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Utilization Review Manager Jobs (NOW HIRING)

ERC Pathlight

Utilization Review Manager

Aspen, CO · Hybrid

As a Manager, Utilization Review, you will hire, evaluate, and supervise Utilization Review Specialists and oversee Utilization Review operations. This role coordinates with Clinical Managers and ...

ERC Pathlight

Utilization Review Manager

Aspen, CO · On-site

$93K - $117K/yr

As a Manager, Utilization Review, you will hire, evaluate, and supervise Utilization Review Specialists and oversee Utilization Review operations. This role coordinates with Clinical Managers and ...

UHS

Utilization Review Manager

Grand Rapids, MI · On-site

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 ...

UHS

Utilization Review Manager

Grand Rapids, MI · On-site

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 ...

UHS

Utilization Review Manager

Grand Rapids, MI · On-site

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 ...

ERC Pathlight

Utilization Review Manager

Denver, CO · On-site +1

$93K - $117K/yr

As a Manager, Utilization Review, you will hire, evaluate, and supervise Utilization Review Specialists and oversee Utilization Review operations. This role coordinates with Clinical Managers and ...

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Utilization Review Manager information

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$39K

$91K

$167.5K

How much do utilization review manager jobs pay per year?

As of Jun 15, 2026, the average yearly pay for utilization review 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 Review Managers typically do not earn $2000 a day; such high daily rates are more common in specialized consulting, executive roles, or highly paid medical professionals. Most jobs with daily earnings of this level require extensive experience, certifications, or work in high-demand industries like finance, law, or executive management.

What are some common challenges faced by Utilization Review Managers in balancing patient care and cost efficiency?

Utilization Review Managers often encounter the challenge of ensuring patients receive appropriate care while also adhering to insurance and regulatory guidelines that emphasize cost efficiency. This requires strong analytical skills to assess clinical information and make fair determinations, often under tight deadlines and with incomplete data. The role also involves frequent communication with physicians, payers, and case managers to resolve disagreements and clarify criteria, making negotiation and diplomacy essential. Staying updated on changing healthcare regulations and payer requirements can add to the complexity, but it also provides opportunities for professional growth and leadership within healthcare administration.

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

A Utilization Review Manager can potentially earn around $10,000 per month, especially with extensive experience and certifications in healthcare management or medical review. These roles typically require strong analytical skills, knowledge of medical billing and coding, and the ability to oversee utilization review processes in healthcare settings. While a degree can be helpful, some professionals advance through experience and industry certifications such as Certified Professional in Healthcare Quality (CPHQ).

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

To thrive as a Utilization Review Manager, you need a solid background in healthcare management, clinical knowledge (often as an RN or healthcare professional), and experience with utilization review processes. Familiarity with case management software, electronic health records (EHRs), and certifications such as Certified Case Manager (CCM) or Certified Professional in Utilization Review (CPUR) are often expected. Strong analytical thinking, attention to detail, leadership, and effective communication are crucial soft skills for success in this role. These skills ensure appropriate resource use, regulatory compliance, and coordinated patient care, which are vital for both healthcare quality and operational efficiency.

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

Utilization Review Managers in healthcare or insurance industries can earn around $300,000 annually with extensive experience, advanced certifications, and leadership responsibilities. High-paying roles often require strong analytical skills, knowledge of medical billing and coding, and proficiency with healthcare management software. Executive-level positions in healthcare organizations may also reach or exceed this salary level.

What is the difference between Utilization Review Manager vs Utilization Review Coordinator?

AspectUtilization Review ManagerUtilization Review Coordinator
CertificationsTypically requires certifications like CCM or ACUMay require similar certifications but often less advanced
Work EnvironmentSupervises review teams, manages processes in healthcare or insurance settingsPerforms case reviews, supports the review process under supervision
Employer & IndustryHospitals, insurance companies, healthcare organizationsInsurance companies, healthcare providers, third-party administrators

The Utilization Review Manager oversees review teams and manages utilization review processes, focusing on policy compliance and efficiency. The Utilization Review Coordinator supports the review process by conducting case assessments and assisting managers. While both roles require similar certifications and work in related environments, the manager holds a supervisory position with broader responsibilities.

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. This role requires strong analytical skills and knowledge of healthcare policies and insurance guidelines.
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Utilization Review Manager jobs near you

Utilization Review Manager

ERC Pathlight

Aspen, CO • Hybrid

Other

Posted 18 days ago

Job description

What You'll Be Doing:

As a Manager, Utilization Review, you will hire, evaluate, and supervise Utilization Review Specialists and oversee Utilization Review operations. This role coordinates with Clinical Managers and Directors, Physicians, Business Office, and Managed Care Organizations to assure the smooth operation of Utilization Review functions and the provision of optimal patient care.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Clinically supervises teammates in 1:1 and group settings; provides in-moment assistance on escalated issues. Provides oversight to assigned team by supervising, guiding, and directing employees to be effective team members. Ensures that everyone is equipped with the right skills, tools, and talents necessary for executing their duties. Using the established people processes (performance, development, succession, and career) to ensure that the team's level of performance and capabilities meet current and future standards.
  • Advocates for optimal patient care in clinical care determination reviews by proactively reviewing and synthesizing the medical record for discussion with licensed mental health counselors and social workers and RNs at managed care organizations
  • Liaison with regional management teams to discuss clinical issues and facilitate solutions to situations that involve the UR process
  • Oversees regional caseload allocation
  • Attends treatment team meetings to share information and represent UR department; shares clinical documentation quality concerns

Education Requirements:

  • Graduate Degree  - Master's degree in psychology, counseling or social work. Alternatively, a bachelor's in Nursing

License and Certification Requirements

  • RN, IF nurse (Required)
  • Full clinical licensure, if mental health. (Required)

Knowledge, Skills and Abilities:

  • 4 to 6 years Utilization review experience (Required)
  • 2 years post-degree mental health experience in direct patient care (Required)
  • 2 years management experience (Preferred)
  • Willingness to work occasional night/weekends

Location & Schedule:

This position is posted as remote; however, per company policy, candidates residing within a 35mile radius of ZIP code 80230 will be required to follow a hybrid schedule, even if they applied to the remote posting.
  • Remote: Mondays and Fridays
  • On-site in our Denver Office: Tuesdays, Wednesdays, and Thursdays

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