As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise clients on network strategy, provider capacity,utilizationtrends, access challenges, and market ...
As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise clients on network strategy, provider capacity,utilizationtrends, access challenges, and market ...
Utilization management includes, but is not limited to, analyzing entrance into care environments from multiple perspectives including payors, healthcare system, patient/family, and providers ...
Utilization management includes, but is not limited to, analyzing entrance into care environments from multiple perspectives including payors, healthcare system, patient/family, and providers ...
Utilization management includes, but is not limited to, analyzing entrance into care environments from multiple perspectives including payors, healthcare system, patient/family, and providers ...
Utilization management includes, but is not limited to, analyzing entrance into care environments from multiple perspectives including payors, healthcare system, patient/family, and providers ...
Utilization management includes, but is not limited to, analyzing entrance into care environments from multiple perspectives including payors, healthcare system, patient/family, and providers ...
Utilization management includes, but is not limited to, analyzing entrance into care environments from multiple perspectives including payors, healthcare system, patient/family, and providers ...
Director, Utilization Management
$70.03 - $81.19/hr
Utilization management includes, but is not limited to, analyzing entrance into care environments from multiple perspectives including payors, healthcare system, patient/family, and providers ...
Director, Utilization Management
$70.03 - $81.19/hr
Utilization management includes, but is not limited to, analyzing entrance into care environments from multiple perspectives including payors, healthcare system, patient/family, and providers ...
Utilization Manager- Region 3 Field Office- Atlanta Pay Grade: K Workplace: Hybrid- 1 to 2 days per week in office Travel: 10% Job Summary: Serves as the Regional Field Office subject matter expert ...
Utilization Manager- Region 3 Field Office- Atlanta Pay Grade: K Workplace: Hybrid- 1 to 2 days per week in office Travel: 10% Job Summary: Serves as the Regional Field Office subject matter expert ...
Utilization Manager- Region 3 Field Office- Atlanta Pay Grade: K Workplace: Hybrid- 1 to 2 days per week in office Travel: 10% Job Summary: Serves as the Regional Field Office subject matter expert ...
Utilization Manager- Region 3 Field Office- Atlanta Pay Grade: K Workplace: Hybrid- 1 to 2 days per week in office Travel: 10% Job Summary: Serves as the Regional Field Office subject matter expert ...
The Utilization Management Representative I is responsible for coordinating cases for ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
The Utilization Management Representative I is responsible for coordinating cases for ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Previous experience in Utilization Management and/or Appeals Required * Previous Epic experience or Meditech/MIDAS experience Required * Previous experience in prior authorization process Required
Previous experience in Utilization Management and/or Appeals Required * Previous Epic experience or Meditech/MIDAS experience Required * Previous experience in prior authorization process Required
Previous experience in Utilization Management and/or Appeals Required * Previous Epic experience or Meditech/MIDAS experience Required * Previous experience in prior authorization process Required
Previous experience in Utilization Management and/or Appeals Required * Previous Epic experience or Meditech/MIDAS experience Required * Previous experience in prior authorization process Required
Previous experience in Utilization Management and/or Appeals Required * Previous Epic experience or Meditech/MIDAS experience Required * Previous experience in prior authorization process Required
Previous experience in Utilization Management and/or Appeals Required * Previous Epic experience or Meditech/MIDAS experience Required * Previous experience in prior authorization process Required
Utilization Management Representative I
Atlanta, GA · On-site
$15.50 - $21/hr
Utilization Management Representative I Utilization Management Representative I Location : This ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Utilization Management Representative I
Atlanta, GA · On-site
$15.50 - $21/hr
Utilization Management Representative I Utilization Management Representative I Location : This ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Case Manager
Alpharetta, GA · Remote
$19.50 - $25.25/hr
Collects and analyzes utilization data. Assists with discharge planning and ambulatory follow up ... Knowledge of utilization management procedures, mental health and substance abuse community ...
Case Manager
Alpharetta, GA · Remote
$19.50 - $25.25/hr
Collects and analyzes utilization data. Assists with discharge planning and ambulatory follow up ... Knowledge of utilization management procedures, mental health and substance abuse community ...
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Atlanta, GA · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
Remote Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Atlanta, GA · Remote
$29.05 - $67.97/hr
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review ...
Description The Registry Utilization Review Nurse (PRN) is responsible for conducting medical ... The UR RN (PRN) will ensure proper use of Case Management Systems and workflows. MINIMUM ...
Description The Registry Utilization Review Nurse (PRN) is responsible for conducting medical ... The UR RN (PRN) will ensure proper use of Case Management Systems and workflows. MINIMUM ...
The Registry Utilization Review Nurse (PRN) is responsible for conducting medical necessity reviews ... The UR RN (PRN) will ensure proper use of Case Management Systems and workflows. MINIMUM ...
The Registry Utilization Review Nurse (PRN) is responsible for conducting medical necessity reviews ... The UR RN (PRN) will ensure proper use of Case Management Systems and workflows. MINIMUM ...
Description The Registry Utilization Review Nurse (PRN) is responsible for conducting medical ... The UR RN (PRN) will ensure proper use of Case Management Systems and workflows. MINIMUM ...
Description The Registry Utilization Review Nurse (PRN) is responsible for conducting medical ... The UR RN (PRN) will ensure proper use of Case Management Systems and workflows. MINIMUM ...
The UR RN (PRN) will ensure proper use of Case Management Systems and workflows. MINIMUM ... Utilization Review Job Type PRN / Registry Job Number 161800 Job Category Nursing Schedule 8a-4:30p ...
The UR RN (PRN) will ensure proper use of Case Management Systems and workflows. MINIMUM ... Utilization Review Job Type PRN / Registry Job Number 161800 Job Category Nursing Schedule 8a-4:30p ...
Description The Registry Utilization Review Nurse (PRN) is responsible for conducting medical ... The UR RN (PRN) will ensure proper use of Case Management Systems and workflows. MINIMUM ...
Description The Registry Utilization Review Nurse (PRN) is responsible for conducting medical ... The UR RN (PRN) will ensure proper use of Case Management Systems and workflows. MINIMUM ...
Description The Registry Utilization Review Nurse (PRN) is responsible for conducting medical ... The UR RN (PRN) will ensure proper use of Case Management Systems and workflows. MINIMUM ...
Description The Registry Utilization Review Nurse (PRN) is responsible for conducting medical ... The UR RN (PRN) will ensure proper use of Case Management Systems and workflows. MINIMUM ...
Utilization Manager information
See Atlanta, GA salary details
$37.5K - $48.7K
9% of jobs
$57K is the 25th percentile. Wages below this are outliers.
$48.7K - $60K
22% of jobs
$60K - $71.2K
11% of jobs
The median wage is $78.1K / yr.
$71.2K - $82.4K
14% of jobs
$82.4K - $93.7K
12% of jobs
$100.7K is the 75th percentile. Wages above this are outliers.
$93.7K - $104.9K
13% of jobs
$104.9K - $116.1K
13% of jobs
$116.1K - $127.4K
5% of jobs
$127.4K - $138.6K
2% of jobs
$138.6K - $149.8K
0% of jobs
$149.8K - $161.1K
0% of jobs
$37.5K
$87.5K
$161.1K
How much do utilization manager jobs pay per year?
What jobs pay $2000 a day?
What job makes $10,000 a month without a degree?
What jobs in the US pay 300,000 a year?
What does a utilization manager do?
What are the key skills and qualifications needed to thrive as a Utilization Manager, and why are they important?
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.
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Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 7 days ago
Accenture Federal Services rating
8.4
Based on 19 frontline employees who took The Breakroom Quiz
46th of 428 rated business services
Job description
Accenture is a leading global professional services company that helps the world's leading businesses, governments and other organizations build their digital core,optimizetheir operations, accelerate revenuegrowthand enhance citizen services-creating tangible value at speed and scale. We are a talent- andinnovation-led company with approximately750,000 peopleserving clients in more than 120 countries. Technology is at the core of change today, and we are one of the world's leaders in helping drive that change, with strong ecosystem relationships. We combine our strength in technology and leadership in cloud, data and AI with unmatched industry experience, functionalexpertiseand global delivery capability. We are uniquely able to deliver tangible outcomes because of our broad range of services, solutions and assets across Strategy & Consulting, Technology, Operations, Industry X and Song. These capabilities, together with our culture of shared success and commitment to creating 360 value, enable us to help our clients reinvent and build trusted, lasting relationships. We measure our success by the 360 value we create for our clients, each other, our shareholders,partnersand communities. Visit us atwww.accenture.com.
Strategy & Consulting:We work with C-suite executives, leaders and boards of the world's leading organizations, helping them reinvent every part of their enterprise to drive greater growth, enhance competitiveness, implement operational improvements, reduce cost, deliver sustainable 360 stakeholder value, and set a new performance frontier for themselves and the industry in which they operate. Our deep industry and functionalexpertiseissupported by proprietary assets and solutions that help organizations transform faster and become more resilient. Underpinned by technology, data, analytics, AI, change management, talent and sustainability capabilities, our Strategy & Consulting services help architect and accelerate all aspects of an organization's total enterprise reinvention.
Role Summary
Advise clients on network strategy,utilizationperformance, and provider market challenges across Medicaid, rural, and financially pressured environments. The successful candidate will combine deep domainexpertisewith strong consulting judgment and will be expected to manage teams, advise senior clients, and deliver complex engagements in network strategy,utilization, and provider performance. This individual will build trusted client relationships and help clients improve network performance, access, and provider sustainability in line with their strategic priorities.
As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include:
Advise clients on network strategy, provider capacity,utilizationtrends, access challenges, and market performance.
Advise clients on evaluating leakage, referral patterns, service distribution, network adequacy, and provider sustainability.
Develop strategic recommendations to improve network design, access,utilizationmanagement, provider alignment, and value-based outcomes.
Translate claims,encounter,provider, and market data into clear insights, strategic options, and executive decision materials.
Manage day-to-day engagement delivery, including workplans, team coordination, deliverable quality, and client communications.
Work across reimbursement, analytics, policy, and provider strategy teams to solve complex market and performance challenges.
Build trusted relationships with client stakeholders and help grow the practice's network performance andutilizationwork.
Travel: As required, up to 80%
Why should I join the Accenture Health team?
Innovate every day.Be at the forefront of designing and delivering health technology solutions that push boundaries and create new opportunities for our clients.
Lead with the industry's best. Join an industry-recognized healthcare leader with more than 20,000 global healthcare professionals collaborating to drive enterprise-wide transformational projects on a global scale. Accenture has worked with more than 200 clients to deliver healthcaretransformationto meet the diverse needs of patients and members.
Learn and grow continuously.Harness unmatched training and professional development to help you build and advance your health, consultative and delivery skills. With learning resources, interactive classroom courses, real-life clientsimulationsand ongoing mentoring available when you need it,you'llexpand your thinking beyond the core Workday implementation.
Qualification
Here'swhat you need:
Minimum of 5 years of experience in network strategy,utilizationanalytics, provider economics, or healthcare market analysis.
Minimum of 2 years of experience assessing hospitals, rural providers, FQHCs, specialty providers, and community-based providers in Medicaid-heavy or financially distressed environments.
Minimum of 2 years of experience turning claims,encounter,provider, and market data into strategic recommendations.
Bachelor's Degree
Bonus points if you have:
Familiarity with provider directory and network data management, data quality, and encounter completeness.
Strong understanding of provider capacity, leakage, referral patterns,utilizationdrivers, access, and network adequacy.
Ability to connectutilizationperformance to reimbursement, provider sustainability, and VBC outcomes.
Experience building provider performance scorecards (utilization, quality, access, equity,financial impact).
Understanding ofservice line strategy and site-of-care optimization (ASC vs HOPD, home-based care, telehealth).
Compensation at Accenture varies depending on a wide array of factors, which may include but are not limited to the specific office location, role, skill set, and level of experience. As required by local law, Accenture provides a reasonable range of compensation for roles that may be hired as set forth below.
We anticipate this job posting will be posted until 06/18/2026.
Accenture offers a market competitive suite of benefits including medical, dental, vision, life, and long-term disability coverage, a 401(k) plan, bonus opportunities, paid holidays, and paid time off. See more information on our benefits here:
U.S. Employee Benefits | Accenture
Role Location Annual Salary Range
California $94,400 to $293,800
Cleveland $87,400 to $235,000
Colorado $94,400 to $253,800
District of Columbia $100,500 to $270,300
Illinois $87,400 to $253,800
Maine $80,400 to $216,200
Maryland $94,400 to $253,800
Massachusetts $94,400 to $270,300
Minnesota $94,400 to $253,800
New York $87,400 to $293,800
New Jersey $100,500 to $293,800
Virginia $87,400 to $270,300
Washington $100,500 to $270,300
About Accenture
Accenture is a leading global professional services company that helps the world's leading businesses, governments and other organizations build their digital core, optimize their operations, accelerate revenue growth and enhance citizen services-creating tangible value at speed and scale. We are a talent- and innovation-led company with approximately 791,000 people serving clients in more than 120 countries. Technology is at the core of change today, and we are one of the world's leaders in helping drive that change, with strong ecosystem relationships. We combine our strength in technology and leadership in cloud, data and AI with unmatched industry experience, functional expertise and global delivery capability. Our broad range of services, solutions and assets across Strategy & Consulting, Technology, Operations, Industry X and Song, together with our culture of shared success and commitment to creating 360 value, enable us to help our clients reinvent and build trusted, lasting relationships. We measure our success by the 360 value we create for our clients, each other, our shareholders, partners and communities.Visit us atwww.accenture.com
What We Believe
We have an unwavering commitment to diversity with the aim that every one of our people has a full sense of belonging within our organization. As a business imperative, every person at Accenture has the responsibility to create and sustain an inclusive environment.
Inclusion and diversity are fundamental to our culture and core values. Our rich diversity makes us more innovative and more creative, which helps us better serve our clients and our communities.Read more here
Requesting An Accommodation
Accenture is committed to providing equal employment opportunities for persons with disabilities or religious observances, including reasonable accommodation when needed. If you are hired by Accenture and require accommodation to perform the essential functions of your role, you will be asked to participate in our reasonable accommodation process. Accommodations made to facilitate the recruiting process are not a guarantee of future or continued accommodations once hired.
If you would like to be considered for employment opportunities with Accenture and have accommodation needs such as for a disability or religious observance, please call us toll free at 1 (877) 889-9009 or send us anemailor speak with your recruiter.
Equal Employment Opportunity Statement
We believe that no one should be discriminated against because of their differences.All employment decisions shall be made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, military veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status or any other basis as protected by applicable law.Our rich diversity makes us more innovative, more competitive, and more creative, which helps us better serve our clients and our communities.
For details, view a copy of the Accenture Equal Opportunity Statement
Accenture is an EEO and Affirmative Action Employer of Veterans/Individuals with Disabilities.
Accenture is committed to providing veteran employment opportunities to our service men and women.
Other Employment Statements
Applicants for employment in the US must have work authorization that does not now or in the future require sponsorship of a visa for employment authorization in the United States.
Candidates who are currently employed by a client of Accenture or an affiliated Accenture business may not be eligible for consideration.
Job candidates will not be obligated to disclose sealed or expunged records of conviction or arrest as part of the hiring process. Further, at Accenture a criminal conviction history is not an absolute bar to employment.
The Company will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. Additionally, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company's legal duty to furnish information.
California requires additional notifications for applicants and employees. If you are a California resident, live in or plan to work from Los Angeles County upon being hired for this position, pleaseclick herefor additional important information.
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About Accenture Federal Services
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Industry
It services
Company size
10,000+ Employees
Headquarters location
Arlington, VA, US
Year founded
1989