Network Performance/Utilization Manager Accenture is a leading global professional services company that helps the world's leading businesses, governments and other organizations build their digital ...
Network Performance/Utilization Manager Accenture is a leading global professional services company that helps the world's leading businesses, governments and other organizations build their digital ...
Utilization Coordinator PRN
Louisville, KY · On-site
$20/hr
The UM Coordinator is responsible for managing and coordinating the treatment activities offered to ... Required: One year of experience in Utilization Management Preferred: Three to five years of ...
Utilization Coordinator PRN
Louisville, KY · On-site
$20/hr
The UM Coordinator is responsible for managing and coordinating the treatment activities offered to ... Required: One year of experience in Utilization Management Preferred: Three to five years of ...
Utilization Coordinator PRN
Louisville, KY · On-site
$20/hr
The UM Coordinator is responsible for managing and coordinating the treatment activities offered to ... Required: One year of experience in Utilization Management Preferred: Three to five years of ...
Utilization Coordinator PRN
Louisville, KY · On-site
$20/hr
The UM Coordinator is responsible for managing and coordinating the treatment activities offered to ... Required: One year of experience in Utilization Management Preferred: Three to five years of ...
The Utilization Management Nurse 2 also plays a key role in facilitating comprehensive, proactive, and barrier-focused discharge planning to home or a lower level of care. The Utilization Management ...
The Utilization Management Nurse 2 also plays a key role in facilitating comprehensive, proactive, and barrier-focused discharge planning to home or a lower level of care. The Utilization Management ...
The Utilization Management Representative I is responsible for coordinating cases for ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
The Utilization Management Representative I is responsible for coordinating cases for ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
The Utilization Management Nurse 2 also plays a key role in facilitating comprehensive, proactive, and barrier-focused discharge planning to home or a lower level of care. The Utilization Management ...
The Utilization Management Nurse 2 also plays a key role in facilitating comprehensive, proactive, and barrier-focused discharge planning to home or a lower level of care. The Utilization Management ...
The Utilization Management Nurse 2 also plays a key role in facilitating comprehensive, proactive, and barrier-focused discharge planning to home or a lower level of care. The Utilization Management ...
The Utilization Management Nurse 2 also plays a key role in facilitating comprehensive, proactive, and barrier-focused discharge planning to home or a lower level of care. The Utilization Management ...
Assists the Utilization Management Department with all utilization activities as requested and directed. * Participates in education on and implementation of clinical guidelines and protocols.
Assists the Utilization Management Department with all utilization activities as requested and directed. * Participates in education on and implementation of clinical guidelines and protocols.
Assists the Utilization Management Department with all utilization activities as requested and directed. * Participates in education on and implementation of clinical guidelines and protocols.
Assists the Utilization Management Department with all utilization activities as requested and directed. * Participates in education on and implementation of clinical guidelines and protocols.
Assists the Utilization Management Department with all utilization activities as requested and directed. * Participates in education on and implementation of clinical guidelines and protocols.
Assists the Utilization Management Department with all utilization activities as requested and directed. * Participates in education on and implementation of clinical guidelines and protocols.
They are responsible for the delivery of the Utilization Management process including but not limited to: making clinical recommendations regarding medical necessity for admission and continues stay ...
They are responsible for the delivery of the Utilization Management process including but not limited to: making clinical recommendations regarding medical necessity for admission and continues stay ...
Utilization Management Nurse RN
$75K - $82K/yr
Collaborate regularly and maintain open communication with leadership, patients, families, internal care givers, and external Utilization Management Nurses. * Coordinate internal and external health ...
Quick apply
Utilization Management Nurse RN
$75K - $82K/yr
Collaborate regularly and maintain open communication with leadership, patients, families, internal care givers, and external Utilization Management Nurses. * Coordinate internal and external health ...
Utilization Management Nurse RN
$75K - $82K/yr
Collaborate regularly and maintain open communication with leadership, patients, families, internal care givers, and external Utilization Management Nurses. * Coordinate internal and external health ...
Quick apply
Utilization Management Nurse RN
$75K - $82K/yr
Collaborate regularly and maintain open communication with leadership, patients, families, internal care givers, and external Utilization Management Nurses. * Coordinate internal and external health ...
Secondary Physician Reviewer at Greenlife Healthcare Staffing Raceland, KY
Raceland, KY · On-site
$158.42 - $165.31/hr
Position Overview Lead utilization management efforts by conducting critical second-level medical necessity reviews. Ensure optimal resource allocation and compliance with CMS/payer guidelines while ...
Secondary Physician Reviewer at Greenlife Healthcare Staffing Raceland, KY
Raceland, KY · On-site
$158.42 - $165.31/hr
Position Overview Lead utilization management efforts by conducting critical second-level medical necessity reviews. Ensure optimal resource allocation and compliance with CMS/payer guidelines while ...
RN Utilization Review PRN
Paris, KY · On-site
PRN, RN - Utilization Review Making Communities Healthier with Comprehensive Care... You can get to know who we are and what truly makes us different by our mission, 'Making Communities Healthier'
RN Utilization Review PRN
Paris, KY · On-site
PRN, RN - Utilization Review Making Communities Healthier with Comprehensive Care... You can get to know who we are and what truly makes us different by our mission, 'Making Communities Healthier'
Utilization Management Peer-to-Peer Specialist
Jeffersontown, KY · On-site
$16.50 - $21.25/hr
... Utilization Management Department's goals and objectives. This position reports directly to the UM ... Partner with manager to align P2P meeting workflow with the Case Management Department goals and ...
Utilization Management Peer-to-Peer Specialist
Jeffersontown, KY · On-site
$16.50 - $21.25/hr
... Utilization Management Department's goals and objectives. This position reports directly to the UM ... Partner with manager to align P2P meeting workflow with the Case Management Department goals and ...
Utilization Management Peer-to-Peer Specialist
Louisville, KY · On-site
$16.50 - $21.25/hr
... Utilization Management Department's goals and objectives. This position reports directly to the UM ... Partner with manager to align P2P meeting workflow with the Case Management Department goals and ...
Utilization Management Peer-to-Peer Specialist
Louisville, KY · On-site
$16.50 - $21.25/hr
... Utilization Management Department's goals and objectives. This position reports directly to the UM ... Partner with manager to align P2P meeting workflow with the Case Management Department goals and ...
Utilization Management Peer-to-Peer Specialist
Jeffersontown, KY · On-site
$16.50 - $21.25/hr
... Utilization Management Department's goals and objectives. This position reports directly to the UM ... Partner with manager to align P2P meeting workflow with the Case Management Department goals and ...
Utilization Management Peer-to-Peer Specialist
Jeffersontown, KY · On-site
$16.50 - $21.25/hr
... Utilization Management Department's goals and objectives. This position reports directly to the UM ... Partner with manager to align P2P meeting workflow with the Case Management Department goals and ...
Summary Case Manager RN (ED) Full-Time, First Shift Fri - Sun 10 am - 10 pm BHCOR-Case Management I ... Completes patient assessments, utilization reviews, and high-risk screenings to identify care needs ...
Summary Case Manager RN (ED) Full-Time, First Shift Fri - Sun 10 am - 10 pm BHCOR-Case Management I ... Completes patient assessments, utilization reviews, and high-risk screenings to identify care needs ...
Case Management Social Worker / Nurse Case Manager - Weekday PRN
Hopkinsville, KY · On-site
$21.75 - $28.50/hr
This role is essential in promoting quality outcomes, efficient resource utilization, patient ... Nurse Case Manager Pathway: * Graduate of an accredited nursing program required. * Associate ...
Case Management Social Worker / Nurse Case Manager - Weekday PRN
Hopkinsville, KY · On-site
$21.75 - $28.50/hr
This role is essential in promoting quality outcomes, efficient resource utilization, patient ... Nurse Case Manager Pathway: * Graduate of an accredited nursing program required. * Associate ...
Utilization Manager information
See Kentucky salary details
$33.9K - $44K
9% of jobs
$51.5K is the 25th percentile. Wages below this are outliers.
$44K - $54.2K
22% of jobs
$54.2K - $64.3K
11% of jobs
The median wage is $70.6K / yr.
$64.3K - $74.5K
14% of jobs
$74.5K - $84.6K
12% of jobs
$90.9K is the 75th percentile. Wages above this are outliers.
$84.6K - $94.7K
13% of jobs
$94.7K - $104.9K
13% of jobs
$104.9K - $115K
5% of jobs
$115K - $125.2K
2% of jobs
$125.2K - $135.3K
0% of jobs
$135.3K - $145.5K
0% of jobs
$33.9K
$79K
$145.5K
How much do utilization manager jobs pay per year?
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 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.
- Manager Care Management
- Utilization Management Nurse
- Independent Contractor Remote Utilization Management Nurse
- Remote Utilization Management
- Temporary Utilization Review Nurse
- Utilization Review Therapist
- Flexible Cvs Utilization Management Nurse
- Freelance Physician Case Reviewer
- Registered Nurse Utilization Review
- Mckesson Nurse

Full-time
Posted 8 days ago
Accenture Federal Services rating
8.7
Based on 20 frontline employees who took The Breakroom Quiz
44th of 481 rated business services
Job description
Network Performance/Utilization Manager
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 791,000 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. Our broad range of services, solutions and assets across Strategy & Consulting, Technology, Operations, Industry X and Song, 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
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).
What Accenture Federal Services employees say
Pay
Benefits
Hours and flexibility
Workplace
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About Accenture Federal Services
Sourced by ZipRecruiter
Industry
It services
Company size
10,000+ Employees
Headquarters location
Arlington, VA, US
Year founded
1989