ZipRecruiter

Log In

1

Utilization Review Manager Jobs in Alabama (NOW HIRING)

Prime Healthcare

RN Case Manager

Gadsden, AL · On-site

An RN Case Manager will oversee and coordinate patient care from admission through discharge to ... Utilization Review: m onitor the use of hospital resources and services to ensure appropriate care ...

Workplace Options

Care Coordinator

Birmingham, AL · On-site

$18 - $24.25/hr

Specific responsibilities include referral and case management activities across all client locations, clinical administration of client benefits and participation in utilization review and quality ...

Workplace Options

Care Coordinator

Birmingham, AL · On-site

$18 - $24.25/hr

Specific responsibilities include referral and case management activities across all client locations, clinical administration of client benefits and participation in utilization review and quality ...

NHS Management, LLC

RN Unit Manager

Lineville, AL · On-site

$35 - $46.25/hr

We are in search of a qualified RN Unit Manager : * Assists in maintaining resident care standards ... utilization review activities. * Receives physicians' instructions regarding resident care and ...

NHS Management, LLC

RN Unit Manager

Columbiana, AL · On-site

$40.25 - $53.25/hr

We are in search of a qualified RN Unit Manager : * Assists in maintaining resident care standards ... utilization review activities. * Receives physicians' instructions regarding resident care and ...

NHS Management, LLC

RN Unit Manager

Birmingham, AL

$37.25 - $49.25/hr

We are in search of a qualified RN Unit Manager : * Assists in maintaining resident care standards ... utilization review activities. * Receives physicians' instructions regarding resident care and ...

NHS Management, LLC

RN Unit Manager (8a-5p)

Mobile, AL

$32.50 - $43/hr

We are in search of a qualified RN Unit Manager : * Assists in maintaining resident care standards ... utilization review activities. * Receives physicians' instructions regarding resident care and ...

NHS Management, LLC

RN Unit Manager 8a-5p

Birmingham, AL · On-site

$37.25 - $49.25/hr

We are in search of a qualified RN Unit Manager : * Assists in maintaining resident care standards ... utilization review activities. * Receives physicians' instructions regarding resident care and ...

previous page

Showing results 41-60

All JobsUtilization Review JobsUtilization Review Manager JobsUtilization Review Manager Jobs in Alabama

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 9, 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.

Is utilization review a stressful job?

Utilization review managers oversee the assessment of healthcare services to ensure appropriate and efficient care, which can involve high workloads and strict deadlines, leading to stress. The job requires strong organizational skills, attention to detail, and the ability to handle complex cases, which may contribute to job-related stress for some individuals.

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 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 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 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 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 87% Full Time, 12% Part Time, and 1% Contract. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution, with an average salary of $82,492 per year, or $39.7 per hour.

RN Case Manager

Riverview Regional Medical Center

Gadsden, AL • On-site

Other

Re-posted 4 days ago

Job description

Overview
Shift's Available: Day
Employment Type: Per Diem/PRN
Hours: 8-hour shift: weekends only
Location: Riverview Regional Medical Center - Gadsden, AL
We are seeking an RN Case Manager, also referred to as a Registered Nurse Case Manager or RN Clinical Case Manager. An RN Case Manager will oversee and coordinate patient care from admission through discharge to ensure quality, cost-effective outcomes. They assess patients' needs, develop care plans, and collaborate with physicians, nurses, social workers, and other providers to manage care transitions. RN Case Managers also conduct discharge planning, utilization review, and helping patients navigate insurance and healthcare systems.
Responsibilities
Essential Duties and Responsibilities (includes, but not limited to):
  • Patient Assessment: evaluate patients' medical, psychosocial, and discharge needs upon admission and throughout their stay
  • Care Coordination: develop and implement individualized care plans in collaboration with the healthcare team to ensure effective treatment and timely interventions
  • Discharge Planning: coordinate safe and appropriate discharge plans, including referrals to rehab, home health, or long-term care facilities
  • Utilization Review: monitor the use of hospital resources and services to ensure appropriate care and avoid unnecessary treatments or extended stays
  • Patient and Family Education: help patients and families understand care plans, post-discharge instructions, and available resources
  • Advocacy: advocate for patient needs and preferences, ensuring care is aligned with their goals and values
Qualifications
Before we go any further, we do have some deal-breakers. You must have:
  • Valid State RN License
  • BSW or other Bachelor degree in a related field
  • Current CCM or obtained within 6 months of hire
  • Experience and knowledge in basic to intermediate computer skills
  • Behavioral Violence Prevention Training within 3 months of hire and maintain current
Additional Qualifications That Are a Plus:
  • Minimum 5 years of acute care experience
  • At least one-year experience in case management, discharge planning or management
  • Current BLS (AHA) certificate
  • Knowledge of Milliman Criteria and InterQual Criteria

Full benefits at Prime Healthcare: https://www.primehealthcare.com/careers/benefits/
#LI-MP1
Pay Transparency
BCBS of Alabama interqual Jiva experience required
Employment Status
Per Diem
Shift
Days
Equal Employment Opportunity
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

Apply