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Utilization Manager Jobs in Albuquerque, NM (NOW HIRING)

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Utilization Manager information

See Albuquerque, NM salary details

$37.8K

$88.2K

$162.4K

How much do utilization manager jobs pay per year?

As of Sep 3, 2026, the average yearly pay for utilization manager in Albuquerque, NM is $88,219.00, according to ZipRecruiter salary data. Most workers in this role earn between $57,700.00 and $106,100.00 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 popular job titles related to Utilization Manager jobs in Albuquerque, NM?

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

What job categories do people searching Utilization Manager jobs in Albuquerque, NM look for?

The top searched job categories for Utilization Manager jobs in Albuquerque, NM are:

Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in Albuquerque, NM as of August 2026, with employment types broken down into 85% Full Time, 13% Part Time, and 2% Contract. Highlights an 83% Physical, 2% Hybrid, and 15% Remote job distribution, with an average salary of $88,219 per year, or $42.4 per hour.

RN Case Manager - Inpatient Care Coordination

Presbyterian Healthcare Services

Albuquerque, NM • On-site

$36.41 - $62/hr

Per diem

Re-posted 24 days ago

Presbyterian Healthcare Services rating

7.2

Company rating: 7.2 out of 10

Based on 164 frontline employees who took The Breakroom Quiz

344th of 898 rated healthcare providers

Job description

Location Address:
1100 Central Ave SEAlbuquerque, NM 87106-4930
Compensation Pay Range:
Minimum Offer $36.41Maximum Offer $62.00
Summary:
Make a difference. Presbyterian Hospital is hiring a RN Case Manager that will provide clinically-based case management to support the delivery of effective and efficient patient care. The role integrates utilization management, care coordination, and transition planning functions. The Case Manager has the overall accountability for a designated case load and plans effectively in order to meet patients needs, manage the length of stay, and promote efficient utilization of resources. In collaboration with the interdisciplinary team, the case manager supports the physician in facilitating patient care with the objective of enhancing the quality of patient outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information to payers.
How you grow, learn and thrive matters here.
• Educational and career development options, including tuition and certification reimbursement, scholarship opportunities
• Staff Safety (a wearable badge that allows nurses to quickly and discreetly call for help when safety is a concern)
• Differentials for night/weekend shifts, higher education, certifications and various lead roles (for eligible positions)
• Malpractice liability insurance
• Loan forgiveness through the New Mexico Higher Education Department
• EPIC electronic charting system
Type of Opportunity: PRNFTE: 0.00Job Exempt: NoWork Shift: Days (United States of America)
Responsibilities:
As an RN Case Manager, you will manage a designated caseload, collaborating with an interdisciplinary team to optimize length of stay, coordinate discharge planning, and support safe transitions across the continuum of care. You will partner with physicians, patients, families, payers, and post-acute providers to improve outcomes, enhance patient satisfaction, and reduce barriers to discharge.
PRN- As needed
Work Schedule: Days
Days 8 hour or 10 hour shifts
Presbyterian Hospital - On-Site
  • Manage Patient Caseloads Across the Continuum of Care - Conduct comprehensive assessments, identify barriers to discharge, and ensure patients receive the right care at the right time from admission through transition.
  • Coordinate Utilization Management and Status Determination - Apply approved clinical criteria to monitor admissions and continued stay, collaborate with providers on medical necessity documentation, and escalate cases as appropriate.
  • Lead Discharge Planning and Care Transitions - Develop and coordinate individualized discharge plans, arrange post-acute services, and ensure timely, safe transitions to prevent delays and reduce readmissions.
  • Collaborate with Interdisciplinary Teams - Partner with physicians, nursing, social work, and ancillary services through daily rounds, care conferences, and complex case discussions to optimize length of stay and patient outcomes.
  • Drive Quality, Communication, and Documentation Excellence - Maintain accurate, timely documentation; communicate effectively with patients, families, and payers; and contribute to performance improvement and professional development initiatives.

Qualifications:
RN IMM Case Management I
  • Associates Degree in nursing required.
  • *BSN within 5 years of hire date.
  • Current State of New Mexico Registered Nurse licensure required.
  • 2 years clinical nursing experience in relevant clinical practice area with utilization review or case management experience desirable.
  • National Case Management certification preferred

RN IMM Case Management II
  • Registered Nurse with Bachelors of Science in nursing (BSN) degree or Registered Nurse with Associates degree in nursing (ADN) plus five years utilization review or case management experience required.
  • BSN to be obtained within 5 years of hire date.
  • Current State of New Mexico Registered Nurse licensure required.
  • 2 years adult bedside experience required.
  • National Case Management certification preferred

RN IMM Case Management III
  • Bachelors degree in nursing plus 5 years utilization review or case management experience required; or Masters degree in Nursing.
  • Current State of New Mexico Registered Nurse licensure required.
  • 2 years adult bedside experience required.
  • National Case Management certification preferred.

RN IMM Case Management IV
  • Masters degree in nursing plus 5 years utilization review or case management experience required; or Bachelors degree in nursing plus 10 years utilization review or case management experience required.
  • Current State of New Mexico Registered Nurse licensure required.
  • 2 years adult bedside experience required.
  • National Case Management certification preferred

We're all about well-being, starting with yours.
Presbyterian employees have access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more.
Learn more about our employee benefits.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
Compensation Disclaimer
The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.
We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services

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About Presbyterian Healthcare Services

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Presbyterian Healthcare Services exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1,600 providers and nearly 4,700 nurses.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Albuquerque, NM, US

Year founded

1908

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