Coordinates, performs, and monitors all utilization review/management activities of the hospital to continuously improve the collection, reimbursement, coordination, and presentation of utilization ...
Coordinates, performs, and monitors all utilization review/management activities of the hospital to continuously improve the collection, reimbursement, coordination, and presentation of utilization ...
Utilization Management/Case Manager
Champaign, IL · On-site
$90K/yr
) Accolade Healthcare Utilization Management/Case Manager About Us At Accolade Healthcare, we put an emphasis on the satisfaction of our team members, understanding that a foundation built on quality ...
Utilization Management/Case Manager
Champaign, IL · On-site
$90K/yr
) Accolade Healthcare Utilization Management/Case Manager About Us At Accolade Healthcare, we put an emphasis on the satisfaction of our team members, understanding that a foundation built on quality ...
Utilization Management/Case Manager
$75K - $90K/yr
Accolade Healthcare Utilization Management/Case Manager About Us At Accolade Healthcare, we put an emphasis on the satisfaction of our team members, understanding that a foundation built on quality ...
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Utilization Management/Case Manager
$75K - $90K/yr
Accolade Healthcare Utilization Management/Case Manager About Us At Accolade Healthcare, we put an emphasis on the satisfaction of our team members, understanding that a foundation built on quality ...
Coordinates, performs, and monitors all utilization review/management activities of the hospital to continuously improve the collection, reimbursement, coordination, and presentation of utilization ...
Coordinates, performs, and monitors all utilization review/management activities of the hospital to continuously improve the collection, reimbursement, coordination, and presentation of utilization ...
Utilization Review Coordinator
Champaign, IL · On-site
Responsibilities Full-time Utilization Review Coordinator Opening The Pavilion Behavioral Health System has been the leading provider of behavioral health and addictions treatment for families in ...
Utilization Review Coordinator
Champaign, IL · On-site
Responsibilities Full-time Utilization Review Coordinator Opening The Pavilion Behavioral Health System has been the leading provider of behavioral health and addictions treatment for families in ...
Utilization Review Coordinator
Champaign, IL · On-site
Responsibilities Full-time Utilization Review Coordinator Opening The Pavilion Behavioral Health System has been the leading provider of behavioral health and addictions treatment for families in ...
Utilization Review Coordinator
Champaign, IL · On-site
Responsibilities Full-time Utilization Review Coordinator Opening The Pavilion Behavioral Health System has been the leading provider of behavioral health and addictions treatment for families in ...
Maintaining a high standard of KPIs including the utilization of experiences, brand awareness ... Supports managing community relationships in conjunction with the Executive Director/ CPD and Local ...
Maintaining a high standard of KPIs including the utilization of experiences, brand awareness ... Supports managing community relationships in conjunction with the Executive Director/ CPD and Local ...
Maintaining a high standard of KPIs including the utilization of experiences, brand awareness ... Supports managing community relationships in conjunction with the Executive Director/ CPD and Local ...
Maintaining a high standard of KPIs including the utilization of experiences, brand awareness ... Supports managing community relationships in conjunction with the Executive Director/ CPD and Local ...
Maintaining a high standard of KPIs including the utilization of experiences, brand awareness ... Supports managing community relationships in conjunction with the Executive Director/ CPD and Local ...
Maintaining a high standard of KPIs including the utilization of experiences, brand awareness ... Supports managing community relationships in conjunction with the Executive Director/ CPD and Local ...
Maintaining a high standard of KPIs including the utilization of experiences, brand awareness ... Supports managing community relationships in conjunction with the Executive Director/ CPD and Local ...
Maintaining a high standard of KPIs including the utilization of experiences, brand awareness ... Supports managing community relationships in conjunction with the Executive Director/ CPD and Local ...
Maintaining a high standard of KPIs including the utilization of experiences, brand awareness ... Supports managing community relationships in conjunction with the Executive Director/ CPD and Local ...
Maintaining a high standard of KPIs including the utilization of experiences, brand awareness ... Supports managing community relationships in conjunction with the Executive Director/ CPD and Local ...
Conducts routine utilization reviews to ensure patients have access to appropriate cost-effective care. * Configures the case management system to organize cases dealing with disease management and ...
Conducts routine utilization reviews to ensure patients have access to appropriate cost-effective care. * Configures the case management system to organize cases dealing with disease management and ...
Corporate Leasing Manager
Champaign, IL · On-site
$85K - $120K/yr
Own the configuration, utilization, optimization, and ongoing performance of Fairlawn's AI Leasing ... Partner with Property Management and Asset Management leadership to develop recommendations ...
Corporate Leasing Manager
Champaign, IL · On-site
$85K - $120K/yr
Own the configuration, utilization, optimization, and ongoing performance of Fairlawn's AI Leasing ... Partner with Property Management and Asset Management leadership to develop recommendations ...
Snack Bar Supervisor
Urbana, IL · On-site
... the disposal and utilization of left-over food, following procedures and brand standards ... Assists in staff management through coaching, training, maintaining documentation, and ...
Snack Bar Supervisor
Urbana, IL · On-site
... the disposal and utilization of left-over food, following procedures and brand standards ... Assists in staff management through coaching, training, maintaining documentation, and ...
RN Manager - Perioperative Services (Evenings)
Urbana, IL · On-site
$53.28 - $91.64/hr
Responsible for planning, organizing, delegating, coordinating staff utilization, budgeting, and ... Manages and supervises functions of assigned direct and non-direct patient care areas on a 24-hour ...
RN Manager - Perioperative Services (Evenings)
Urbana, IL · On-site
$53.28 - $91.64/hr
Responsible for planning, organizing, delegating, coordinating staff utilization, budgeting, and ... Manages and supervises functions of assigned direct and non-direct patient care areas on a 24-hour ...
Responsible for planning, organizing, delegating, coordinating staff utilization, budgeting, and ... Manages and supervises functions of assigned direct and non-direct patient care areas on a 24-hour ...
Responsible for planning, organizing, delegating, coordinating staff utilization, budgeting, and ... Manages and supervises functions of assigned direct and non-direct patient care areas on a 24-hour ...
Responsible for planning, organizing, delegating, coordinating staff utilization, budgeting, and ... Manages and supervises functions of assigned direct and non-direct patient care areas on a 24-hour ...
Responsible for planning, organizing, delegating, coordinating staff utilization, budgeting, and ... Manages and supervises functions of assigned direct and non-direct patient care areas on a 24-hour ...
Documents plan of care and utilization issues in appropriate locations, including but not limited to: case management/utilization review software and the multidisciplinary plan of care document on ...
Documents plan of care and utilization issues in appropriate locations, including but not limited to: case management/utilization review software and the multidisciplinary plan of care document on ...
Documents plan of care and utilization issues in appropriate locations, including but not limited to: case management/utilization review software and the multidisciplinary plan of care document on ...
Documents plan of care and utilization issues in appropriate locations, including but not limited to: case management/utilization review software and the multidisciplinary plan of care document on ...
RN - Clinical Transition Specialist
Urbana, IL · On-site
$35.87 - $58.37/hr
Documents plan of care and utilization issues in appropriate locations, including but not limited to: case management/utilization review software and the multidisciplinary plan of care document on ...
RN - Clinical Transition Specialist
Urbana, IL · On-site
$35.87 - $58.37/hr
Documents plan of care and utilization issues in appropriate locations, including but not limited to: case management/utilization review software and the multidisciplinary plan of care document on ...
Utilization Manager information
See Champaign, IL salary details
$39.1K - $50.8K
9% of jobs
$59.4K is the 25th percentile. Wages below this are outliers.
$50.8K - $62.5K
22% of jobs
$62.5K - $74.2K
11% of jobs
The median wage is $81.4K / yr.
$74.2K - $85.9K
14% of jobs
$85.9K - $97.6K
12% of jobs
$104.9K is the 75th percentile. Wages above this are outliers.
$97.6K - $109.3K
13% of jobs
$109.3K - $121K
13% of jobs
$121K - $132.6K
5% of jobs
$132.6K - $144.3K
2% of jobs
$144.3K - $156K
0% of jobs
$156K - $167.7K
0% of jobs
$39.1K
$91.1K
$167.7K
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?

Job description
About the Job:
The Utilization Specialist is responsible for reviewing of assigned admissions, continued stays, utilization practices and discharge planning according to approved clinically valid criteria which meets the daily deadlines to obtain authorizations and complete other pertinent processes. Coordinates, performs, and monitors all utilization review/management activities of the hospital to continuously improve the collection, reimbursement, coordination, and presentation of utilization review information; Educates hospital staff about requirements and trends.Roles and Responsibilities:
Performs admission, concurrent, continued stay, and retrospective reviews using the established hospital criteria. Communicates effectively with insurance companies, health maintenance organization (HMOs) and other similar entities for approval of initial or additional inpatient days for treatment. Provides information they need in a logical, concise manner using technical language that accurately describes patient's condition and need for hospitalization.
Communicates directly with physicians and other providers with respect to specific inquires and perceived trends of issues as they relate to utilization management.
Appeals all denials ensuring accuracy of information and effective coordination of correspondence. Initiates, coordinates, and monitors the appeal process. Provides information to physicians to assist them in their role in appeals.
Assists the admissions department with pre-certifications of care. Performs pre and post admission benefit verification with managed care organizations.
Maintains accurate documentation and files as it relates to utilization management.
Provides ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.
Communicates effectively with co-workers, program, and nursing staff regarding charting deficiencies and problems/issues identified. Follows up in each instance to determine if corrective action was taken. Notifies supervisor if corrective action is not completed.
Coordinates information and findings with the business office to help recognize or resolve possible payment problems.
Monitors patient length of stay and extensions and informs clinical and medical staff on issues that may impact length of stay. Investigates short term length of stays and endeavor to create alternate financial planning which would offer the patient extended days of treatment. Participates in discharge planning as required.
Gathers and develops 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.
Conducts quality reviews for medical necessity and services provided. Facilitates peer review calls between facility and external organizations. Identifies potential review problems and discuss them with multi-disciplinary team and/or administration.
Acts as liaison between managed care organizations and the facility professional clinical staff.
Assists with any problems encountered during on-site or telephone reviews by the third-party payers or review organization, when necessary.
Graduation from an approved/accredited school of nursing or a Bachelor's degree in social work, behavioral or mental health, or other related health field required.
Two or more years of direct clinical experience in a psychiatric or mental health setting required.
Current licensure as an LPN or RN or current clinical professional license or certification, as required, within the state where the facility provides services.
Why The Pavilion at Williamsburg Place?The Pavilion at Williamsburg Place offers a comprehensive benefit plan and a competitive salary commensurate with experience and qualifications. Qualified candidates should apply by submitting a resume. The Pavilion at Williamsburg Place is an EOE.Veterans and military spouses are highly encouraged to apply. Summit BHC is dedicated to serving Veterans with specialized programming at our treatment centers across the country. We recognize and value the unique strengths of the military community in supporting our mission to serve those who have served.
About Summit BHC
Sourced by ZipRecruiter
Summit BHC, based in Franklin, TN, USA, is a recognized leader in the field of addiction treatment and behavioral health care services. The company operates a nationwide network of treatment centers aimed at caring for individuals battling substance abuse and mental health disorders. Summit BHC was established with the mission to provide high-quality, addiction treatment and behavioral health services to those in need throughout the United States. With compassion, dignity, and respect as their core values, they endeavor to instill hope during the journey to recovery and beyond.
Industry
Health care and social assistance
Company size
501 - 1,000 Employees
Headquarters location
Franklin, TN, US
Year founded
2013