Perform admission, concurrent, and post-discharge utilization reviews in accordance with the Utilization Management Plan and regulatory requirements. * Apply Milliman Care Guidelines and payer ...
Perform admission, concurrent, and post-discharge utilization reviews in accordance with the Utilization Management Plan and regulatory requirements. * Apply Milliman Care Guidelines and payer ...
Perform admission, concurrent, and post-discharge utilization reviews in accordance with the Utilization Management Plan and regulatory requirements. * Apply Milliman Care Guidelines and payer ...
Perform admission, concurrent, and post-discharge utilization reviews in accordance with the Utilization Management Plan and regulatory requirements. * Apply Milliman Care Guidelines and payer ...
Perform admission, concurrent, and post-discharge utilization reviews in accordance with the Utilization Management Plan and regulatory requirements. * Apply Milliman Care Guidelines and payer ...
Perform admission, concurrent, and post-discharge utilization reviews in accordance with the Utilization Management Plan and regulatory requirements. * Apply Milliman Care Guidelines and payer ...
This position is ideal for an RN leader with strong experience in case management, utilization review, discharge planning, and patient flow. What You'll Do * Lead and supervise daily workflow for ...
Quick apply
This position is ideal for an RN leader with strong experience in case management, utilization review, discharge planning, and patient flow. What You'll Do * Lead and supervise daily workflow for ...
Case Manager RN
Des Moines, IA · On-site
Support Utilization Management & Clinical Review * Perform admission, concurrent, and post-discharge utilization reviews. * Apply Milliman Care Guidelines and payer-specific criteria to determine ...
Case Manager RN
Des Moines, IA · On-site
Support Utilization Management & Clinical Review * Perform admission, concurrent, and post-discharge utilization reviews. * Apply Milliman Care Guidelines and payer-specific criteria to determine ...
Support Utilization Management & Clinical Review * Perform admission, concurrent, and post-discharge utilization reviews. * Apply Milliman Care Guidelines and payer-specific criteria to determine ...
Support Utilization Management & Clinical Review * Perform admission, concurrent, and post-discharge utilization reviews. * Apply Milliman Care Guidelines and payer-specific criteria to determine ...
Maintain skills in case management and utilization review to allow for coverage of patient caseload to cover staffing needs of all areas of hospital. * Communicate with physicians concerning patient ...
Quick apply
Maintain skills in case management and utilization review to allow for coverage of patient caseload to cover staffing needs of all areas of hospital. * Communicate with physicians concerning patient ...
Support Utilization Management & Clinical Review * Perform admission, concurrent, and post-discharge utilization reviews. * Apply Milliman Care Guidelines and payer-specific criteria to determine ...
Support Utilization Management & Clinical Review * Perform admission, concurrent, and post-discharge utilization reviews. * Apply Milliman Care Guidelines and payer-specific criteria to determine ...
Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review ...
Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review ...
Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review ...
Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review ...
Internal Medicine Physician General Internist - Physicians Only Apply - Perm
Des Moines, IA · On-site
Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review ...
Internal Medicine Physician General Internist - Physicians Only Apply - Perm
Des Moines, IA · On-site
Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review ...
Staff Dentist (Part-Time, Remote, Nevada /California License)
Nevada, IA · On-site
$101.94 - $112.96/hr
Dental About the Role The Staff Dentist will support Liberty Dental Plan's Utilization Management and Utilization Review programs by evaluating dental claims, prior authorizations, referrals, and ...
Staff Dentist (Part-Time, Remote, Nevada /California License)
Nevada, IA · On-site
$101.94 - $112.96/hr
Dental About the Role The Staff Dentist will support Liberty Dental Plan's Utilization Management and Utilization Review programs by evaluating dental claims, prior authorizations, referrals, and ...
Network Contracting Director
Nevada, IA · On-site
The Director partners closely with executive leadership, Finance, Clinical Operations, Provider Data Management, Legal, Local Leadership, Utilization Management, and Strategic Initiatives to advance ...
Network Contracting Director
Nevada, IA · On-site
The Director partners closely with executive leadership, Finance, Clinical Operations, Provider Data Management, Legal, Local Leadership, Utilization Management, and Strategic Initiatives to advance ...
Network Contracting Director
Nevada, IA · On-site
The Director partners closely with executive leadership, Finance, Clinical Operations, Provider Data Management, Legal, Local Leadership, Utilization Management, and Strategic Initiatives to advance ...
New
Network Contracting Director
Nevada, IA · On-site
The Director partners closely with executive leadership, Finance, Clinical Operations, Provider Data Management, Legal, Local Leadership, Utilization Management, and Strategic Initiatives to advance ...
New
Educates patients and families, addresses psychosocial and social determinants of health barriers, and collaborates with Utilization Management regarding level of care considerations. Serves as the ...
Educates patients and families, addresses psychosocial and social determinants of health barriers, and collaborates with Utilization Management regarding level of care considerations. Serves as the ...
Educates patients and families, addresses psychosocial and social determinants of health barriers, and collaborates with Utilization Management regarding level of care considerations. Serves as the ...
Educates patients and families, addresses psychosocial and social determinants of health barriers, and collaborates with Utilization Management regarding level of care considerations. Serves as the ...
UM / Data Entry Tech
Des Moines, IA · On-site
$16.50 - $22.25/hr
Supports Utilization Management nurses with data entry. * Performs other duties as assigned. * Adheres to Select Health and KMHP policies and procedures. * Supports and carries out the Select Health ...
UM / Data Entry Tech
Des Moines, IA · On-site
$16.50 - $22.25/hr
Supports Utilization Management nurses with data entry. * Performs other duties as assigned. * Adheres to Select Health and KMHP policies and procedures. * Supports and carries out the Select Health ...
Two years of experience in managed care quality assurance or utilization review. RN must have two years of experience in an acute care hospital. Position Summary: Responsible for conducting timely ...
Two years of experience in managed care quality assurance or utilization review. RN must have two years of experience in an acute care hospital. Position Summary: Responsible for conducting timely ...
Educates patients and families, addresses psychosocial and social determinants of health barriers, and collaborates with Utilization Management regarding level of care considerations. Serves as the ...
Educates patients and families, addresses psychosocial and social determinants of health barriers, and collaborates with Utilization Management regarding level of care considerations. Serves as the ...
Educates patients and families, addresses psychosocial and social determinants of health barriers, and collaborates with Utilization Management regarding level of care considerations. Serves as the ...
Educates patients and families, addresses psychosocial and social determinants of health barriers, and collaborates with Utilization Management regarding level of care considerations. Serves as the ...
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?
What are some common challenges faced by utilization managers, and how can they be addressed?
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.
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:

Trinity Health rating
6.6
Based on 354 frontline employees who took The Breakroom Quiz
572nd of 898 rated healthcare providers
Job description
Shift:
Weekends: Saturday and Sunday 7am - 7:30 PM
General Summary:
Responsible for the review of inpatient and outpatient admission records for appropriate admission status at Mercy Medical Center and Mercy West Lakes. Works in collaboration with the attending physician and the Case Management staff utilizing admission criteria guidelines-and second level physician review process when appropriate. Interacts with insurance providers to obtain authorization and continued stay approval for admission. Collaborates with the Verification department, Revenue cycle and Medical Eligibility to facilitate the establishment of the correct payer source for patient stay and the documentation of the interactions in the STAR admitting system
Key ResponsibilitiesPerform admission, concurrent, and post-discharge utilization reviews in accordance with the Utilization Management Plan and regulatory requirements.
Apply Milliman Care Guidelines and payer-specific criteria to determine appropriate patient status.
Collaborate with attending physicians to clarify admission status and initiate second-level physician reviews as needed.
Communicate status changes promptly to Case Management, Admitting, and other relevant departments.
Provide patient/family education and issue Notices of Status Change when required.
Accurately document utilization review activities, status determinations, authorizations, denials, and communications in the medical record and STAR system.
Submit timely clinical information to payers to prevent technical denials and support authorization and continued stay.
Review and route denial notifications for appeal consideration; collaborate with post-denials, RAC, and appeal teams.
Monitor insurance coverage and communicate updates to verification and financial teams.
Participate in peer-to-peer reviews and advocate for appropriate admission status and continued stay.
Current Iowa RN license.
Minimum of five (5) years of clinical nursing experience.
BSN or healthcare-related degree preferred.
Knowledge of insurance eligibility, CMS rules, and utilization review processes across the continuum of care.
Strong clinical judgment, communication, and independent decision-making skills.
Utilization Review certification within 12 months of hire preferred.
Completion of Mandatory Reporter abuse training within three (3) months of hire.
Primarily office-based with computer, phone, and documentation tasks.
Light physical activity with occasional lifting; use of assistive devices and additional personnel as required.
Visual acuity sufficient to review medical records and electronic systems.
Ability to work collaboratively in a fast-paced, high-stress healthcare environment while maintaining professionalism and courtesy.
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
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About Trinity Health
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Trinity Health Ann Arbor is a 537 -bed teaching hospital located on 340 acre campus. Recognized by IBM Watson as a Top 100 Hospital and #1 Teaching Hospital, Trinity Health Ann Arbor has been a leading health care provider for more than 100 years. Trinity Health has received numerous local and national awards in recognition of our leadership, quality outcomes, and clinical excellence.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Livonia, MI, US