Oversee the management of patient care utilization, ensuring appropriate healthcare services are provided while optimizing resource use. This individual will be responsible for leading a team of ...
Oversee the management of patient care utilization, ensuring appropriate healthcare services are provided while optimizing resource use. This individual will be responsible for leading a team of ...
Oversee the management of patient care utilization, ensuring appropriate healthcare services are provided while optimizing resource use. This individual will be responsible for leading a team of ...
Oversee the management of patient care utilization, ensuring appropriate healthcare services are provided while optimizing resource use. This individual will be responsible for leading a team of ...
Director of Utilization Review
Gulfport, MS · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Minimum of 2 years clinical experience and 1 year of management experience with case management and the utilization review process including concurrent reviews. Previous continuum of care experience ...
New
Director of Utilization Review
Gulfport, MS · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Minimum of 2 years clinical experience and 1 year of management experience with case management and the utilization review process including concurrent reviews. Previous continuum of care experience ...
New
Director of Utilization Review
Gulfport, MS · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Minimum of 2 years clinical experience and 1 year of management experience with case management and the utilization review process including concurrent reviews. Previous continuum of care experience ...
Director of Utilization Review
Gulfport, MS · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Minimum of 2 years clinical experience and 1 year of management experience with case management and the utilization review process including concurrent reviews. Previous continuum of care experience ...
Director of Utilization Review
Medical
Dental
Vision
Life
Retirement
PTO
Minimum of 2 years clinical experience and 1 year of management experience with case management and the utilization review process including concurrent reviews. Previous continuum of care experience ...
Director of Utilization Review
Medical
Dental
Vision
Life
Retirement
PTO
Minimum of 2 years clinical experience and 1 year of management experience with case management and the utilization review process including concurrent reviews. Previous continuum of care experience ...
Director of Utilization Review
Medical
Dental
Vision
Life
Retirement
PTO
Minimum of 2 years clinical experience and 1 year of management experience with case management and the utilization review process including concurrent reviews. Previous continuum of care experience ...
Director of Utilization Review
Medical
Dental
Vision
Life
Retirement
PTO
Minimum of 2 years clinical experience and 1 year of management experience with case management and the utilization review process including concurrent reviews. Previous continuum of care experience ...
Director of Utilization Review
Gulfport, MS · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Minimum of 2 years clinical experience and 1 year of management experience with case management and the utilization review process including concurrent reviews. Previous continuum of care experience ...
Director of Utilization Review
Gulfport, MS · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Minimum of 2 years clinical experience and 1 year of management experience with case management and the utilization review process including concurrent reviews. Previous continuum of care experience ...
Registered Nurse Care Manager
Biloxi, MS · On-site
Medical
Dental
Vision
Life
Retirement
PTO
The Care Manager possesses intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ...
Registered Nurse Care Manager
Biloxi, MS · On-site
Medical
Dental
Vision
Life
Retirement
PTO
The Care Manager possesses intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ...
Collaborate with internal stakeholders to include Care Management, Utilization Management, Product Teams, Program Integrity, Regulatory and Claims to ensure providers are educated on billing ...
Collaborate with internal stakeholders to include Care Management, Utilization Management, Product Teams, Program Integrity, Regulatory and Claims to ensure providers are educated on billing ...
Registered Nurse Care Manager
Biloxi, MS · On-site
Medical
Dental
Vision
Life
Retirement
PTO
The Care Manager possesses intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ...
Registered Nurse Care Manager
Biloxi, MS · On-site
Medical
Dental
Vision
Life
Retirement
PTO
The Care Manager possesses intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ...
Registered Nurse Care Manager
Biloxi, MS · On-site +1
$67K - $161K/yr
Medical
Dental
Vision
Life
Retirement
PTO
The Care Manager possesses intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ...
Registered Nurse Care Manager
Biloxi, MS · On-site +1
$67K - $161K/yr
Medical
Dental
Vision
Life
Retirement
PTO
The Care Manager possesses intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ...
Registered Nurse Care Manager
Biloxi, MS · On-site
Medical
Dental
Vision
Life
Retirement
PTO
The Care Manager possesses intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ...
Registered Nurse Care Manager
Biloxi, MS · On-site
Medical
Dental
Vision
Life
Retirement
PTO
The Care Manager possesses intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ...
RN Case Manager
Bay Saint Louis, MS · On-site
Preferred - 3 years of hospital-based experience in discharge planning, case management or utilization review. Certifications Required - Current registered nurse license in state of practice. Basic ...
RN Case Manager
Bay Saint Louis, MS · On-site
Preferred - 3 years of hospital-based experience in discharge planning, case management or utilization review. Certifications Required - Current registered nurse license in state of practice. Basic ...
RN Case Manager
Bay Saint Louis, MS · On-site
Preferred - 3 yearsof hospital-based experience in discharge planning, case management or utilization review. Certifications Required -Current registered nurse license in state of practice. Basic ...
RN Case Manager
Bay Saint Louis, MS · On-site
Preferred - 3 yearsof hospital-based experience in discharge planning, case management or utilization review. Certifications Required -Current registered nurse license in state of practice. Basic ...
Program Manager
$125K/yr
... utilization, operational risks, and program outcomes; identifying issues and developing ... management decision-making. * Experience planning, coordinating, monitoring, and evaluating ...
Program Manager
$125K/yr
... utilization, operational risks, and program outcomes; identifying issues and developing ... management decision-making. * Experience planning, coordinating, monitoring, and evaluating ...
Program Manager
Gulfport, MS · On-site
$125K/yr
... utilization, operational risks, and program outcomes; identifying issues and developing ... management decision-making. * Experience planning, coordinating, monitoring, and evaluating ...
Program Manager
Gulfport, MS · On-site
$125K/yr
... utilization, operational risks, and program outcomes; identifying issues and developing ... management decision-making. * Experience planning, coordinating, monitoring, and evaluating ...
Program Manager
$125K/yr
... utilization, operational risks, and program outcomes; identifying issues and developing ... management decision-making. * Experience planning, coordinating, monitoring, and evaluating ...
Program Manager
$125K/yr
... utilization, operational risks, and program outcomes; identifying issues and developing ... management decision-making. * Experience planning, coordinating, monitoring, and evaluating ...
Program Manager
$125K/yr
... utilization, operational risks, and program outcomes; identifying issues and developing ... management decision-making. * Experience planning, coordinating, monitoring, and evaluating ...
Program Manager
$125K/yr
... utilization, operational risks, and program outcomes; identifying issues and developing ... management decision-making. * Experience planning, coordinating, monitoring, and evaluating ...
RN Case Manager - PRN
Slidell, LA · On-site
Preferred - 3 years of hospital-based experience in discharge planning, case management or utilization review. Certifications Required - Current registered nurse license in state of practice. Basic ...
RN Case Manager - PRN
Slidell, LA · On-site
Preferred - 3 years of hospital-based experience in discharge planning, case management or utilization review. Certifications Required - Current registered nurse license in state of practice. Basic ...
RN Case Manager - PRN
Slidell, LA · On-site
Preferred - 3 yearsof hospital-based experience in discharge planning, case management or utilization review. Certifications Required -Current registered nurse license in state of practice. Basic ...
RN Case Manager - PRN
Slidell, LA · On-site
Preferred - 3 yearsof hospital-based experience in discharge planning, case management or utilization review. Certifications Required -Current registered nurse license in state of practice. Basic ...
Utilization Manager information
See Perkinston, MS salary details
$34.4K - $44.7K
9% of jobs
$52.3K is the 25th percentile. Wages below this are outliers.
$44.7K - $55K
22% of jobs
$55K - $65.2K
11% of jobs
The median wage is $71.6K / yr.
$65.2K - $75.5K
14% of jobs
$75.5K - $85.8K
12% of jobs
$92.3K is the 75th percentile. Wages above this are outliers.
$85.8K - $96.1K
13% of jobs
$96.1K - $106.4K
13% of jobs
$106.4K - $116.7K
5% of jobs
$116.7K - $127K
2% of jobs
$127K - $137.3K
0% of jobs
$137.3K - $147.6K
0% of jobs
$34.4K
$80.2K
$147.6K
How much do utilization manager jobs pay per year?
What are the key skills and qualifications needed to thrive as a utilization manager?
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.
What cities near Perkinston, MS are hiring for Utilization Manager jobs?
Cities near Perkinston, MS with the most Utilization Manager job openings:

Utilization Management Manager-Utilization Mgmt- Days - FT
Gulfport, MS • On-site
Full-time
Re-posted 5 days ago
Job description
Oversee the management of patient care utilization, ensuring appropriate healthcare services are provided while optimizing resource use. This individual will be responsible for leading a team of nurses who review medical necessity, appropriateness and efficiency of healthcare services. Ensure compliance with regulatory requirements and maintain high standards of care.
Responsibilities
- Supervise and lead the UM nursing team and Pre-Certification Specialists, ensuring the review of patient cases for appropriate medical necessity and care protocols
- Develop, implement and maintain UM policies and procedures in accordance with healthcare regulation and organizational standards
- Conduct regular training and provide ongoing support for UR team to improve knowledge and performance
- Collaborate with physicians, other healthcare providers and insurance companies to review and improve treatment plans. Ensure all services are medically necessary and cost effective
- Evaluate and analyze healthcare utilization trends, identify opportunities for improvement and solutions to improve outcome
- Monitor and ensure compliance with regulatory requirements including Medicare, Medicaid and other payer policies
- Prepare and present reports on utilization metrics, case reviews and outcomes to administration leadership groups
- Resolve complex case issues and provide guidance on challenging utilization decisions
- Ensure accurate documentation of all UM reviews, ensuring compliance with internal and external audit
- Foster effective communication between departments, stakeholders and healthcare professionals
Qualifications
Education Requirements
Required: Bachelor Degree
- Bachelor of Science in Nursing, with an active unrestricted license
Preferred: Master's Degree
- Nursing or other clinical discipline, Health Administration, Finance, Business Administration, or a related field
License or Certification Requirements
Required: License
- Nursing degree (RN, BS, BSN, or advanced degree) and unrestricted active nursing license
Experience Requirements
Required: 5 years
- Nursing experience with at least 2 years in Utilization Management or case management role
Preferred: 2 years
- Leadership or management experience in nursing or related field
Core Competencies
Knowledge:
- In depth knowledge of healthcare utilization management processes, medical terminology and clinical guidelines
- Familiarity with payer requirements and regulation including Medicare, Medicaid and private insurers
- Working knowledge of applications that are used to enhance utilization management based on evidenced based approach and guidelines
- Strong knowledge of Microsoft Office applications
Skills:
- Analytical Skills: The ability to analyze large data sets, determine trends, synthesize results, and deliver prioritized details through effective reporting
- Communication Skills: Strong communication and interpersonal skills for effective collaboration and education
- Problem-Solving Skills: The capacity to understand issues, derive many potential solutions, troubleshoot discrepancies, and understand systematic approaches to problem resolution
Abilities:
- Attention to Detail: Precision is essential when reporting critical analysis to inform decision-making and operational change
- Time Management: Managing multiple tasks and deadlines while prioritizing work is essential in a fast-paced healthcare environment
- Technology Proficiency: Beyond EHR systems, familiarity with various billing software and technology tools
Work Environment: This position may involve working in a variety of clinical and administrative settings, requiring adaptability and a proactive approach to problem-solving.
Physical Demands: Frequent reaching, sitting, walking, and standing may be required. No special coordination beyond that used for normal mobility and handling of everyday objects and materials is needed to perform the job.