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Utilization Manager Jobs in Oklahoma (NOW HIRING)

Healthcare Scouts

Hospital Case Manager

Tulsa, OK · On-site

Responsible for all case management activities assignedm, including case management and utilization management * The Case Manager provides concise management of patients hospitalization from pre ...

OU Health

Palliative RN Care Manager

Oklahoma City, OK · On-site

OUMC Care Management New to OU Health? Ask your recruiter about our competitive wages and total ... Evaluate healthcare utilization patterns and identify opportunities for improving efficiency and ...

Artesian Hotel

Inpatient Case Manager

Ada, OK · On-site

$52 - $72/hr

Summary Provides comprehensive nursing care and care coordination, including patient education, clinical support, case management, and utilization review activities to support appropriate resource ...

New

The Chickasaw Nation

Inpatient Case Manager

Ada, OK · On-site

Provides comprehensive nursing care and care coordination, including patient education, clinical support, case management, and utilization review activities to support appropriate resource use and ...

OU Health

Palliative RN Care Manager

Oklahoma City, OK · On-site

OUMC Care Management New to OU Health? Ask your recruiter about our competitive wages and total ... Evaluate healthcare utilization patterns and identify opportunities for improving efficiency and ...

Bluestone Physician Services

$68K - $80K/yr

Gaps-in-Care & Utilization Management: Proactively identify and close clinical and documentation gaps to support Value-Based Care (VBC) contracts, including ACO initiatives. Take accountability for ...

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Showing results 21-40

All JobsUtilization JobsUtilization Manager JobsUtilization Manager Jobs in Oklahoma

Utilization Manager information

See Oklahoma salary details

$36K

$84K

$154.7K

How much do utilization manager jobs pay per year?

As of Sep 4, 2026, the average yearly pay for utilization manager in Oklahoma is $84,034.00, according to ZipRecruiter salary data. Most workers in this role earn between $54,900.00 and $101,100.00 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 Oklahoma?

The most popular types of Utilization jobs in Oklahoma are:

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

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

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

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

What cities in Oklahoma are hiring for Utilization Manager jobs?

Cities in Oklahoma with the most Utilization Manager job openings:

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

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

Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in Oklahoma as of August 2026, with employment types broken down into 84% Full Time, 14% Part Time, and 2% Contract. Highlights an 82% Physical, 2% Hybrid, and 16% Remote job distribution, with an average salary of $84,034 per year, or $40.4 per hour.

Medical Management - Senior Manager Clinical Governance and Performance 145-2056

CommunityCare

Tulsa, OK • On-site

Full-time

Re-posted 10 days ago

Job description

WORK ARRANGEMENT:
Remote, with occasional travel as needed for meetings, audits, training, or other business requirements.
JOB SUMMARY:
Responsible for leading governance, audit readiness, training, policy and procedure management, corrective action oversight, and performance improvement across Physical Health Utilization Management, Behavioral Health Utilization Management, Pharmacy Utilization Management, and Appeals and Grievances.
Reporting to the Chief Medical Officer, the Director provides centralized leadership for internal and delegated entity auditing, continuous regulatory and accreditation readiness, corrective action monitoring, operational training, process standardization, and alignment of policies and procedures across the assigned functions.
Works closely with clinical and operational leaders to translate Medicare Advantage, Marketplace, state, accreditation, contractual, and organizational requirements into consistent and sustainable operational practices. Serves as the Chief Medical Officer's designated leader for governance and performance activities within the assigned areas and provides leadership to audit, training, administrative support, and process improvement staff.
KEY RESPONSIBILITIES:
  • Lead governance and performance activities across Physical Health UM, Behavioral Health UM, Pharmacy UM, and Appeals and Grievances.
  • Maintain continuous readiness for CMS, Marketplace, state, URAC, delegated oversight, contractual, and internal audits.
  • Develop and oversee risk-based internal and delegated entity audits, including operational and clinical reviews.
  • Establish standardized audit tools, sampling methods, scoring, documentation requirements, reporting, and escalation thresholds.
  • Analyze audit and monitoring results to identify trends, control gaps, training needs, repeat findings, and systemic risk.
  • Oversee corrective action plans, including root cause analysis, accountable owners, remediation timelines, effectiveness monitoring, and closure.
  • Escalate material findings, delayed remediation, repeat deficiencies, and delegate performance concerns to the Chief Medical Officer and appropriate leaders.
  • Oversee onboarding, annual, regulatory, remedial, and role-specific training and monitors completion, competency, and effectiveness.
  • Lead the development, alignment, implementation, and maintenance of policies, desk level procedures, and related operational documents.
  • Monitor regulatory and accreditation changes and coordinates updates to policies, procedures, training, audit tools, and operational practices.
  • Use audit findings, appeals and grievance trends, complaints, overturns, delegate performance, and operational data to identify improvement opportunities.
  • Lead process improvement initiatives and cross-functional workgroups addressing operational, regulatory, and performance concerns.
  • Develop reports and governance updates for the Chief Medical Officer, functional leaders, and applicable committees.
  • Partner with Compliance, Legal, Quality, Contracting, Credentialling, HR, and other departments as appropriate.
  • Provide leadership, performance oversight, and professional development for assigned audit, training, administrative support, and process improvement staff.
  • Perform other related job duties as required or assigned.

QUALIFICATIONS:
  • Demonstrated leadership ability within a health plan, managed care, or similarly regulated health care environment.
  • Strong knowledge of Medicare Advantage and Marketplace regulatory and operational requirements for a health plan.
  • Broad understanding of health plan operations, including utilization management, prior authorization, organization and coverage determinations, appeals, grievances, notices, delegation, and member and provider communications.
  • Demonstrated experience with continuous audit readiness, internal auditing, delegated entity oversight, corrective action planning, policy and procedure management, training, and performance improvement.
  • Ability to interpret complex regulatory, accreditation, contractual, and operational requirements and translate them into practical and sustainable processes.
  • Strong analytical skills with the ability to identify trends, systemic risks, control gaps, root causes, and improvement opportunities.
  • Ability to exercise authority and influence across multiple operational areas while maintaining collaborative relationships with functional leaders.
  • Ability to distinguish regulatory requirements from organizational policy, clinical judgment, and operational preference.
  • Well-developed written, verbal, interpersonal, facilitation, and presentation skills.
  • Strong organizational and project management skills with the ability to manage competing priorities and regulatory deadlines.
  • Ability to respectfully challenge existing practices, escalate concerns appropriately, and facilitate cross-functional resolutions.
  • Demonstrated sound judgment, integrity, accountability, professionalism, and discretion.
  • Successful completion of Health Care Sanctions background check.
  • Successful completion of pre-employment drug testing.
  • Ability to converse and write fluently in English.

EDUCATION/EXPERIENCE:
  • Bachelor's degree in health care administration, business administration, public health, nursing, compliance, pharmacy, quality, or a related field.
  • Minimum of five years of progressive experience in health plan operations, utilization management, appeals and grievances, regulatory operations, auditing, accreditation, delegated oversight, performance improvement, or a related function.
  • Minimum of three years of leadership or supervisory experience, including responsibility for staff performance, development, and accountability.
  • Demonstrated experience supporting or leading CMS, URAC, state, delegated entity, client, or internal audit activities.
  • Demonstrated experience developing or overseeing audit programs, corrective action plans, policies, procedures, training programs, or operational monitoring.
  • Experience with Medicare Advantage program audits, organization determinations, coverage determinations, appeals, grievances, reopening requirements, and delegated oversight strongly preferred.
  • Experience with Marketplace requirements and URAC accreditation audits strongly preferred.
  • Experience leading multidisciplinary teams or functions involving audit, training, policy management, administrative support, or process improvement preferred.
  • Advanced degree or certification in health care administration, compliance, quality, audit, project management, or process improvement preferred.

CommunityCare is an equal opportunity at will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation or national origin

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