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Utilization Manager Jobs in Rhode Island (NOW HIRING)

Bcbsri

Case Manager - Behavioral Health

Providence, RI · On-site +1

$73K - $110K/yr

Manage members through the behavioral healthcare delivery system; assess needs in order to identify ... Collaborate with the Utilization Review process including pre-authorization, concurrent review ...

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Showing results 21-40

All JobsUtilization JobsUtilization Manager JobsUtilization Manager Jobs in Rhode Island

Utilization Manager information

See Rhode Island salary details

$38.2K

$89.1K

$164K

How much do utilization manager jobs pay per year?

As of Aug 15, 2026, the average yearly pay for utilization manager in Rhode Island is $89,128.00, according to ZipRecruiter salary data. Most workers in this role earn between $58,300.00 and $107,200.00 per year, depending on experience, location, and employer.

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 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?

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 Rhode Island?

The most popular types of Utilization jobs in Rhode Island are:

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

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

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

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

What cities in Rhode Island are hiring for Utilization Manager jobs?

Cities in Rhode Island with the most Utilization Manager job openings:

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

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

Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in Rhode Island as of August 2026, with employment types broken down into 100% Full Time. Highlights an 80% In-person, and 20% Remote job distribution, with an average salary of $89,128 per year, or $42.9 per hour.

Field Reimbursement Manager - Warwick RI

Veteran Jobs - 2023 Mar 01 - Veterans Resources

Warwick, RI • Hybrid

Full-time

Posted 10 days ago

Job description

 
ATTENTION MILITARY AFFILIATED JOB SEEKERS - Our organization works with partner companies to source qualified talent for their open roles. The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers. If you have the required skill set, education requirements, and experience, please click the submit button and follow the next steps. Unless specifically stated otherwise, this role is On-Site at the location detailed in the job post.
 
Our award-winning culture is collaborative, innovative, and science based. If you have a passion for challenges and the opportunities that lay within them, you'll thrive as part of the Amgen team. Join us and transform the lives of patients while transforming your career.
Field Reimbursement Manager 
What you will do
Let's do this. Let's change the world. In this vital role the Field Reimbursement Manager (FRM) will manage defined accounts within a specified geographic region for Patient Access and Reimbursement. This role involves supporting products by executing the collaborative territory strategic plan. The FRM will ensure an understanding of the reimbursement process, field reimbursement services, and patient support programs. They will also work on patient-level reimbursement issue resolution, requiring knowledge and experience with patient health information (PHI).
Act as an extension of the HUB, providing live one-on-one coverage support
Offer assistance from physician order to reimbursement, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements and forms
Review patient-specific information in cases where the site has specifically requested assistance resolving any issues or coverage challenges
Educate and update healthcare providers (HCPs) on key private and public payer coverage and changes that impact patient product access
Coordinate access/reimbursement issues with relevant partners, including the HUB
Provide information to HCPs on how the products are covered under the benefit design (Commercial, Medicare, Medicaid)
Serve as a payer expert for defined geography and promptly communicate payer changes to key stakeholders
Offer office education during the access process, including formulary coverage/utilization management criteria, insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or claims resolution
Educate offices using approved materials
Review patient insurance benefit options and alternate funding/financial assistance programs
Collaborate with other departments to resolve reimbursement issues
Working Conditions:
3 days a week in geography for customer appointments, (geography specific)
General office demands - Remote, Work from Home.
One to two home office days per week.
Must be able to travel up to 60-80% via automobile or plane.
Must have a valid driver's license with a clean driving record.
Possible long periods of sitting and/or keyboard work.

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