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Utilization Review Manager information

See Alabama salary details

$35.3K

$82.5K

$151.8K

How much do utilization review manager jobs pay per year?

As of Aug 28, 2026, the average yearly pay for utilization review manager in Alabama is $82,492.00, according to ZipRecruiter salary data. Most workers in this role earn between $53,900.00 and $99,200.00 per year, depending on experience, location, and employer.

What does a utilization review manager do?

A Utilization Review Manager oversees the process of evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. They ensure that patient care adheres to established guidelines and that healthcare resources are used effectively. Their duties typically include leading a team of reviewers, collaborating with healthcare providers, ensuring compliance with regulations, and making recommendations on care authorization. The goal is to balance quality patient care with cost-effective resource management.

What are the key skills and qualifications needed to thrive as a utilization review manager?

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 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 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.

How much does a utilization review manager make?

A utilization review manager typically earns between $70,000 and $110,000 annually, depending on experience, location, and the size of the organization. They often require knowledge of healthcare policies, insurance processes, and may hold certifications such as URAC or CCM.

Is utilization review manager a stressful job?

Utilization review managers often work in a fast-paced healthcare environment, which can be stressful due to the need to meet strict deadlines, ensure accurate assessments, and handle complex cases. The role requires strong organizational skills and attention to detail, and some individuals may find the responsibility and workload challenging, especially during high-volume periods.

What are the most commonly searched types of Utilization Review jobs in Alabama?

The most popular types of Utilization Review jobs in Alabama are:

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

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

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

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

What cities in Alabama are hiring for Utilization Review Manager jobs?

Cities in Alabama with the most Utilization Review Manager job openings:

Utilization Review Manager jobs near you
Infographic showing various Utilization Review Manager job openings in Alabama as of August 2026, with employment types broken down into 84% Full Time, 12% Part Time, and 4% Contract. Highlights an 81% Physical, 2% Hybrid, and 17% Remote job distribution, with an average salary of $82,492 per year, or $39.7 per hour.

Utilization Review Technician

Gadsden, AL

Prime Healthcare
Hospitals • 10K+ employees

6.4

Company rating: 6.4 out of 10

Based on 286 frontline employees who took The Breakroom Quiz

645th of 895 rated healthcare providers

Free food

People enjoy working here

Recommended by students

Learn more about Prime Healthcareexternal

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 16 days ago

Job description

Department: Social Work Services 

Shifts Available: Days  

Employment Type: Full Time 

Hours: 8-hour shift – 7:30am to 3:30pm 

Location: Riverview Regional Medical Center – Gadsden, AL 

We are seeking an Utilization Review Technician II, sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator II. The Utilization Review Technician II supports the utilization review, appeals, and denial management process by coordinating communication and tracking payer-related activity. This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals, and denials. The position also assists with payer audits, Release of Information, discharge coordination, and other departmental needs. 


  • Coordinate phone calls, data entry, and tracking related to authorizations, expedited reviews, appeals, and denials 
  • Document and track all communication attempts with insurance providers and health plans 
  • Follow up on denials while partnering with Utilization Review, Business Office, and Case Management teams 
  • Maintain accurate tracking of government and payer audits, including RAC, MAC, CERT, ADR, QIO, Medicaid, and pre/post-payment reviews 
  • Provide support with Release of Information, discharge coordination, and other assigned departmental duties 

  • High School Diploma or equivalent
  • Two years of relevant experience
  • Accurate alphabetic, numeric, and/or terminal-digit filing skills
  • Computer data entry with 10-key, with accurate typing speed of 35 wpm
  • Associates Degree or higher, preferred
  • Excel skills. highly preferred
  • Knowledge of terminal digit filing and medical terminology, preferred
  • Knowledge of State and Federal regulatory requirements for medical staff documentation, preferred
  • Completion of a medical terminology course, preferred
  • Background in business and office training, preferred

Here are some of the benefits of working at Prime Healthcare: 

  • Health, dental, and vision insurance options 
  • Paid vacation, sick time and holidays 
  • Bereavement leave, FMLA and other leave options 
  • Employer 401K options 
  • Tuition reimbursement options  
  • Life, disability, and other insurance options 
  • Many other amazing benefits 

Full benefits at Prime Healthcare: https://www.primehealthcare.com/careers/benefits/   

#LI-MP1


Full Time
Days

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

 

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