See Iowa salary details
$36.6K - $47.6K
9% of jobs
$55.7K is the 25th percentile. Wages below this are outliers.
$47.6K - $58.6K
22% of jobs
$58.6K - $69.5K
11% of jobs
The median wage is $76.3K / yr.
$69.5K - $80.5K
14% of jobs
$80.5K - $91.5K
12% of jobs
$98.4K is the 75th percentile. Wages above this are outliers.
$91.5K - $102.5K
13% of jobs
$102.5K - $113.4K
13% of jobs
$113.4K - $124.4K
5% of jobs
$124.4K - $135.4K
2% of jobs
$135.4K - $146.4K
0% of jobs
$146.4K - $157.3K
0% of jobs
$36.6K
$85.5K
$157.3K
How much do utilization manager jobs pay per year?
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 are the key skills and qualifications needed to thrive as a Utilization Manager, and why are they important?
What are some common challenges faced by Utilization Managers, and how can they be addressed?
What does a Utilization Manager do?
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.
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
This job post has expired today. Applications are no longer accepted.
Accenture Federal Services rating
8.4
Based on 19 frontline employees who took The Breakroom Quiz
47th of 424 rated business services
Job description
Accenture is a leading global professional services company that helps the world's leading businesses, governments and other organizations build their digital core, optimize their operations, accelerate revenue growth and enhance citizen services-creating tangible value at speed and scale. We are a talent- and innovation -led company with approximately 750,000 people serving clients in more than 120 countries. Technology is at the core of change today, and we are one of the world's leaders in helping drive that change, with strong ecosystem relationships. We combine our strength in technology and leadership in cloud, data and AI with unmatched industry experience, functional expertise and global delivery capability. We are uniquely able to deliver tangible outcomes because of our broad range of services, solutions and assets across Strategy & Consulting, Technology, Operations, Industry X and Song. These capabilities, together with our culture of shared success and commitment to creating 360° value, enable us to help our clients reinvent and build trusted, lasting relationships. We measure our success by the 360° value we create for our clients, each other, our shareholders, partners and communities. Visit us at www.accenture.com .
Strategy & Consulting: We work with C-suite executives, leaders and boards of the world's leading organizations, helping them reinvent every part of their enterprise to drive greater growth, enhance competitiveness, implement operational improvements, reduce cost, deliver sustainable 360° stakeholder value, and set a new performance frontier for themselves and the industry in which they operate. Our deep industry and functional expertise is supported by proprietary assets and solutions that help organizations transform faster and become more resilient. Underpinned by technology, data, analytics, AI, change management, talent and sustainability capabilities, our Strategy & Consulting services help architect and accelerate all aspects of an organization's total enterprise reinvention.
Role Summary Advise clients on network strategy, utilization performance, and provider market challenges across Medicaid, rural, and financially pressured environments. The successful candidate will combine deep domain expertise with strong consulting judgment and will be expected to manage teams, advise senior clients, and deliver complex engagements in network strategy, utilization , and provider performance. This individual will build trusted client relationships and help clients improve network performance, access, and provider sustainability in line with their strategic priorities.
As a Network Performance/Utilization Manager , your primary responsibilities may include:
- Advise clients on network strategy, provider capacity, utilization trends, access challenges, and market performance.
- Advise clients on evaluating leakage, referral patterns, service distribution, network adequacy, and provider sustainability.
- Develop strategic recommendations to improve network design, access, utilization management, provider alignment, and value-based outcomes.
- Translate claims, encounter , provider , and market data into clear insights, strategic options, and executive decision materials.
- Manage day-to-day engagement delivery, including workplans, team coordination, deliverable quality, and client communications.
- Work across reimbursement, analytics, policy, and provider strategy teams to solve complex market and performance challenges.
- Build trusted relationships with client stakeholders and help grow the practice's network performance and utilization work.
- Travel: As required, up to 80%
Why should I join the Accenture Health team? ? ?
- Innovate every day. Be at the forefront of designing and delivering health technology solutions that push boundaries and create new opportunities for our clients. ? ?
- Lead with the industry's best . Join an industry-recognized healthcare leader with more than 20,000 global healthcare professionals collaborating to drive enterprise-wide transformational projects on a global scale. Accenture has worked with more than 200 clients to deliver healthcare transformation to meet the diverse needs of patients and members.????
- Learn and grow continuously. Harness unmatched training and professional development to help you build and advance your health, consultative and delivery skills. With learning resources, interactive classroom courses, real-life client simulations and ongoing mentoring available when you need it, you'll expand your thinking beyond the core Workday implementation. ? ?
Qualification
Here's what you need: ? ?
- Minimum of 5 years of experience in network strategy, utilization analytics, provider economics, or healthcare market analysis .
- Minimum of 2 years of experience assessing hospitals, rural providers, FQHCs, specialty providers, and community-based providers in Medicaid-heavy or financially distressed environments .
- Minimum of 2 years of experience turning claims, encounter , provider , and market data into strategic recommendations .
- Bachelor 's Degree
Bonus points if you have: ?
- Familiarity with provider directory and network data management, data quality, and encounter completeness.
- Strong understanding of provider capacity, leakage, referral patterns, utilization drivers, access, and network adequacy .
- Ability to connect utilization performance to reimbursement, provider sustainability, and VBC outcomes .
- Experience building provider performance scorecards ( utilization , quality, access, equity, financial impact ).
- Understanding of service line strategy and site-of-care optimization (ASC vs HOPD, home-based care, telehealth).
Compensation at Accenture varies depending on a wide array of factors, which may include but are not limited to the specific office location, role, skill set, and level of experience. As required by local law, Accenture provides a reasonable range of compensation for roles that may be hired as set forth below.We anticipate this job posting will be posted until 05/16/2026.Accenture offers a market competitive suite of benefits including medical, dental, vision, life, and long-term disability coverage, a 401(k) plan, bonus opportunities, paid holidays, and paid time off. See more information on our benefits here:
U.S. Employee Benefits | Accenture (https://www.accenture.com/us-en/careers/local/benefits)
Role Location Annual Salary RangeCalifornia $94,400 to $293,800Cleveland $87,400 to $235,000Colorado $94,400 to $253,800District of Columbia $100,500 to $270,300Illinois $87,400 to $253,800Maryland $94,400 to $253,800Massachusetts $94,400 to $270,300Minnesota $94,400 to $253,800New York $87,400 to $293,800New Jersey $100,500 to $293,800Washington $100,500 to $270,300
Requesting an Accommodation
Accenture is committed to providing equal employment opportunities for persons with disabilities or religious observances, including reasonable accommodation when needed. If you are hired by Accenture and require accommodation to perform the essential functions of your role, you will be asked to participate in our reasonable accommodation process. Accommodations made to facilitate the recruiting process are not a guarantee of future or continued accommodations once hired.
If you would like to be considered for employment opportunities with Accenture and have accommodation needs such as for a disability or religious observance, please call us toll free at 1 (877) 889-9009 or send us an email or speak with your recruiter.
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We believe that no one should be discriminated against because of their differences.?All employment decisions shall be made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status or any other basis as protected by federal, state, or local law.?Our rich diversity makes us more innovative, more competitive, and more creative, which helps us better serve our clients and our communities.
For details, view a copy of the?Accenture Equal Opportunity Statement (https://www.accenture.com/content/dam/accenture/final/accenture-com/document-4/Accenture-Equal-Opportunity-Statement.pdf#zoom=50)
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Accenture is committed to providing veteran employment opportunities to our service men and women.
Other Employment Statements
Applicants for employment in the US must have work authorization that does not now or in the future require sponsorship of a visa for employment authorization in the United States.
Candidates who are currently employed by a client of Accenture or an affiliated Accenture business may not be eligible for consideration.
Job candidates will not be obligated to disclose sealed or expunged records of conviction or arrest as part of the hiring process. Further, at Accenture a criminal conviction history is not an absolute bar to employment.
The Company will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. Additionally, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company's legal duty to furnish information.
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About Accenture Federal Services
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Industry
It services
Company size
10,000+ Employees
Headquarters location
Arlington, VA, US
Year founded
1989