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Utilization Review Manager Jobs in Kentucky (NOW HIRING)

UHS

Utilization Coordinator PRN

Louisville, KY · On-site

$20/hr

  • Retirement

... Review Coordinator to join our team. Hourly pay: $20 Since 1985 The Brook Hospital has been ... The UM Coordinator is responsible for managing and coordinating the treatment activities offered to ...

UHS

Utilization Coordinator PRN

Louisville, KY

$20/hr

  • Retirement

... Review Coordinator to join our team. Hourly pay: $20 Since 1985 The Brook Hospital has been ... The UM Coordinator is responsible for managing and coordinating the treatment activities offered to ...

University of Minnesota School of Nursing

$249 - $373/hr

  • Retirement

Perform utilization review determinations for oncology populations, and support case and disease management teams to achieve optimal clinical outcomes * Serve as a subject matter expert in evidence ...

Stryker Corporation

$249 - $373/hr

  • Retirement

Perform utilization review determinations for oncology populations, and support case and disease management teams to achieve optimal clinical outcomes * Serve as a subject matter expert in evidence ...

Texas Health Institute

$249 - $373/hr

  • Retirement

Perform utilization review determinations for oncology populations, and support case and disease management teams to achieve optimal clinical outcomes * Serve as a subject matter expert in evidence ...

ScionHealth

Case Manager II

Louisville, KY · On-site

... utilization review and management, and discharge planning. Essential Functions Care Coordination ... Coordinates clinical and/or psycho-social activities with the Interdisciplinary Team and Physicians.

Prime Healthcare

$85 - $124/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Lead Case Management, Social Work, Utilization Review, and * Discharge Planning teams. * Drive patient throughput, LOS, utilization management, readmission, and denial prevention strategies.

ScionHealth

Case Manager II PRN

Louisville, KY · On-site

Utilization Management Conducts medical necessity review for appropriate utilization of services from admission through discharge. * Promotes effective and efficient utilization of clinical resources.

Firstsource

Clinical Denials Specialist

Louisville, KY · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Prepares reports for management review and identifies trends. * Reviews and understands utilization review and coverage guidelines for multiple payers * Identify process improvement opportunities

Elevance Health

Clinical Review Nurse II (US)

Louisville, KY · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Medical management or Utilization Review experience is preferred. For candidates working in person or virtually in the below locations, the salary* range for this specific position is $75,680 to $130 ...

Elevance Health

Clinical Review Nurse II (US)

Louisville, KY · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Medical management or Utilization Review experience is preferred. For candidates working in person or virtually in the below locations, the salary* range for this specific position is $75,680 to $130 ...

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Showing results 21-40

All JobsUtilization Review JobsUtilization Review Manager JobsUtilization Review Manager Jobs in Kentucky

Utilization Review Manager information

See Kentucky salary details

$33.9K

$79K

$145.5K

How much do utilization review manager jobs pay per year?

As of Aug 18, 2026, the average yearly pay for utilization review manager in Kentucky is $79,046.00, according to ZipRecruiter salary data. Most workers in this role earn between $51,700.00 and $95,100.00 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 Kentucky?

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

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

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

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

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

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

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

Utilization Review Manager jobs near you
Infographic showing various Utilization Review Manager job openings in Kentucky as of August 2026, with employment types broken down into 84% Full Time, 14% Part Time, and 2% Contract. Highlights an 83% Physical, 2% Hybrid, and 15% Remote job distribution, with an average salary of $79,046 per year, or $38 per hour.

Utilization Coordinator PRN

UHS

Louisville, KY • On-site

$20/hr

Per diem

Retirement

Re-posted 23 days ago

Universal Health Services rating

6.8

Company rating: 6.8 out of 10

Based on 253 frontline employees who took The Breakroom Quiz

494th of 888 rated healthcare providers

Job description

Responsibilities
The Brook Hospital Dupont located at 1405 Browns Ln is seeking a PRN Utilization Review Coordinator to join our team. Hourly pay: $20
Since 1985 The Brook Hospital has been offering hope to individuals, families, and communities. The Brook offers two outstanding hospitals in Louisville, Kentucky, KMI & Dupont. The Brook is the leader in providing quality mental health and addiction treatment services. Our commitment to care includes developing integrated delivery systems through partnerships with medical surgical hospitals, community mental health centers, educational institutions, managed care organizations, local health professionals and agencies. The Brook Hospital will strive to set the standard for excellence in the field of behavioral health care and will maintain its leadership role by treating each patient as a respected individual of our community.
Key Responsibilities include:
The UM Coordinator is responsible for managing and coordinating the treatment activities offered to the patient, interface with the treatment team/external case managers/managed care organizations, referring professionals and implementation and supervision of the discharge planning.
Benefit Highlights
Challenging and rewarding work environment
Growth and development opportunities within UHS and its subsidiaries
Competitive Compensation
401k plan with company match
Free Meals
Qualifications
EDUCATION:
Required: LPN, and/or Bachelor/Masters Degree in Social Work or Psychology
LICENSURE / CERTIFICATION:
Licensed LPN to practice in Kentucky if applicable
EXPERIENCE:
Required: One year of experience in Utilization Management
Preferred: Three to five years of experience in Utilization Management
EEO Statement
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
Notice
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best-in-class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.
The Brook Hospital Dupont is not accepting unsolicited assistance from search firms for this employment opportunity. Please, no phone calls or emails. All resumes submitted by search firms to any employee at UHS via-email, the Internet or in any form and/or method without a valid written search agreement in place for this position will be deemed the sole property of UHS. No fee will be paid in the event the candidate is hired by UHS as a result of the referral or through other means.

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About Universal Health Services

Sourced by ZipRecruiter

Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

King of Prussia, PA, US

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