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Utilization Manager Jobs in Westfield, MA (NOW HIRING)

MiraVista

Utilization Review Clinician

Holyoke, MA · On-site

Master's level clinician or RN. * Previous utilization management, preferably in an inpatient psychiatric setting * License eligible (LMHC or LICSW preferred) or RN * Possess sufficient knowledge ...

Lifepoint Health

Specialist, Utilization Review

Holyoke, MA · On-site

$33.22 - $44.85/hr

Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued ... UR contacts external case managers/managed care organizations for certification of insurance ...

Mission Hospital

RN - Case Manager

Springfield, MA · On-site

$2.0K/wk

Strong assessment, discharge planning, and utilization review skills Description: The RN Case Manager coordinates patient care plans and services across the continuum of care. Works closely with ...

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Utilization Manager information

See Westfield, MA salary details

$40.7K

$95K

$174.9K

How much do utilization manager jobs pay per year?

As of Aug 24, 2026, the average yearly pay for utilization manager in Westfield, MA is $95,030.00, according to ZipRecruiter salary data. Most workers in this role earn between $62,100.00 and $114,300.00 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?

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 Westfield, MA look for?

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

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

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

Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in Westfield, MA as of August 2026, with employment types broken down into 80% Full Time, 19% Part Time, and 1% Contract. Highlights an 81% Physical, 2% Hybrid, and 17% Remote job distribution, with an average salary of $95,030 per year, or $45.7 per hour.

Utilization Review Clinician

Holyoke, MA • On-site

MiraVista
Health Care and Social Assistance • 1 - 10 employees
Learn more about MiraVistaexternal

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 6 days ago

Job description

Join us as a Utilization Review Clinician!

Schedule: Monday - Friday, 40 hours, onsite 5 days a week.

As a Utilization Review Clinician for MiraVista in Holyoke, Massachusetts, you’ll bring your experience and knowledge where your voice matters. A Utilization Review Clinician is an integral part of our multidisciplinary team.

As a Utilization Review Clinician:

  • You will be an active participant in the health care team.

  • You are responsible for pre-certification, concurrent and discharge reviews, appeals and denials, and the compliance of contracted quality measures identified by managed care organizations.

  • You will serve as liaison between the hospital and outside payor sources in accordance with the mission and core principals of MiraVista Behavioral Health Center.

The Utilization Review Clinician will have the following:

  • Master's level clinician or RN.

  • Previous utilization management, preferably in an inpatient psychiatric setting

  • License eligible (LMHC or LICSW preferred) or RN

  • Possess sufficient knowledge regarding clinical treatment of psychiatric patients, the mental health care delivery system, and the managed care environment

  • Display excellent communication skills and an ability to integrate clinical and financial information in the context of an overall utilization management program

  • Requires the ability to work in a multidisciplinary, fast paced environment with a demonstrated sense of autonomy and professionalism.

When you join the growing MiraVista team as a Utilization Review Clinician, you’ll receive:

  • Medical, Dental, and Vision

  • 401(k) match

  • Employer paid long term disability (LTD)

  • Short term disability (STD)

  • Employer paid life and AD&D Insurance

  • Generous Paid Time Off

  • Flexible Spending Account

  • Tuition Reimbursement

Pay Range:

Compensation will be determined based on the candidate's relevant experience.

$80,000 - $90,000

MiraVista is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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