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Utilization Review Manager Jobs in Ontario (NOW HIRING)

ST JOHNS HEALTH

$22.68 - $27/hr

John's Health as a whole. · Assists Supervisor or Manager with various special projects as needed. · Collaborates with other departments such as Utilization Review, Case Management, Nursing Units ...

Compass Health Network

$36.29 - $39.29/hr

Provide licensure supervision and perform utilization review activities as assigned * Attend ... Are adaptable, organized, and able to manage both scheduled and unscheduled patient needs * Believe ...

LRQA

Automotive Auditor Manager

Toronto, ON · On-site

Support audit planning, resource allocation, regional capacity management, and auditor utilization. * Review audit reports, nonconformities, corrective actions, and certification recommendations for ...

Brookfield Asset Management Us

Manager, FP&A

Toronto, ON · On-site

CA$120K - CA$140K/yr

... utilization to support management reporting, forecasting and analysis * Serve as first reviewer of consolidated forecasts, actual results and business plans, including detailed analysis of key ...

HOME CAREGIVERS PARTNERSHIP LLC

Participates in peer review and quality management as assigned. * Participates in utilization review of medical records as assigned. * Gives total patient care as needed. * Takes on-call duty nights ...

HOME CAREGIVERS PARTNERSHIP LLC

Participates in peer review and quality management as assigned. * Participates in utilization review of medical records as assigned. * Gives total patient care as needed. * Takes on-call duty nights ...

HOME CAREGIVERS PARTNERSHIP LLC

Participates in peer review and quality management as assigned. * Participates in utilization review of medical records as assigned. * Gives total patient care as needed. * Takes on-call duty nights ...

Titanium Logistics Inc.

Terminal Manager

Bolton, ON · On-site

CA$80K - CA$90K/yr

Strong knowledge of transportation operations, dispatch, routing, equipment utilization, and fleet ... Strong financial and analytical skills with the ability to manage budgets, review expenses, and ...

Humber River Health

Patient Flow Manager

Toronto, ON · On-site

CA$115K - CA$141K/yr

Define and prepare reports to inform management, physician chiefs, and administrative team of patient activity and bed utilization to manage surges in patient volumes * Review/Approve Observer ...

Humber River Health

Patient Flow Manager

Toronto, ON · On-site

CA$118K - CA$144K/yr

Define and prepare reports to inform management, physician chiefs, and administrative team of patient activity and bed utilization to manage surges in patient volumes * Review/Approve Observer ...

Humber River Health

Patient Flow Manager

Toronto, ON

CA$118K - CA$144K/yr

Define and prepare reports to inform management, physician chiefs, and administrative team of patient activity and bed utilization to manage surges in patient volumes * Review/Approve Observer ...

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All JobsUtilization Review JobsUtilization Review Manager JobsUtilization Review Manager Jobs in Ontario

Utilization Review Manager information

See Ontario salary details

$56.5K

$74.6K

$84K

How much do utilization review manager jobs pay per year?

As of Sep 6, 2026, the average yearly pay for utilization review manager in Ontario is $74,627.00, according to ZipRecruiter salary data. Most workers in this role earn between $67,500.00 and $80,000.00 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 Ontario?

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

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

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

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

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

Utilization Review Manager jobs near you
Infographic showing various Utilization Review Manager job openings in Ontario as of August 2026, with employment types broken down into 80% Full Time, 19% Part Time, and 1% Contract. Highlights an 81% Physical, 2% Hybrid, and 17% Remote job distribution, with an average salary of $74,627 per year, or $35.9 per hour.

Patient Admissions Coordinator

ST JOHNS HEALTH

On-site

$22.68 - $27/hr

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

JOB SUMMARY
Embraces the vision of Patient Financial Services: "To provide highly regarded and desirable Patient Financial
Services that are caring, honorable, and innovative." Under the direction of the Patient Financial Services Supervisor,
the Patient Admissions Coordinator maintains proficient emergency registration as well as various inpatient and
outpatient registration. Engages in efficient processing of assigned tasks and projects while providing an exceptional
level of customer service for all hospital customers. Provides multiple patient financial services in the form of: timely
and accurate patient registrations, existing patient system demographic, insurance data updates, basic payment
collections, and engagement in quality assurance and process accuracy.
 
ESSENTIAL FUNCTIONS
Registration
· Registers patients in a timely and effective manner, while maintaining a high level of attention to detail with data
entry. Audits visits for completeness. Ensures that paperwork and documentation are collected when appropriate; i.e.
ID, insurance, consent, physician order, name change information, advance directives, etc.
· Identifies compliance of orders, including CPT and ICD-10 codes, along with other requirements per policy. If an
order is identified as incomplete, contacts the physician's office to obtain the necessary information.
· Protects and ensures the confidentiality of patient information, especially when delivering paperwork to the
appropriate department.
· Follows federal, state, and any other legal guidelines such as EMTALA or HIPAA with regards to job functions.
· Coordinates with internal departments such as Utilization Review for the appropriate status of patients as well as
collecting any legally required documentation.
 
Customer Service and Communication
· Meets the needs of all customers to enhance communication, way-finding, and access to available services at St.
John's Health and affiliated facilities.
· Able to field questions and/or issues to the appropriate person or department. Communicates effectively, and
presents a confident and friendly demeanor with all customers internally and externally.
· Performs duties according to the Scope of Service for Patient Access.
· Continuously contributes to an extraordinary patient and customer experience throughout St. John's Health.
· Comfortable providing registration service for patients in pain, distress, or a traumatic situations; whether it be at the
main emergency entrance of bedside.
 
Financial Services
· Collect patient financial obligations such as copays or estimated liability at time of discharge/check out.
· Applies collected amounts to the appropriate patient account, ensures cash is given to the appropriate staff member
for bank deposit, and delivers receipts to the Cash Posting Team for reconciliation.
· Connects the patient with Financial Navigation for more complex financial discussions.
· Collect appropriate forms and patient signatures in relation to financial obligations, i.e. Patient Responsibility
Waiver, Important Message from Medicare/TRICARE, etc...
 
Teamwork
· Represents, facilitates, and elevates team success within Patient Financial Services, and St. John's Health as a
whole.
· Assists Supervisor or Manager with various special projects as needed.
· Collaborates with other departments such as Utilization Review, Case Management, Nursing Units, Patient
Assistance, etc., as needed, when additional information from the patient is necessary.
· Is clocked in and ready to take patients or carry out job responsibilities right at the start of shift. General expectation
is to be clocking in 5 minutes prior to shift.
 
Problem Solving and Improvement Activities
· Autonomously applies sound judgment to solve operational problems, appropriately following up with team
members and leadership to address. Participates in the launch, development, implementation, and control of
improvement projects.
· Adheres to and practices in St. John's Health Corporate Compliance Program, and participates in Performance
Improvement activities.
· Seeks and implements improvement projects directly related to patient admission functions.
 
Communication
· Support and backup the general switchboard function for St. John's Health. Call inbound to the hospital general line
should be handled in a professional and courteous manner and connected promptly with requested connection.
· Respond appropriately to all applicable emergency response situations (aka Code scenarios) such as local
disasters, bomb threats, fires, etc.
· Monitor alarm panel and respond appropriately and quickly to resolve. This may involve overhead paging, calling
appropriate staff or local emergency services.
 
JOB REQUIREMENTS
Minimum Education
Required: High School Degree or GED equivalent.
Preferred: Associates or Bachelors Degree, medical terminology certification or proven knowledge of medical terminology, other
relevant professional certifications.
 
Minimum Work Experience
Required: Must be able to read, write and speak English fluently. Prior Front Desk or Business Office experience. One year or
more of strong customer service experience.
Preferred: Prior healthcare experience.
 
FUNCTIONAL DEMANDS
Working Conditions
Varying shifts, primarily on weekends, within a 24/7 department. On-site hospital emergency access area position.
Frequent interruptions and stressful situations. Contact with patients, co-workers and community members under a
variety of circumstances. Must be on-site at the St. John's Health campus or other facilities to fulfill the responsibilities
of this role.
 
Physical Requirements
60 to 80% of day sitting and computer use. Medium phone usage. Intermittent standing and walking. Ability to
lift/push/pull 20 pounds.
 
Direct Reports: None
 
Reports to: Sr. Business Relationship Manager
 
Internal & External Contacts: Patients, patient's family members, members of the community, physicians, nurses, St. John's Health staff, Fire/EMS,
Law Enforcement Officers and vendors.
 
LEADERSHIP CAPABILITIES
Attention to Detail
• Completes tasks in a way that ensures there are no errors
• Methodically and patiently reviews work to identify any mistakes or discrepancies
• Creates and stores documentation in a way that is thorough and easy to access
 
Priority Setting
• Spends his/her time and the time of others on what's important
• Quickly zeros in on the critical few and puts the trivial many aside
 
Time Management
• Uses his/her time effectively and efficiently
• Concentrates his/her efforts on the more important priorities
• Gets more done in less time than others
 
Composure
• Avoids becoming defensive or irritated when times are tough
• Maintains balance when the unexpected happens
 
Interpersonal Skills
• Relates well to all kinds of people, up, down and sideways, inside and outside the organization
• Builds appropriate rapport
• Uses diplomacy and tact
 
Organizing
• Can coordinate multiple activities and resources at once to accomplish a goal
• Arranges information and files in a useful manner

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