Summary Completes all aspects of Utilization Management for assigned patient population by evaluating appropriate status and physician orders for admission, observation, or outpatient at all points ...
Summary Completes all aspects of Utilization Management for assigned patient population by evaluating appropriate status and physician orders for admission, observation, or outpatient at all points ...
Summary Completes all aspects of Utilization Management for assigned patient population by evaluating appropriate status and physician orders for admission, observation, or outpatient at all points ...
Summary Completes all aspects of Utilization Management for assigned patient population by evaluating appropriate status and physician orders for admission, observation, or outpatient at all points ...
Summary Completes all aspects of Utilization Management for assigned patient population by evaluating appropriate status and physician orders for admission, observation, or outpatient at all points ...
Summary Completes all aspects of Utilization Management for assigned patient population by evaluating appropriate status and physician orders for admission, observation, or outpatient at all points ...
Summary Completes all aspects of Utilization Management for assigned patient population by evaluating appropriate status and physician orders for admission, observation, or outpatient at all points ...
Summary Completes all aspects of Utilization Management for assigned patient population by evaluating appropriate status and physician orders for admission, observation, or outpatient at all points ...
Summary Completes all aspects of Utilization Management for assigned patient population by evaluating appropriate status and physician orders for admission, observation, or outpatient at all points ...
Summary Completes all aspects of Utilization Management for assigned patient population by evaluating appropriate status and physician orders for admission, observation, or outpatient at all points ...
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 ...
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 ...
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 ...
The Medical Director, Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to UPMC Health Plan members. This fully remote ...
The Medical Director, Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to UPMC Health Plan members. This fully remote ...
The Medical Director, Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to UPMC Health Plan members. This fully remote ...
The Medical Director, Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to UPMC Health Plan members. This fully remote ...
Utilization Management Representative I Shift: Monday-Friday Location: Virtual: This role enables ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Utilization Management Representative I Shift: Monday-Friday Location: Virtual: This role enables ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Utilization Management Rep I
Mars, PA · On-site
Utilization Management Representative I Shift: Monday-Friday Location: Virtual: This role enables ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
New
Utilization Management Rep I
Mars, PA · On-site
Utilization Management Representative I Shift: Monday-Friday Location: Virtual: This role enables ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
New
The Medical Director, Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to UPMC Health Plan members. This fully remote ...
The Medical Director, Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to UPMC Health Plan members. This fully remote ...
The Medical Director, Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to UPMC Health Plan members. This fully remote ...
The Medical Director, Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to UPMC Health Plan members. This fully remote ...
Be Seen First
Medical Director
Pittsburgh, PA · Remote
$1/hr
Job Summary The Medical Director is responsible for ensuring utilization management activities are conducted in accordance with current clinical standards, regulatory requirements, and organizational ...
Quick apply
Be Seen First
Medical Director
Pittsburgh, PA · Remote
$1/hr
Job Summary The Medical Director is responsible for ensuring utilization management activities are conducted in accordance with current clinical standards, regulatory requirements, and organizational ...
Clinical Management Manager
Pittsburgh, PA · On-site
$94K - $293K/yr
Design and implement care delivery models, workflows, and utilization management solutions * Drive measurable improvements in patient flow, capacity, LOS, and avoidable utilization * Partner with ...
Clinical Management Manager
Pittsburgh, PA · On-site
$94K - $293K/yr
Design and implement care delivery models, workflows, and utilization management solutions * Drive measurable improvements in patient flow, capacity, LOS, and avoidable utilization * Partner with ...
Clinical Management Manager
Pittsburgh, PA · On-site
$94K - $293K/yr
Design and implement care delivery models, workflows, and utilization management solutions * Drive measurable improvements in patient flow, capacity, LOS, and avoidable utilization * Partner with ...
Clinical Management Manager
Pittsburgh, PA · On-site
$94K - $293K/yr
Design and implement care delivery models, workflows, and utilization management solutions * Drive measurable improvements in patient flow, capacity, LOS, and avoidable utilization * Partner with ...
Monitor and analyze key resource management metrics, including utilization, availability, capacity ... billable hours, backlog, pipeline, and open staffing needs. * Develop and distribute reports ...
New
Monitor and analyze key resource management metrics, including utilization, availability, capacity ... billable hours, backlog, pipeline, and open staffing needs. * Develop and distribute reports ...
New
Actively participates in the daily utilization management and quality improvement review processes, including concurrent, prospective and retrospective reviews, member grievances, provider appeals ...
Actively participates in the daily utilization management and quality improvement review processes, including concurrent, prospective and retrospective reviews, member grievances, provider appeals ...
Actively participates in the daily utilization management and quality improvement review processes, including concurrent, prospective and retrospective reviews, member grievances, provider appeals ...
Actively participates in the daily utilization management and quality improvement review processes, including concurrent, prospective and retrospective reviews, member grievances, provider appeals ...
Utilization Manager information
See Pittsburgh, PA salary details
$37.9K - $49.2K
9% of jobs
$57.6K is the 25th percentile. Wages below this are outliers.
$49.2K - $60.5K
22% of jobs
$60.5K - $71.9K
11% of jobs
The median wage is $78.9K / yr.
$71.9K - $83.2K
14% of jobs
$83.2K - $94.6K
12% of jobs
$101.7K is the 75th percentile. Wages above this are outliers.
$94.6K - $105.9K
13% of jobs
$105.9K - $117.2K
13% of jobs
$117.2K - $128.6K
5% of jobs
$128.6K - $139.9K
2% of jobs
$139.9K - $151.3K
0% of jobs
$151.3K - $162.6K
0% of jobs
$37.9K
$88.4K
$162.6K
How much do utilization manager jobs pay per year?
As of Aug 25, 2026, the average yearly pay for utilization manager in Pittsburgh, PA is $88,355.00, according to ZipRecruiter salary data. Most workers in this role earn between $57,800.00 and $106,300.00 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?
| 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.
More about Utilization Manager jobs
What are popular job titles related to Utilization Manager jobs in Pittsburgh, PA?
For Utilization Manager jobs in Pittsburgh, PA, the most frequently searched job titles are:
What job categories do people searching Utilization Manager jobs in Pittsburgh, PA look for?
The top searched job categories for Utilization Manager jobs in Pittsburgh, PA are:
What cities near Pittsburgh, PA are hiring for Utilization Manager jobs?
Cities near Pittsburgh, PA with the most Utilization Manager job openings:
REGISTERED NURSE CARE MANAGER UTILIZATION MANAGEMENT
Pittsburgh, PA • On-site
St. Clair Hospital •
Health Care and Social Assistance • 1 - 5K employees1,001 - 5,000 employees
6.8
Based on 31 frontline employees who took The Breakroom Quiz
498th of 893 rated healthcare providers
People enjoy working here
Recommended by students
Recommended by parents
Respectful managers
Good training
Full-time
Re-posted 26 days ago
Job description
Summary
Completes all aspects of Utilization Management for assigned patient population by evaluating appropriate status and physician orders for admission, observation, or outpatient at all points of entry to St. Clair Hospital, and ensures that appropriate orders are placed in the electronic medical record.
Minimum Qualifications
Preferred Qualifications
Completes all aspects of Utilization Management for assigned patient population by evaluating appropriate status and physician orders for admission, observation, or outpatient at all points of entry to St. Clair Hospital, and ensures that appropriate orders are placed in the electronic medical record.
Minimum Qualifications
- Current licensure as a Registered Nurse in Pennsylvania.
- Five years of clinical experience as a Registered Nurse in an acute care setting.
- Two years of experience in Utilization Review.
- Highly effective communication skills.
- Ability to identify appropriate status and physician orders for the level of care the patient is or will be placed in.
- Ability to navigate electronic medical records and web-based applications.
- Possesses the ability to manage multiple tasks in a fast-paced environment.
Preferred Qualifications
- Bachelor's degree in nursing or health related field.
- Certification in Case Management.
About St. Clair Health
Sourced by ZipRecruiter
St. Clair Hospital is a highly honored, independent, 329 bed acute-care medical center that provides advanced, high quality health care to the residents of southwestern Pennsylvania. A member of the Mayo Clinic Care Network, St. Clair has 600 physicians and 2,500 employees. St. Clair Hospital is the largest employer in Pittsburgh’s South Hills. Providing virtually every health care service that residents may need throughout their lives, the Hospital is focused on continuously enhancing its services and technologies to ensure that the community’s health needs are met. The Hospital offers a comprehensive array of high-quality inpatient and outpatient services, including advanced cardiovascular services; specialized care for women and children; oncology services; orthopedics; emergency care; urgent care; and psychiatry and mental health services.
Industry
Health care and social assistance
Company size
1,001 - 5,000 Employees
Headquarters location
Pittsburgh, PA, US
Year founded
1954
Website
What St. Clair Health employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom