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Utilization Manager Jobs in Iowa (NOW HIRING)

Virginia Gay Hospital

Utilization Tech

Vinton, IA · On-site

Utilization Tech/Nurse M-F 1st shift, 32 biweekly hours 8-4:30 Clinical background preferred About VGH Virginia Gay Hospital, established in Vinton in 1923, is an independent, nonprofit critical ...

Trinity Health

Case Manager RN

Des Moines, IA

Perform admission, concurrent, and post-discharge utilization reviews in accordance with the Utilization Management Plan and regulatory requirements. * Apply Milliman Care Guidelines and payer ...

Trinityhealth

Case Manager RN

Des Moines, IA · On-site

Perform admission, concurrent, and post-discharge utilization reviews in accordance with the Utilization Management Plan and regulatory requirements. * Apply Milliman Care Guidelines and payer ...

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All JobsUtilization JobsUtilization Manager JobsUtilization Manager Jobs in Iowa

Utilization Manager information

See Iowa salary details

$36.6K

$85.5K

$157.3K

How much do utilization manager jobs pay per year?

As of Sep 4, 2026, the average yearly pay for utilization manager in Iowa is $85,484.00, according to ZipRecruiter salary data. Most workers in this role earn between $55,900.00 and $102,800.00 per year, depending on experience, location, and employer.

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?

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 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 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.

More about Utilization Manager jobs

What are the most commonly searched types of Utilization jobs in Iowa?

The most popular types of Utilization jobs in Iowa are:

What are popular job titles related to Utilization Manager jobs in Iowa?

For Utilization Manager jobs in Iowa, the most frequently searched job titles are:

What job categories do people searching Utilization Manager jobs in Iowa look for?

The top searched job categories for Utilization Manager jobs in Iowa are:

What cities in Iowa are hiring for Utilization Manager jobs?

Cities in Iowa with the most Utilization Manager job openings:

What are popular job titles related to Utilization Manager jobs in IA?

For Utilization Manager jobs in IA, the most frequently searched job titles are:

Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in Iowa as of August 2026, with employment types broken down into 1% As Needed, 85% Full Time, 13% Part Time, and 1% Contract. Highlights an 81% Physical, 2% Hybrid, and 17% Remote job distribution, with an average salary of $85,484 per year, or $41.1 per hour.

Utilization Management Nurse

Medical Associates

Dubuque, IA

Full-time

Medical, Dental, Life, Retirement, PTO

Posted 3 days ago

New

Key responsibilities

  • Review requests from providers or members for approval of procedures, medications, and services prior to delivery.

  • Utilize established screening criteria to determine medical necessity and facilitate appropriate treatment options.

  • Conduct reviews of hospital and skilled admissions to justify continued care based on established guidelines.

Job description

Medical Associates is looking for a Utilization Management Nurse to join our Health Care Services team! 
Schedule: Primary schedule will be Monday through Friday 8:00am to 5:00pm, 40 hours/week with flexibility. After training, there is opportunity for work from home if desired!

Location: Training is in-person at Medical Associates Health Plans, 1605 Associates Drive, Dubuque, IA 52002

Benefits Package Includes:

  • Single or Family Health Insurance with discounted premium rates for wellness program participation.
  • 401k with immediate matching (50% on the dollar up to 7% of pay + additional annual Profit Sharing)
  • Flexible Paid Time Off Program (24 days off/year)
  • Medical and Dependent Care Flex Spending Accounts
  • Life insurance, Long Term Disability Coverage, Short Term Disability Coverage, Dental Insurance, etc.

What You Will Be Doing:

  • Review requests from providers or members for approval of procedures, medications, durable medical and/or services prior to delivery of the service.
  • Utilize established screening criteria to ensure patients get the correct treatment from the resources that are available at the most cost-effective level to meet their needs. 
  • Facilitate options and services for meeting individuals’ health needs with the goal of decreasing fragmentation, duplication of care and enhancing quality, cost‑effective clinical outcomes.
  • Review of hospital and skilled admissions to justify continued care is medically necessary per Health Plan established guidelines.

Essential Functions & Responsibilities:

  1. Conduct reviews inclusive of physician referrals, medication reviews, admissions, utilization review updates, investigating alternatives to hospitalization such as home health care and durable medical equipment, utilizing the assessment process by obtaining pertinent patient history and accurate vital data, anticipating patient and family needs, working with the Health Choice Claims and Membership Services to determine benefit eligibility, facilitating crisis intervention, sharing information with co‑workers and documenting accurately.  Utilize established screening criteria to determine medical necessity of requested authorizations.  Refer patients to case management nurse or health coach as appropriate.
  2. Facilitate out‑of‑plan referrals, out‑of‑area urgent and emergent care for enrollees and provider offices and provide necessary information to Medical Director on specified referrals. Communicate decision to enrollees, providers, and facilities per established policies.
  3. Work collaboratively with internal and external staff, in determining extent of benefits and coverage for services being coordinated.  Document authorizations, denials, cost savings and other outcome measurements.
  4. Act as a resource for the enrollee, provider offices, and other MAHP departments.  Perform retrospective review to determine coverage of hospitalizations, and outpatient services.  Communicate with enrollees regarding the use of managed care systems and participate in answering enrollees and providers inquiries. 
  5. Assist in preparations for external review/regulatory agencies.
  6. Complete all other assigned projects and duties.

Knowledge, Skills and Abilities:
Experience - Three years to five years of similar or related experience.
Education - Valid RN nursing license is required.