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Utilization Review Manager Jobs in Alabama (NOW HIRING)

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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 21, 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.

Quality Utilization Reviewer I

Children's of Alabama

Birmingham, AL • On-site

Full-time

Re-posted 2 days ago

Children's Of Alabama rating

6.5

Company rating: 6.5 out of 10

Based on 41 frontline employees who took The Breakroom Quiz

722nd of 1,061 rated hospitals

Job description

In Utilization Management at Main Campus Lee Building
Work schedule will be 7on / 7off on the Day Shift, 7am- 3:30pm, Monday- Sunday every other week after completion of orientation.
Summary:
The UR Reviewer 1 is responsible for performing inpatient admission, concurrent, and observation reviews based on pre-established criteria exclusively for AL Medicaid and all commercial payers other than BCBS AL. Upon successful completion of training by UR Reviewer 2 and with the approval of the UR Manager & Department Director, UR Reviewer 1 with LPN/RN licensure may advance to Reviewer 2 (if position becomes available).
Other information:
Education
  • Graduate of an accredited School of Nursing or Social Work

Experience
  • 2 years in hospital setting or related field (i.e. third-party payer)
  • Utilization review experience preferred

Licensures, Certifications, and/or Registries
  • Current AL licensure as RN or LPN

Knowledge, Skills, and Abilities
  • Knowledge of third-party payer requirements in utilization review preferred

Credentials with Equivalent Qualifications:
Essential:
* Registered Nurse AL Single State or any of the following equivalent qualifications below:
- Registered Nurse AL NLC Multi State
- Registered Nurse Non-AL NLC Multi State
- Licensed Practical Nurse AL Only
- Licensed Practical Nurse AL NLC Multi State
- Licensed Practical Nurse Non-AL NLC Multi State
- Licensed Independent Clinical Social Worker
Education with Equivalent Qualifications:
Essential:
* Associate of Science Nursing in Nursing or Bachelors of Science or Arts in Nursing
Experience with Equivalent Qualifications:
Essential:
* 2 Years Staff Level

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About Children's of Alabama

Sourced by ZipRecruiter

Since 1911, Children’s of Alabama has provided specialized medical care for ill and injured children. Ranked among the best children’s hospitals in the nation by U.S. News & World Report, Children’s serves patients from every county in Alabama and nearly every state. With more than 3.5 million square feet, it is one of the largest pediatric medical facilities in the United States. Children’s offers inpatient and outpatient services at its Russell Campus on Birmingham’s historic Southside with additional specialty services provided at Children’s South, Children’s on 3rd and in Huntsville and Montgomery. Primary medical care is provided in more than a dozen communities across central Alabama. Children’s is the only health system in Alabama dedicated solely to the care and treatment of children. It is a private, not-for-profit medical center that serves as the teaching hospital for the University of Alabama at Birmingham (UAB) pediatric medicine, surgery, psychiatry, research and residency programs. The medical staff consists of UAB faculty and Children’s full-time physicians as well as private practicing community physicians. Our staff is committed to providing the finest pediatric healthcare to all children. We built our legacy on our core values of trust, teamwork, compassion, innovation and commitment. We know that every time we come through these doors we will live up to our high standards as we work to make a difference in children's lives. You've chosen a career that’s all about care. If you want to make a difference the life of children and their families, if you want to advance in your profession, if you appreciate good benefits, and want to work with outstanding medical professionals in a variety of areas, then Children’s of Alabama is where you belong.

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Birmingham, AL, US

Year founded

1911

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