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Utilization Manager Jobs (NOW HIRING)

UNC Health

Utilization Manager (RN)

Hendersonville, NC · On-site

Utilization Manager (RN) Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve. Summary: The ...

Hhs

Linen Utilization Manager

Youngstown, OH

Manage the hospital's linen program to support effective distribution, collection, and overall linen usage. Linen is one of the most overused resources in a hospital, and through effective management ...

New

Duke Health

Utilization Manager 30 hour EOW

Durham, NC · On-site

Complies with current rules and regulatory requirements pertaining to utilization management. Initiates actions to obtain appropriate determinations. Collaborates with members of the healthcare team ...

Duke Health

Utilization Manager 30 hour EOW

Durham, NC · On-site

Complies with current rules and regulatory requirements pertaining to utilization management. Initiates actions to obtain appropriate determinations. Collaborates with members of the healthcare team ...

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$91K

$167.5K

How much do utilization manager jobs pay per year?

As of Jun 6, 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 does a Utilization Manager do?

A Utilization Manager is responsible for evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. Their primary goal is to ensure that patients receive the right care at the right time while also controlling costs for hospitals, insurance companies, or healthcare organizations. Utilization Managers review patient records, coordinate with healthcare providers, and use clinical guidelines to make informed decisions about treatment approvals or denials. They play a key role in maintaining quality care and regulatory compliance.

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.

More about Utilization Manager jobs
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Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in the United States as of May 2026, with employment types broken down into 84% Full Time, 15% Part Time, and 1% Contract. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution, with an average salary of $91,011 per year, or $43.8 per hour.

RN - Utilization Manager

Talented Medical Solutions

Middleburg Heights, OH • On-site

$1K - $2K/wk

Full-time

Posted 13 days ago

Job description

Job Title: RN – Utilization Manager
Location: Middleburg Heights, OH

Schedule:

  • Full-time, 40 hours/week

  • Five 8-hour shifts (8:00a–4:30p)

  • 40 hours not guaranteed; may be low-censused up to one 12-hour shift per pay period

  • Start Date: ASAP or 12/08 (URGENT NEED)

Pay:

  • Local: $47/hr

  • Traveler: $54/hr

Position Details:
Seeking an experienced RN Utilization Manager to support clinical reviews and care coordination in an acute care setting. The ideal candidate will have a strong background in clinical nursing, case management, and utilization management.

Requirements:

  • Minimum 5 years of recent clinical nursing experience

  • Prior Case Management or Utilization Management experience required

  • Experience with screening criteria: Cerner, InterQual, and MCG

  • Active, unencumbered Ohio RN license

  • ACM or CCM certification preferred