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Utilization Review Case Manager Jobs in Utah (NOW HIRING)

University of Utah Health

Case Manager

Salt Lake City, UT · On-site

$19.25 - $25/hr

Case management services include monitoring patient care to ensure progress toward desired outcome ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

University of Utah Health

Case Manager

Salt Lake City, UT · On-site

$19.25 - $25/hr

Case management services include monitoring patient care to ensure progress toward desired outcome ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

University of Utah Health

Case Manager

Salt Lake City, UT · On-site

$19.75 - $25.25/hr

Case management services include monitoring patient care to ensure progress toward desired outcome ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

University of Utah Health

Case Manager

Salt Lake City, UT · On-site

$19.25 - $25/hr

Case management services include monitoring patient care to ensure progress toward desired outcome ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

University of Utah Health

Case Manager

Park City, UT · On-site

$21 - $27/hr

Case management services include monitoring patient care to ensure progress toward desired outcome ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

Imh

Manager Utilization and Care Management

Murray, UT · On-site +1

$44.99 - $69.44/hr

The Clinical Manager at Select Health leads and supervises a team of Utilization Review and Care Management clinicians within an insurance and managed care environment. This role ensures delivery of ...

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Utilization Review Case Manager information

See Utah salary details

$15

$33

$54

How much do utilization review case manager jobs pay per hour?

As of Sep 3, 2026, the average hourly pay for utilization review case manager in Utah is $33.22, according to ZipRecruiter salary data. Most workers in this role earn between $26.92 and $35.00 per hour, depending on experience, location, and employer.

What is a utilization review case manager?

A Utilization Review Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical treatments and services provided to patients. They review clinical information, coordinate with providers and insurance companies, and ensure that patient care aligns with established guidelines and policies. Their goal is to optimize patient outcomes while managing healthcare costs and ensuring compliance with regulations.

What are some common challenges utilization review case managers face when coordinating care across multiple departments?

Utilization Review Case Managers often navigate complex communication between physicians, nursing staff, insurance providers, and patients to ensure appropriate care and resource use. Balancing timely authorizations with evolving patient needs and varying documentation standards can be challenging. Additionally, staying current with changing regulations and payer requirements requires ongoing learning and adaptability. Building strong collaborative relationships and maintaining clear, concise documentation are key strategies for overcoming these hurdles.

What are the key skills and qualifications needed to thrive as a utilization review case manager, and why are they important?

To thrive as a Utilization Review Case Manager, you need a clinical background such as an RN or LCSW license, strong knowledge of medical necessity criteria, and experience with case management. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of regulatory guidelines like Medicare and Medicaid are essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration between patients, providers, and payers. These skills ensure appropriate resource use, compliance with regulations, and high-quality patient care.

What is the difference between Utilization Review Case Manager vs Utilization Review Nurse?

AspectUtilization Review Case ManagerUtilization Review Nurse
CredentialsTypically requires a nursing license or relevant healthcare certificationRegistered Nurse (RN) license is required
Work EnvironmentOffice-based, insurance companies, healthcare organizationsHospital, clinic, insurance review departments
Primary FocusReviewing medical necessity, coordinating care, managing casesAssessing medical records, clinical review, patient care evaluation

Both roles involve healthcare review and require nursing credentials, but the Utilization Review Case Manager often focuses on coordinating care and managing cases, while the Utilization Review Nurse emphasizes clinical assessment and review of medical records. Understanding these differences helps in choosing the right career path or job search focus.

What are popular job titles related to Utilization Review Case Manager jobs in Utah?

For Utilization Review Case Manager jobs in Utah, the most frequently searched job titles are:

What job categories do people searching Utilization Review Case Manager jobs in Utah look for?

The top searched job categories for Utilization Review Case Manager jobs in Utah are:

What cities in Utah are hiring for Utilization Review Case Manager jobs?

Cities in Utah with the most Utilization Review Case Manager job openings:

Utilization Review Case Manager jobs near you
Infographic showing various Utilization Review Case Manager job openings in Utah as of August 2026, with employment types broken down into 56% Full Time, and 44% Contract. Highlights an 100% In-person job distribution, with an average salary of $69,089 per year, or $33.2 per hour.

Behavioral Health Utilization/Authorization Specialist

Threshold Billing Solutions

Sandy, UT • On-site

$47K - $57K/yr

Full-time

Medical, Dental, Vision, Life, PTO

Re-posted 27 days ago

Key responsibilities

  • Review and interpret clinical documentation to determine and advocate for the appropriate level of care.

  • Prepare and submit authorization requests and appeals, and track authorization needs across all levels of care.

  • Maintain communication with insurance payers, treatment providers, and internal staff regarding client coverage and clinical needs.

Job description

Description

Edit
Posting
We are seeking a Behavioral Health Utilization Review / Authorization Specialist to support clinical authorization and utilization management for substance use disorder and mental health treatment programs. This role works closely with insurance companies and treatment providers to obtain authorizations for ASAM levels of care, including detoxification, residential, PHP, IOP and GOP treatment services.
 
Position Summary
The Utilization/Authorization Specialist plays a key role in advocating for clients by obtaining treatment authorizations and facilitating communication between providers and insurance payers. This position is responsible for reviewing behavioral health clinical documentation, submitting authorization requests, and ensuring accurate, timely tracking of coverage. The ideal candidate will be detail-oriented, organized, capable of communicating clearly with both internal teams and external insurance representatives, and may have direct clinical experience working as a Peer Support Specialist, Case Manager, SUDC, LCSW/CSW, CMHC in the substance abuse or mental health treatment field.
 
Experience in Utilization Review Not Required
While prior utilization review experience is always valued, many of our most successful team members have come from a variety of backgrounds within the behavioral health treatment field. Candidates who have worked in residential treatment centers, outpatient programs, or other clinical/administrative behavioral health settings often transition very well into this role. Their firsthand understanding of the treatment process, client needs, and clinical workflows provides an excellent foundation for learning utilization review.
 
We provide comprehensive training and ongoing support, so if you bring a strong work ethic, attention to detail, and a passion for supporting access to care, you can thrive with us even without previous UR experience.
 
Key Responsibilities
 
  • Maintain proactive and effective communication with insurance payers and managed care organizations.
  • Review and interpret clinical documentation, case notes, and assessments to determine and advocate for the appropriate level of care.
  • Prepare and submit initial and concurrent authorization requests, as well as appeals when necessary.
  • Enter and update authorization details in internal data systems accurately and promptly.
  • Track ongoing authorization needs across all levels of care (RTC, PHP, IOP, OP).
  • Communicate with facility staff and internal departments regarding client coverage and clinical needs.
  • Serve as a client advocate, ensuring access to appropriate care through effective payer communication.
  • Ensure timely documentation of all authorizations, decisions, and payer communications.
  • Perform other related duties as assigned.
 
Qualifications
 
  • May have direct clinical/behavioral health experience working as a Peer Support Specialist, Case Manager, SUDC, LCSW/CSW, CMHC in the substance abuse or mental health treatment field is preferred (but not required).
  • Experience in behavioral health or utilization review preferred (but not required).
  • Knowledge of CPT/ICD-10 coding, ASAM/LOCUS criteria, and EMR systems is a plus but not a requirement.
  • Strong verbal and written communication skills.
  • Excellent organization and attention to detail; able to manage multiple tasks and priorities.
  • Critical thinking and analytical skills with the ability to interpret and present clinical information.
  • Ability to work independently and as part of a collaborative team.
  • Proficiency in Microsoft Office and Google Workspace.
  • Comfortable working in a fast-paced environment with deadlines and competing priorities.
 
Education & Experience
 
  • High school diploma or equivalent required. Associate’s degree or higher preferred.
  • At least 1 year of experience in behavioral health or utilization review preferred (not required).
  • Prior experience in the substance use and/or mental health treatment field is highly valued.
  • Licensed or credentialed as a Peer Support Specialist, Case Manager, SUDC, LCSW/CSW, CMHC in the substance abuse or mental health treatment field is preferred (but not required).
 
 Benefits
 
  • Health, dental, and vision insurance
  • Paid time off (PTO)
  • Sick Time
  • Life insurance
  • Short- and long-term disability coverage
  • Lunch catered two times per week
  • Supportive, team-oriented work environment
  
Work Environment
 

  • This is a full-time, on-site position located at our Sandy, Utah office.
 
To Apply: Please submit your resume and a brief cover letter detailing your interest in the role and relevant experience.

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