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Utilization Manager Jobs in Frederick, MD (NOW HIRING)

ECHO

Program Manager - Employment Services

Leesburg, VA · On-site

$65K - $85K/yr

Develop staffing plans and monitor productivity, scheduling, and utilization. Participant Success ... Oversee participant intakes, assessments, case management, Individual Support Plans (ISPs), and ...

ECHO

Program Manager - Employment Services

Leesburg, VA · On-site

$65K - $85K/yr

Develop staffing plans and monitor productivity, scheduling, and utilization.Participant ... Oversee participant intakes, assessments, case management, Individual Support Plans (ISPs), and ...

Forterra

Integration Manager

Clarksburg, MD · On-site

Ensure efficient resource allocation and utilization * Drive safety best-practices within ... General Management Responsibilities: * * Track and regularly report on utilization and readiness of ...

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Showing results 21-40

All JobsUtilization JobsUtilization Manager JobsUtilization Manager Jobs in Frederick, MD

Utilization Manager information

See Frederick, MD salary details

$38.8K

$90.5K

$166.5K

How much do utilization manager jobs pay per year?

As of Aug 20, 2026, the average yearly pay for utilization manager in Frederick, MD is $90,490.00, according to ZipRecruiter salary data. Most workers in this role earn between $59,200.00 and $108,900.00 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

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For Utilization Manager jobs in Frederick, MD, the most frequently searched job titles are:

What job categories do people searching Utilization Manager jobs in Frederick, MD look for?

The top searched job categories for Utilization Manager jobs in Frederick, MD are:

What cities near Frederick, MD are hiring for Utilization Manager jobs?

Cities near Frederick, MD with the most Utilization Manager job openings:

Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in Frederick, MD as of August 2026, with employment types broken down into 83% Full Time, 16% Part Time, and 1% Contract. Highlights an 81% Physical, 2% Hybrid, and 17% Remote job distribution, with an average salary of $90,490 per year, or $43.5 per hour.

Social Work Manager, SDoH

Maryland Physicians Care

Frederick, MD • On-site

$88K - $97K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 4 days ago

Job description

Job Type
Full-time
Description
*The ideal candidate would reside in Frederick County, MD*
Summary/Position Objectives:
This role serves as the co-manager of SDoH programs, focusing on complex cases aligning with department SDoH operations. This position is responsible for co-managing the Social Determinants of Health (SDoH) strategy and vision for Maryland Physicians Care (MPC), partnering with leadership within and across all MPC departments. The manager will lead regional multidisciplinary teams of social workers and community health workers addressing the complex social needs of members that impact health outcomes, ensuring coordinated, high-quality, and cost-effective interventions. This role is responsible for advancing scalable workflows, collecting and analyzing performance metrics, and using data-driven insights to target services to members with the greatest need and opportunity for impact.
About Maryland Care Management, Inc. (MCMI)
Maryland Care Management, Inc. (MCMI) manages Maryland Physician Care's (MPC) statewide provider network of hospitals and physicians. Maryland Physicians Care has been providing services to the HealthChoice Medicaid populations since 1996, and we are proud of our footprint in the community. With over 230,000 members, MPC consistently has been one of MD's largest Medicaid-managed care organizations.
Why join us?
MCMI recognizes the importance of flexibility and offers multiple work arrangements. Along with competitive pay, we offer excellent benefits (medical, dental, and vision plans, 100% employer Term Life Insurance, Short and Long-Term Disability, 401k Employer Match up to 4%) as well as 20 days of PTO, and tuition assistance/professional development plans.
Your future colleagues at MCMI are welcoming, friendly, and eager to help each other succeed. We are committed to Diversity, Equity, and Inclusion, providing organizational-wide social opportunities, and constantly improving our ongoing efforts to positively impact our members' lives.
What You'll Do:
  • Leads assigned SDoH team to outreach to, screen, assess and connect MPC members with social care needs.
  • Drives the advancement of integrated social care models by partnering across care management, utilization management, community engagement, prevention and wellness, HEDIS, and community-based organizations to address complex member needs.
  • Provides complex case supervision, consultation, and review to all department social workers.
  • Provides supervision to regional community health workers on workflow, resource development, community partnerships and relationships.
  • Leads individual and group departmental social work supervision as relates to high risk complex SDoH needs, i.e. suicide risk, IPV, child welfare escalation.
  • Collaborates routinely with other MPC departments on complex cases.
  • Manages social work ethics and mandated reporting.
  • Oversees development and processes for care planning, crisis planning, formal assessments and barrier mapping.
  • Involved in initiative planning, ongoing member relationship management and satisfaction for assigned initiatives that impact the delivery of products and services to the internal and external environment.
  • Collaborates with external vendors, external consultants, consulting team members and/or staff as required in support of initiatives.
  • Manages and evaluates team member performance; provides coaching, consultation, employee development, and recognition, ensures ongoing, appropriate staff training; holds regular team meetings to drive good communication and collaboration.
  • Assists in formulating and updating departmental plans and priorities to address any business or operational challenges, supports and collaborates with the Sr. Director of Population Health to provide insight into specialty roles and implement changes as needed.
  • Implements and scales the overall strategy to address SDoH for members and communities.
  • Hires, trains, and manages field staff in assigned regions.
  • Gathers input and maintain initiative-taking communication across business units to coordinate SDoH function across the regions.
  • Travel to Maryland community meetings and events approx. 20% to Upper Montgomery County and Western MD.

Requirements
Knowledge and Skills:
  • Understanding of social determinants of health, health disparities, inequities, and social risk factors.
  • Build strong relationships with key internal and external stakeholders through active participation in community-based initiatives.
  • Maintain confidentiality and comply with the Health Insurance Portability and Accountability Act (HIPAA).

Education and Work Experience:
  • Master's degree in Social Work.
  • LCSW or LCSW-C Licensure, current board-approved supervision preferred or ability to obtain.
  • Three-plus (3+) years' experience with population health, care coordination, and/or community-based programs.
  • 1-2 years' management experience.
  • Experience within a Medicaid/Medicare managed care environment.
  • Valid MD Driver's License.

EEOC Statement:
Following applicable federal, state, and local laws, MCMI prohibits discrimination in employment based on race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age, disability, genetic information, or any other characteristic protected by law. This commitment extends to all aspects of employment, including hiring, promotion, compensation, benefits, training, social and recreational programs, and all other conditions and privileges of employment.
As a healthcare organization, we recognize the vital importance of inclusivity in delivering quality care to our patients. We strive to foster an environment where individuals of all backgrounds feel respected, valued, and supported. We aim to better comprehend the unique needs of our patients and provide healthcare services that are culturally competent and sensitive.
We encourage candidates from all backgrounds to apply and join us in our mission to provide compassionate and inclusive healthcare. We believe that a diverse workforce enriches our organization and allows us to better understand, connect with, and serve our diverse patient population.
Salary Description
88-97k

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