Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.
PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize ... Act as liaison between managed care organizations and the facility professional clinical staff.
New
PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize ... Act as liaison between managed care organizations and the facility professional clinical staff.
New
The Utilization Review Care Manager is responsible for the direction, management and monitoring of activities related to Quality and Process Improvement, Case Management, Clinical Pathway Development ...
The Utilization Review Care Manager is responsible for the direction, management and monitoring of activities related to Quality and Process Improvement, Case Management, Clinical Pathway Development ...
The Utilization Review Care Manager is responsible for the direction, management and monitoring of activities related to Quality and Process Improvement, Case Management, Clinical Pathway Development ...
The Utilization Review Care Manager is responsible for the direction, management and monitoring of activities related to Quality and Process Improvement, Case Management, Clinical Pathway Development ...
The Utilization Review Care Manager is responsible for the direction, management and monitoring of activities related to Quality and Process Improvement, Case Management, Clinical Pathway Development ...
The Utilization Review Care Manager is responsible for the direction, management and monitoring of activities related to Quality and Process Improvement, Case Management, Clinical Pathway Development ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Act as liaison between managed care organizations and the facility professional clinical staff.
VP of Utilization Review
Franklin, TN · On-site
$120 - $180/hr
This executive leader is responsible for developing, standardizing, optimizing, and overseeing utilization management practices that support quality care, appropriate reimbursement, regulatory ...
New
VP of Utilization Review
Franklin, TN · On-site
$120 - $180/hr
This executive leader is responsible for developing, standardizing, optimizing, and overseeing utilization management practices that support quality care, appropriate reimbursement, regulatory ...
New
VP of Utilization Review
Franklin, TN · On-site +1
This executive leader is responsible for developing, standardizing, optimizing, and overseeing utilization management practices that support quality care, appropriate reimbursement, regulatory ...
VP of Utilization Review
Franklin, TN · On-site +1
This executive leader is responsible for developing, standardizing, optimizing, and overseeing utilization management practices that support quality care, appropriate reimbursement, regulatory ...
Manager of Utilization Review
Franklin, TN · On-site +1
Position Summary The Manager of Utilization Review (UR) manages the daily operations of the UR practices for an assigned division. Leads This position ensures timely initial, concurrent, and ...
Manager of Utilization Review
Franklin, TN · On-site +1
Position Summary The Manager of Utilization Review (UR) manages the daily operations of the UR practices for an assigned division. Leads This position ensures timely initial, concurrent, and ...
RN Utilization Review
Memphis, TN · On-site
$63K - $65K/yr
... Utilization Review As a nurse at Sedgwick, you can build a meaningful and rewarding career while ... Apply your RN clinical knowledge and experience to assist in the management of complex medical ...
RN Utilization Review
Memphis, TN · On-site
$63K - $65K/yr
... Utilization Review As a nurse at Sedgwick, you can build a meaningful and rewarding career while ... Apply your RN clinical knowledge and experience to assist in the management of complex medical ...
RN Utilization Review
Knoxville, TN · On-site
$63K - $65K/yr
... Utilization Review As a nurse at Sedgwick, you can build a meaningful and rewarding career while ... Apply your RN clinical knowledge and experience to assist in the management of complex medical ...
RN Utilization Review
Knoxville, TN · On-site
$63K - $65K/yr
... Utilization Review As a nurse at Sedgwick, you can build a meaningful and rewarding career while ... Apply your RN clinical knowledge and experience to assist in the management of complex medical ...
RN Utilization Review
Nashville, TN · On-site
$63K - $65K/yr
... Utilization Review As a nurse at Sedgwick, you can build a meaningful and rewarding career while ... Apply your RN clinical knowledge and experience to assist in the management of complex medical ...
RN Utilization Review
Nashville, TN · On-site
$63K - $65K/yr
... Utilization Review As a nurse at Sedgwick, you can build a meaningful and rewarding career while ... Apply your RN clinical knowledge and experience to assist in the management of complex medical ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the course of treatment for patients admitted to the inpatient and outpatient programs and coordinates ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the course of treatment for patients admitted to the inpatient and outpatient programs and coordinates ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the course of treatment for patients admitted to the inpatient and outpatient programs and coordinates ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the course of treatment for patients admitted to the inpatient and outpatient programs and coordinates ...
Description Job Summary Manages the care for a specific population; facilitates the safe transition of patients throughout the continuum of care for appropriate utilization of resources, service ...
Description Job Summary Manages the care for a specific population; facilitates the safe transition of patients throughout the continuum of care for appropriate utilization of resources, service ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the course of treatment for patients admitted to the inpatient and outpatient programs and coordinates ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the course of treatment for patients admitted to the inpatient and outpatient programs and coordinates ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the course of treatment for patients admitted to the inpatient and outpatient programs and coordinates ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the course of treatment for patients admitted to the inpatient and outpatient programs and coordinates ...
Utilization Manager information
See Tennessee salary details
$35.4K - $46K
9% of jobs
$53.8K is the 25th percentile. Wages below this are outliers.
$46K - $56.6K
22% of jobs
$56.6K - $67.2K
11% of jobs
The median wage is $73.7K / yr.
$67.2K - $77.8K
14% of jobs
$77.8K - $88.4K
12% of jobs
$95K is the 75th percentile. Wages above this are outliers.
$88.4K - $99K
13% of jobs
$99K - $109.6K
13% of jobs
$109.6K - $120.2K
5% of jobs
$120.2K - $130.8K
2% of jobs
$130.8K - $141.4K
0% of jobs
$141.4K - $152K
0% of jobs
$35.4K
$82.6K
$152K
How much do utilization manager jobs pay per year?
As of Aug 7, 2026, the average yearly pay for utilization manager in Tennessee is $82,603.00, according to ZipRecruiter salary data. Most workers in this role earn between $54,000.00 and $99,400.00 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?
| 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.
More about Utilization Manager jobs
What are the most commonly searched types of Utilization jobs in Tennessee? The most popular types of Utilization jobs in Tennessee are:
What cities in Tennessee are hiring for Utilization Manager jobs? Cities in Tennessee with the most Utilization Manager job openings:
What are popular job titles related to Utilization Manager jobs in TN? For Utilization Manager jobs in TN, the most frequently searched job titles are:
Utilization Specialist - Part Time
Nashville, TN • On-site
Part-time
Re-posted 6 days ago
Job description
Overview
PURPOSE STATEMENT:
Proactively monitor utilization of services for patients to optimize reimbursement for the facility.
ResponsibilitiesESSENTIAL FUNCTIONS:
- Act as liaison between managed care organizations and the facility professional clinical staff.
- Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
- Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.
- Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
- Conduct quality reviews for medical necessity and services provided.
- Facilitate peer review calls between facility and external organizations.
- Initiate and complete the formal appeal process for denied admissions or continued stay.
- Assist the admissions department with pre-certifications of care.
- Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.
OTHER FUNCTIONS:
- Perform other functions and tasks as assigned.
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
- Required Education: High school diploma or equivalent.
- Preferred Education: Associate's, Bachelor's, or Master's degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field.
- Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred
LICENSES/DESIGNATIONS/CERTIFICATIONS:
- Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
- CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.
- First aid may be required based on state or facility requirements.
ADDITIONAL REGULATORY REQUIREMENTS:
While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances (e.g. emergencies, changes in workload, rush jobs or technological developments) dictate.
We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.
ASCST
Employment Type: PART_TIME