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Utilization Manager Jobs in Lowell, MA (NOW HIRING)

RPh on the Go

Pharmacist in Leominster, MA

Leominster, MA · On-site +1

$55 - $65/hr

Apply clinical policies, utilization management criteria, and Medicare requirements to authorization decisions. * Provide support to internal clinical and non-clinical teams regarding Part B drug ...

BMC HealthNet Plan

Medical Director

Boston, MA · On-site +1

$173K - $250K/yr

The Medical Director will report to the Senior Medical Director of Utilization Management, Member Appeals & Grievances, and Medical Policy (Senior Medical Director of Utilization Management) and ...

WellSense Health Plan

Medical Director

MA · On-site +1

$173K - $250K/yr

The Medical Director will report to the Senior Medical Director of Utilization Management, Member Appeals & Grievances, and Medical Policy (Senior Medical Director of Utilization Management) and ...

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All JobsUtilization JobsUtilization Manager JobsUtilization Manager Jobs in Lowell, MA

Utilization Manager information

See Lowell, MA salary details

$38.7K

$90.3K

$166.1K

How much do utilization manager jobs pay per year?

As of Sep 2, 2026, the average yearly pay for utilization manager in Lowell, MA is $90,262.00, according to ZipRecruiter salary data. Most workers in this role earn between $59,000.00 and $108,600.00 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 job categories do people searching Utilization Manager jobs in Lowell, MA look for?

The top searched job categories for Utilization Manager jobs in Lowell, MA are:

What cities near Lowell, MA are hiring for Utilization Manager jobs?

Cities near Lowell, MA with the most Utilization Manager job openings:

Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in Lowell, MA 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 $90,262 per year, or $43.4 per hour.

RN Utilization Review - Patient & Family Services - Per Diem

SolutionHealth

Nashua, NH • On-site

Part-time

Medical, Dental, Vision, Life, Retirement

Re-posted 17 days ago

Job description

Come work at the best place to give and receive care!
Job Description:
This Role is On-Site
Who We Are:
Southern NH Medical Centers strives to keep patients on a continuous track to discharge and receive the continuity of care that our patients and their families need. Our Patient and Family Services Department is the driving force to assure communication, respect, and safety follows our patients throughout the admission phase, all the way through the discharge process. This department includes a dedicated team of Case Managers, Social Workers, and Interpreters that ensure that all care is equal, and our patient's dignity is maintained above all else.
About the Job:
The Utilization Review/Denial Specialist works with the care team to evaluate medical acuity for the appropriate level of care orders and documentation to facilitate insurance coverage, and proactively prevent denials. This specialist ensures level of care charges are applied accurately and meet compliance with CMS and commercial insurance guidelines as well as reviewing appeal options for medical necessity insurance denials
What You'll Do:
  • Assess acute medical necessity utilizing appropriate criteria.
  • Collect and trend Utilization Review data metrics.
  • Review appeal options for commercial insurance, RAC, and QIO medical necessity denials.
  • Understand and apply CMS Regulations to meet compliance

Who You Are:
  • Current NH Nursing License as a Registered Nurse.
    • ASN accepted; BSN required within 10 years of hire.
  • A minimum of 5-years' of experience as a Registered Nurse.
  • Experience in use of Interqual, Milliman or other Healthcare acute criteria preferred.

Why You'll Love Us:
  • Health, dental, prescription, and vision coverage for full-time & part-time employees
  • Short-term, long-term disability, life & pet insurance
  • Student Loan Forgiveness & Discounts
  • 403(b) Retirement savings plans
  • Continuous earned time accrual

& So much more!
Work Shift:
Per diem weekends and holiday. Other days available if staff have availability.
SolutionHealth is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, disability status, veteran status, or any other characteristic protected by law.

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