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Utilization Review Manager Jobs in Florida (NOW HIRING)

Enlyte

Utilization Reviewer 2

Tampa, FL · On-site

$59K - $76K/yr

Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...

Genex Services

Utilization Reviewer 2

Tampa, FL · On-site

$59K - $76K/yr

Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...

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All JobsUtilization Review JobsUtilization Review Manager JobsUtilization Review Manager Jobs in Florida

Utilization Review Manager information

See Florida salary details

$29.1K

$68K

$125.2K

How much do utilization review manager jobs pay per year?

As of Aug 23, 2026, the average yearly pay for utilization review manager in Florida is $68,012.00, according to ZipRecruiter salary data. Most workers in this role earn between $44,500.00 and $81,800.00 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 Florida?

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

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

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

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

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

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

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

Utilization Review Manager jobs near you
Infographic showing various Utilization Review Manager job openings in Florida as of August 2026, with employment types broken down into 87% Full Time, 12% Part Time, and 1% Contract. Highlights an 81% Physical, 2% Hybrid, and 17% Remote job distribution, with an average salary of $68,012 per year, or $32.7 per hour.

Utilization Reviewer 2

Enlyte

Tampa, FL • On-site

$59K - $76K/yr

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 25 days ago

Job description

Company Overview
At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our industry-leading solutions and services. Whether you're supporting a Fortune 500 client or a local business, developing cutting-edge technology, or providing clinical services you'll work alongside dedicated professionals who share your commitment to excellence and make a meaningful impact. Join us in fueling our mission to protect dreams and restore lives, while building your career in an environment that values collaboration, innovation, and personal growth.
Be part of a team that makes a real difference.
Job Description
This is an In Office Position from Monday - Friday from 9 AM - 5 PM EST
FL Registered Nurse or Chiropractor License Required
We are seeking a qualified Utilization Reviewer located in the Tampa, FL area. The ideal candidate performs utilization review on workers' compensation related prospective, concurrent, and retrospective treatment referrals. The ideal candidate will play a crucial role in assessing and ensuring the appropriateness of medical treatment plans, contributing to effective claims management and optimal patient outcomes.
  • Uses solid clinical judgment to ensure treatment approved is medically necessary.
  • Forwards treatment requests for physician reviewer that cannot be approved as medically necessary based on application of solid clinical judgment.
  • Collaborates with healthcare providers, claims adjusters, and other stakeholders to gather relevant information for comprehensive assessments.
  • Evaluates medical documentation to ensure compliance with industry standards and regulatory requirements.
  • Communicates findings clearly and concisely through written reports and verbal discussions.
  • Stays up-to-date on industry regulations, medical advancements, and best practices to enhance the quality of reviews.
  • Participates in team meetings and contributes to the continuous improvement of utilization review processes.

Qualifications
Minimum Education: Bachelor's degree.
Required Skills and Experience:
  • Registered Nurse (RN) or chiropractor with a valid license in the state of Florida.
  • Minimum of 2 years of utilization review experience; or an advanced degree without experience.
  • Knowledge of medical terminology, treatment modalities, and healthcare guidelines.
  • Analytical and critical thinking skills for effective decision-making.
  • Strong communication and interpersonal skills to liaise with diverse stakeholders.
  • Ability to work independently and collaboratively within a team environment.
  • Detail-oriented with strong organizational skills to manage multiple cases efficiently.
  • Familiarity with relevant software and tools used in healthcare.

Desired Skills and Experience:
  • Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity.
  • Prior experience in the workers' compensations field.

Benefits
We're committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Health Savings Accounts / Flexible Spending Accounts, Life and AD&D Insurance, 401(k), Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living. Benefits eligibility may differ depending on full-time or part-time status. Compensation depends on the applicable US geographic market. The expected base pay for this position ranges from $59,500 - $76,000 annually, and will be based on a number of additional factors including skills, experience, and education.
The Company is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.
Don't meet every single requirement? Studies have shown that women and underrepresented minorities are less likely to apply to jobs unless they meet every single qualification. We are dedicated to building a diverse, inclusive, and authentic workplace, so if you're excited about this role but your past experience doesn't align perfectly with every qualification in the job description, we encourage you to apply anyway. You may be just the right candidate for this or other roles.
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