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Utilization Manager Jobs (NOW HIRING)

Franciscan Health

Utilization Management Supervisor

... the Manager and Director, including ensuring appropriate utilization and denial management. QUALIFICATIONS * Bachelor's Degree in Nursing required * Active Indiana Registered Nurse (RN) license ...

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Utilization Manager information

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$39K

$91K

$167.5K

How much do utilization manager jobs pay per year?

As of Jun 29, 2026, the average yearly pay for utilization manager in the United States is $91,011.00, according to ZipRecruiter salary data. Most workers in this role earn between $59,500.00 and $109,500.00 per year, depending on experience, location, and employer.

What jobs pay $2000 a day?

Utilization Managers typically do not earn $2000 a day; such high daily rates are more common in specialized consulting, executive roles, or highly experienced professionals in fields like finance, law, or certain medical specialties. These roles often require advanced certifications, extensive experience, and work in high-demand environments. Most standard utilization management positions offer salaries that are significantly lower than this daily rate.

What job makes $10,000 a month without a degree?

A Utilization Manager can potentially earn $10,000 or more per month through experience and advanced skills in healthcare or corporate settings, often without a formal degree. Success in such roles depends on industry knowledge, certifications, and the ability to optimize resource use, with some professionals reaching high earnings through management of large teams or projects.

What jobs in the US pay 300,000 a year?

Utilization Managers in healthcare and insurance industries can earn around $300,000 annually, especially with extensive experience, certifications, and leadership responsibilities. High-paying roles often require advanced skills in data analysis, resource allocation, and strategic planning, and may involve managing large teams or complex projects.

What does a utilization manager do?

A utilization manager oversees the efficient use of resources, such as staff and equipment, to ensure that services are delivered within budget and meet organizational goals. They analyze data, monitor utilization rates, and coordinate with teams to optimize productivity and reduce waste, often using management software and reporting tools.

What are the key skills and qualifications needed to thrive as a Utilization Manager, and why are they important?

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 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?

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.

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Utilization Manager jobs near you
Utilization Manager

Utilization Manager

Arkansas Childrens Hospital

Little Rock, AR

Full-time

Posted 14 days ago

Key responsibilities

  • Complete concurrent and retrospective medical record reviews to ensure services are appropriate, efficient, and compliant with payer and regulatory guidelines.

  • Process pre-authorizations and requests for services that are medically necessary and adherent to payer rules.

  • Consult with multidisciplinary team members regarding patient diagnosis, medical justification, length of treatment, and case documentation.

Arkansas Children's Hospital rating

7.5

Company rating: 7.5 out of 10

Based on 55 frontline employees who took The Breakroom Quiz

318th of 1,003 rated hospitals

Job description

ARKANSAS CHILDREN'S IS A TOBACCO FREE WORKPLACE. FLU VACCINES ARE REQUIRED. ARKANSAS CHILDREN'S IS AN EQUAL OPPORTUNITY EMPLOYER. ALL QUALIFIED APPLICANTS WILL RECEIVE CONSIDERATION FOR EMPLOYMENT WITHOUT REGARD TO RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, GENDER IDENTITY OR EXPRESSION, NATIONAL ORIGIN, AGE, DISABILITY, PROTECTED VETERAN STATUS OR ANY OTHER CHARACTERISTIC PROTECTED BY FEDERAL, STATE, OR LOCAL LAWS.

This position has been designated as safety sensitive and cannot be filled by a candidate who is a current user of medical marijuana.

CURRENT EMPLOYEES: Please apply via the internal career site by logging into your Workday Account (https://www.myworkday.com/archildrens/)and search the "Find Jobs" report.

Work Shift:

Day Shift

Time Type:

Full time

Department:

CC017217 Children's Specialty ServicesSummary:Arkansas Children's Behavioral Health, FT, M-F, 8a-5pAdditional Information:

The Utilization Manager improves overall quality of clinical documentation to ensure that information in the medical record accurately reflects client's care and progress, and thus utilization of resources. This role works with providers to correctly capture that services being delivered are medically necessary and timely.

RN or LPC Required

Masters Degree Required

3 years in Mental Health/ Hospital Setting

Required Education:Master's degree in a related field of study.Recommended Education:Master's degree in a related field of study., Master's Degree NursingRequired Work Experience:Recommended Work Experience:Required Certifications:1 of the following certifications is required - Recommended Certifications:Licensed Certified Social Worker (LCSW) - Arkansas Professional Board, Licensed Professional Counselor (LPC) - Arkansas Board of Examiners in Counseling, RN License (AR or Compact State) - Arkansas State Board of Nursing (ASBN)Description
1. Complete concurrent and retrospective medical record reviews to ensure services are appropriate, efficient, and compliant with payer and regulatory guidelines.
2. Process pre-authorizations and requests for services that are medically necessary and adherent to payer rules.
3. Consult with multidisciplinary team members regarding patient diagnosis, medical justification, length of treatment, and case documentation.
4. Represents the clinical and administrative team with payers for any appeals or disagreements related to care plans.
5. Provide training and education about utilization requirements to clinical and supervisory staff.
6. Demonstrate competency on mental health symptomology, treatment options and efficacies, and impact of trauma and mental health on overall well-being.
7. Participate in quality or accreditation audits to ensure program compliance on utilization review regulations.
8. Completes clinical supervision and staffing to clinicians completing their required supervision hours for full licensure, if necessary.
9. Knowledge of regulatory requirements and Arkansas laws governing services to children, adolescent and adults preferred.
10. Other duties as assigned.

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