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Utilization Review Management Jobs (NOW HIRING)

... Utilization Review Manager. Position Description: The Utilization Manager is responsible for ... This includes the implementation of case management scenarios, consulting with all services to ...

... management including, but not limited to: utilization review, case documentation, payer relationships, regulatory requirements, staff management and department administration. Supports the overall ...

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... management including, but not limited to: utilization review, case documentation, payer relationships, regulatory requirements, staff management and department administration. Supports the overall ...

New

... Utilization Review Manager. Position Description: The Utilization Manager is responsible for ... This includes the implementation of case management scenarios, consulting with all services to ...

... management including, but not limited to: utilization review, case documentation, payer relationships, regulatory requirements, staff management and department administration. Supports the overall ...

Manager - Utilization Management DEPARTMENT: Utilization Management DATE LAST REVIEWED: August 2025 OUR VISION: Creating America's healthiest community, together OUR MISSION: In the spirit of love ...

Direct Hire - Utilization Review Nurse, this is an onsite position, working with our client in ... Collaborate with physicians, case management, and care teams * Support discharge planning and care ...

Direct Hire - Utilization Review Nurse, this is an onsite position, working with our client in ... Collaborate with physicians, case management, and care teams * Support discharge planning and care ...

Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No ... cycle management professionals specializing in the substance use disorder, mental health, and ...

The Utilization review tech essentially works to coordinate the utilization review and appeals process as part of the denial management initiatives. Utilization review tech is responsible for ...

Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No ... cycle management professionals specializing in the substance use disorder, mental health, and ...

To provide ongoing support and enhance the quality of resident care, to promote continuity of care and cost effectiveness through the integrating and function of case management, utilization review ...

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Utilization Review Management information

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$15

$31

$53

How much do utilization review management jobs pay per hour?

As of Jun 24, 2026, the average hourly pay for utilization review management in the United States is $31.94, according to ZipRecruiter salary data. Most workers in this role earn between $22.36 and $40.62 per hour, depending on experience, location, and employer.

Is utilization management a hard job?

Utilization review management is a demanding role that requires strong analytical skills, attention to detail, and knowledge of healthcare policies. It often involves reviewing medical records, making decisions on coverage, and working under tight deadlines, which can be challenging for some professionals.

What jobs pay 2000 a day?

In utilization review management, high-paying roles such as senior or executive-level positions can potentially pay around $2,000 per day, especially for experienced professionals with specialized certifications and extensive industry knowledge. These roles often involve leadership, complex case assessments, and may require advanced degrees or licensure, with compensation varying by employer and location.

What is the difference between Utilization Review Management vs Utilization Review Nurse?

AspectUtilization Review ManagementUtilization Review Nurse
CredentialsTypically requires a healthcare management or related certification, sometimes a nursing backgroundRegistered Nurse (RN) license, often with additional utilization review certification
Work EnvironmentOffice-based, administrative setting, collaborating with healthcare providers and insurance companiesClinical setting, reviewing patient charts, and making utilization decisions
Employer & IndustryHealth insurance companies, managed care organizations, healthcare administratorsHospitals, insurance companies, healthcare facilities

Utilization Review Management professionals focus on overseeing review processes, policy compliance, and administrative tasks, while Utilization Review Nurses conduct clinical assessments to determine appropriate care. Both roles are essential in healthcare utilization management but differ in responsibilities and work environment.

What are some common challenges faced by professionals in Utilization Review Management, and how can they be addressed?

Professionals in Utilization Review Management often encounter challenges such as balancing regulatory compliance with patient advocacy and managing high caseloads under tight deadlines. Navigating complex insurance policies and ensuring timely communication between healthcare providers and payers can be demanding. Staying organized, leveraging technology for workflow management, and participating in ongoing training can help address these challenges. Additionally, strong collaboration with interdisciplinary teams ensures more effective and efficient utilization review processes.

What does a utilization review manager do?

A utilization review manager oversees the process of evaluating medical services to ensure they are necessary, appropriate, and cost-effective. They coordinate with healthcare providers, review patient records, and ensure compliance with insurance and regulatory standards, often using specialized software. Strong analytical skills and knowledge of healthcare policies are essential for this role.

What is Utilization Review Management?

Utilization Review Management is a process used in healthcare to evaluate the necessity, appropriateness, and efficiency of medical services, procedures, and facilities. Its primary goal is to ensure that patients receive appropriate care while preventing unnecessary or duplicative services. Utilization Review Management helps healthcare providers and insurance companies manage costs, maintain high-quality care, and comply with regulations. Professionals in this field often review patient records, coordinate with clinicians, and make recommendations about coverage or care plans.

What are the key skills and qualifications needed to thrive in Utilization Review Management, and why are they important?

To thrive in Utilization Review Management, you need a solid background in healthcare, strong analytical skills, and often a clinical degree such as RN or LPN, with certification in utilization review or case management being highly beneficial. Familiarity with medical coding systems (ICD-10, CPT), electronic health records (EHRs), and utilization management software is typically required. Excellent communication, critical thinking, and negotiation skills help you collaborate with providers and payers while advocating for patient care. These competencies are vital for ensuring appropriate resource use, regulatory compliance, and optimal patient outcomes.

What is the highest paying job in healthcare management?

In healthcare management, executive roles such as Chief Executive Officer (CEO), Chief Operating Officer (COO), and Chief Financial Officer (CFO) tend to be the highest paid, often earning six-figure salaries or more. These positions require extensive experience, leadership skills, and often advanced degrees or certifications, and they oversee large healthcare organizations or systems.
More about Utilization Review Management jobs
What cities are hiring for Utilization Review Management jobs? Cities with the most Utilization Review Management job openings:
What states have the most Utilization Review Management jobs? States with the most job openings for Utilization Review Management jobs include:
Infographic showing various Utilization Review Management job openings in the United States as of June 2026, with employment types broken down into 95% Full Time, 4% Part Time, and 1% Temporary. Highlights an 90% Physical, 2% Hybrid, and 8% Remote job distribution, with an average salary of $66,436 per year, or $31.9 per hour.
Utilization Review Manager

Utilization Review Manager

UHS

Grand Rapids, MI

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 23 days ago


Universal Health Services rating

6.7

Company rating: 6.7 out of 10

Based on 249 frontline employees who took The Breakroom Quiz

523rd of 875 rated healthcare providers


Job description

Responsibilities

Benefit Highlights:

·       Excellent Medical, Dental, Vision and Prescription Drug Plans

·       Student Loan Repayment Program

·       401(k) and Roth 401(k) with Company Match

·       Employee Stock Purchase Program

·       Competitive Compensation & Paid Time Off

·       Disability, Life, Pet Insurance and much more!

More information is available on our Benefits Guest Website: benefits.uhsguest.com 

Forest View Hospital, located just seven miles southeast of downtown Grand Rapids, Michigan, is a private 108 bed psychiatric facility that serves children, adolescents and adults. We are licensed by the State of Michigan, fully accredited by The Joint Commission and we bring more than 45 years of experience to the evaluation, diagnosis and treatment of a wide range of behavioral health problems. As a part of our continued success and growth, we are seeking qualified applicants for a Utilization Review Manager. 

Position Description:

The Utilization Manager is responsible for directing and overseeing the Utilization Program for Inpatient and Outpatient services. This includes the implementation of case management scenarios, consulting with all services to ensure the provision of an effective treatment plan for all patients, oversees the response to requests for services and interfaces with managed care organizations, external reviewers, and other payors.

More information is available on our Benefits Guest Website: benefits.uhsguest.com 

Forest View also has a focus on furthering your Education and Career Development:

·       Career ladder focus with opportunities to cross train, build skills and grow in leadership

·       Tuition reimbursement assistance program

·       Tuition savings through a partnership with Chamberlain University

·       In-house Psychiatric Nurse Residency Transition-to-Practice Orientation (20 CEUs)

·       Career development opportunities across UHS and our 300+ locations!

·       HealthStream online learning catalogue with plenty of free CEU courses


Qualifications

Job Requirements:

Education: Bachelor's Degree required.

Experience:  A minimum of three years’ experience in Utilization Management Required. 

License: State of Michigan licensure as LLP, LPC, LLPC LMSW, LLMSW, or Registered Nurse RN.

About Universal Health Services

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

Avoid and Report Recruitment Scams

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.

Qualifications:

Job Requirements:

Education: Bachelor's Degree required.

Experience:  A minimum of three years’ experience in Utilization Management Required. 

License: State of Michigan licensure as LLP, LPC, LLPC LMSW, LLMSW, or Registered Nurse RN.

About Universal Health Services

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

Avoid and Report Recruitment Scams

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.

Education:UNAVAILABLEEmployment Type: FULL_TIME

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About Universal Health Services

Sourced by ZipRecruiter

Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

King of Prussia, PA, US