Direct and manage the day-to-day operations of the Utilization Review department. ESSENTIAL FUNCTIONS: * Monitor utilization of services and optimize reimbursement for the facility while maximizing ...
Direct and manage the day-to-day operations of the Utilization Review department. ESSENTIAL FUNCTIONS: * Monitor utilization of services and optimize reimbursement for the facility while maximizing ...
The Utilization Management Coordinator will report to the Director of Utilization Review and will be responsible to provide quality case management services to all patients and their families, to ...
The Utilization Management Coordinator will report to the Director of Utilization Review and will be responsible to provide quality case management services to all patients and their families, to ...
Director of Utilization
El Paso, TX · On-site
Direct and manage the day-to-day operations of the Utilization Review department. Responsibilities ESSENTIAL FUNCTIONS: * Monitor utilization of services and optimize reimbursement for the facility ...
Director of Utilization
El Paso, TX · On-site
Direct and manage the day-to-day operations of the Utilization Review department. Responsibilities ESSENTIAL FUNCTIONS: * Monitor utilization of services and optimize reimbursement for the facility ...
The Utilization Management Nurse PRN is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This Nurse ...
The Utilization Management Nurse PRN is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This Nurse ...
Director of Utilization
El Paso, TX · On-site
Direct and manage the day-to-day operations of the Utilization Review department. Responsibilities ESSENTIAL FUNCTIONS: * Monitor utilization of services and optimize reimbursement for the facility ...
Director of Utilization
El Paso, TX · On-site
Direct and manage the day-to-day operations of the Utilization Review department. Responsibilities ESSENTIAL FUNCTIONS: * Monitor utilization of services and optimize reimbursement for the facility ...
The Utilization Management Coordinator will report to the Director of Utilization Review and will be responsible to provide quality case management services to all patients and their families, to ...
The Utilization Management Coordinator will report to the Director of Utilization Review and will be responsible to provide quality case management services to all patients and their families, to ...
Summary Job Summary Provides strategic leadership and oversight of El Paso Health's Utilization Management (UM) program, including planning, development, implementation, and continuous quality ...
Summary Job Summary Provides strategic leadership and oversight of El Paso Health's Utilization Management (UM) program, including planning, development, implementation, and continuous quality ...
Job Profile Job Summary The Utilization Management Review Nurse (UMRN) performs technical and administrative work required to evaluate the necessity, appropriateness, and efficiency of the ...
Job Profile Job Summary The Utilization Management Review Nurse (UMRN) performs technical and administrative work required to evaluate the necessity, appropriateness, and efficiency of the ...
Job Summary Provides strategic leadership and oversight of El Paso Health's Utilization Management (UM) program, including planning, development, implementation, and continuous quality improvement of ...
Job Summary Provides strategic leadership and oversight of El Paso Health's Utilization Management (UM) program, including planning, development, implementation, and continuous quality improvement of ...
Job Summary Provides strategic leadership and oversight of El Paso Health's Utilization Management (UM) program, including planning, development, implementation, and continuous quality improvement of ...
Job Summary Provides strategic leadership and oversight of El Paso Health's Utilization Management (UM) program, including planning, development, implementation, and continuous quality improvement of ...
The Utilization Management Nurse II is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This Nurse ...
The Utilization Management Nurse II is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This Nurse ...
The Utilization Management Nurse II is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This Nurse ...
The Utilization Management Nurse II is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This Nurse ...
Utilization Review Nurse
Dallas, TX · Remote
As a Utilization Review Nurse (UR Nurse) , you'll play an important role in helping us offer ... The UR Nurse collaborates closely with intake staff, physicians, specialists, case managers, and ...
Utilization Review Nurse
Dallas, TX · Remote
As a Utilization Review Nurse (UR Nurse) , you'll play an important role in helping us offer ... The UR Nurse collaborates closely with intake staff, physicians, specialists, case managers, and ...
Utilization Review Nurse
Dallas, TX · On-site
$90K - $98K/yr
As a Utilization Review Nurse (UR Nurse) , you'll play an important role in helping us offer ... The UR Nurse collaborates closely with intake staff, physicians, specialists, case managers, and ...
Quick apply
Utilization Review Nurse
Dallas, TX · On-site
$90K - $98K/yr
As a Utilization Review Nurse (UR Nurse) , you'll play an important role in helping us offer ... The UR Nurse collaborates closely with intake staff, physicians, specialists, case managers, and ...
This role serves as the clinical lead for utilization management and a key contributor to denial prevention, partnering closely with Denial Management and Revenue Cycle teams to proactively identify ...
This role serves as the clinical lead for utilization management and a key contributor to denial prevention, partnering closely with Denial Management and Revenue Cycle teams to proactively identify ...
Two (2) years prior experience with Utilization Management. * Previous training and demonstrated competence in negotiations, quality assurance, case management outcomes, and keyboarding/computer use.
Two (2) years prior experience with Utilization Management. * Previous training and demonstrated competence in negotiations, quality assurance, case management outcomes, and keyboarding/computer use.
This role serves as the clinical lead for utilization management and a key contributor to denial prevention, partnering closely with Denial Management and Revenue Cycle teams to proactively identify ...
This role serves as the clinical lead for utilization management and a key contributor to denial prevention, partnering closely with Denial Management and Revenue Cycle teams to proactively identify ...
Two (2) years prior experience with Utilization Management. * Previous training and demonstrated competence in negotiations, quality assurance, case management outcomes, and keyboarding/computer use.
Two (2) years prior experience with Utilization Management. * Previous training and demonstrated competence in negotiations, quality assurance, case management outcomes, and keyboarding/computer use.
Ensures the Utilization Management (UM) unit's compliance with all regulatory agencies' rules and regulations, which govern health plan operations. Serves as the primary back up for the inpatient ...
Ensures the Utilization Management (UM) unit's compliance with all regulatory agencies' rules and regulations, which govern health plan operations. Serves as the primary back up for the inpatient ...
The Utilization Management Nurse II is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This Nurse ...
The Utilization Management Nurse II is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This Nurse ...
Utilization Manager information
See Texas salary details
$36.3K - $47.2K
9% of jobs
$55.3K is the 25th percentile. Wages below this are outliers.
$47.2K - $58.1K
22% of jobs
$58.1K - $69K
11% of jobs
The median wage is $75.7K / yr.
$69K - $79.9K
14% of jobs
$79.9K - $90.8K
12% of jobs
$97.6K is the 75th percentile. Wages above this are outliers.
$90.8K - $101.6K
13% of jobs
$101.6K - $112.5K
13% of jobs
$112.5K - $123.4K
5% of jobs
$123.4K - $134.3K
2% of jobs
$134.3K - $145.2K
0% of jobs
$145.2K - $156.1K
0% of jobs
$36.3K
$84.8K
$156.1K
How much do utilization manager jobs pay per year?
What does a utilization manager do?
What jobs pay 4000 a week without a degree?
What are the key skills and qualifications needed to thrive as a Utilization Manager, and why are they important?
What is the highest paying job in healthcare management?
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.
Is being a MOA a good entry level job?
- Flexible Cvs Utilization Management Nurse
- Chart Reviewer
- Pre Service Review Nurse
- Healthcare Revenue Cycle Manager
- Remote Cvs Utilization Management Nurse
- Lvn Utilization Review
- Entry Level Utilization Management Nurse
- Freelance Physician Case Reviewer
- Remote Utilization Management
- Overnight Physician Case Reviewer
- Director Optum Utilization Review
- Commission Anthem Utilization Review
- Utilization Management Care Coordinator
- Assistant Remote Utilization Review
- Utilization Management Team Lead
- Care Manager
- Night Shift Optum Utilization Review
- Flex Schedule Utilization Review
- Authorization Utilization Review
- Free Utilization Review Training

Acadia Healthcare rating
6.2
Based on 189 frontline employees who took The Breakroom Quiz
696th of 884 rated healthcare providers
Job description
PURPOSE STATEMENT:
Direct and manage the day-to-day operations of the Utilization Review department.
ESSENTIAL FUNCTIONS:
- Monitor utilization of services and optimize reimbursement for the facility while maximizing use of the patient’s provider benefits for their needs.
- Conducts and oversees concurrent and retrospective reviews for all patients.
- Act as a liaison between Medicaid reviewers and the staff completing required paperwork to facilitate the Utilization Review process.
- Collaborates with physicians, therapist and nursing staff to provide optimal review based on patient needs.
- Collaborates with ancillary services in order to prevent delays in services.
- Evaluates the UM program for compliance with regulations, policies and procedures.
- May review charts and make necessary recommendations to the physicians, regarding utilization review and specific managed care issues.
- Provide staff management to including hiring, development, training, performance management and communication to ensure effective and efficient department operation.
OTHER FUNCTIONS:
- Perform other functions and tasks as assigned.
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
- Bachelor's Degree in nursing or other clinical field required. Master's Degree in clinical field preferred.
- Six or more year's clinical experience with the population of the facility preferred.
- Four or more years’ experience in utilization management required.
- Three or more years of supervisoryexperience required.
LICENSES/DESIGNATIONS/CERTIFICATIONS:
- If applicable, current licensure as an LPN or RN 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.
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.
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About Acadia Healthcare
Sourced by ZipRecruiter
Acadia Healthcare is a leading provider in the healthcare and hospital industry, based in Franklin, Tennessee, United States. The company is recognised for its commitment to creating a behavioural health network that provides accessible, high-quality treatment options for individuals suffering from mental health issues, addiction, eating disorders, and PTSD. Acadia Healthcare was founded in 2005, with the mission to create a world-class organization that sets the standard of excellence in the treatment of specialty behavioural health and addiction disorders.
Industry
Hospitals
Company size
10,000+ Employees
Headquarters location
Franklin, TN, US
Year founded
2005