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Utilization Review Manager Jobs in Jackson, NJ (NOW HIRING)

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Utilization Review Manager information

See Jackson, NJ salary details

$39.1K

$91.1K

$167.8K

How much do utilization review manager jobs pay per year?

As of Aug 18, 2026, the average yearly pay for utilization review manager in Jackson, NJ is $91,148.00, according to ZipRecruiter salary data. Most workers in this role earn between $59,600.00 and $109,700.00 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 popular job titles related to Utilization Review Manager jobs in Jackson, NJ?

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

What cities near Jackson, NJ are hiring for Utilization Review Manager jobs?

Cities near Jackson, NJ with the most Utilization Review Manager job openings:

Utilization Review Manager jobs near you

Utilization Review Coordinator - Behavioral Health

Avenues Recovery

Toms River, NJ • On-site

Full-time

Medical, Dental, Vision, Life, Retirement

Re-posted yesterday

Job description

Avenues Recovery Center is Now Hiring: Utilization Review Specialists
Avenues Recovery Center is a nationwide network of drug and alcohol rehabilitation centers with eighteen locations across seven states. We provide highly individualized, evidence-based treatment in clean, modern settings across all levels of care including detox, residential, PHP, IOP, and outpatient services.
Our success is driven by our people and a strong clinical model that has helped transform thousands of lives. We are seeking a Utilization Review Specialist to join our corporate team in New Jersey and support authorization, clinical documentation integrity, and continued stay coordination across our network.
Position Overview
Location: Corporate office - New Jersey
Schedule: Full-time
The Utilization Review Specialist ensures timely authorization of client services, supports appropriate level-of-care determinations, and partners closely with clinical and billing teams to maintain accurate documentation and continuity of care across facilities.
This role requires strong communication, attention to detail, and the ability to collaborate across clinical, administrative, and billing departments.
Key Responsibilities
Utilization Review & Authorization Management
  • Field incoming calls, emails, and documentation requests related to client authorizations
  • Ensure timely approval and continuation of services at the appropriate level of care
  • Manage client caseloads and support authorization workflows across facilities
  • Advocate for continued stay based on clinical documentation and treatment needs
Clinical & Billing Collaboration
  • Work closely with billing and clinical teams to identify and resolve authorization issues
  • Communicate with facility leadership regarding UR status and documentation needs
  • Support coordination between treatment teams and administrative departments
Documentation & Compliance
  • Maintain accurate electronic records of all UR activity and authorization communications
  • Ensure documentation meets internal standards and payer requirements
  • Assist in identifying gaps in charting and supporting improvements in documentation workflows
Systems & Process Improvement
  • Assist in creating standardized templates and UR workflows across facilities
  • Work with site leaders to ensure consistent implementation of processes
  • Support improvement of internal UR systems and efficiency initiatives
Qualifications
Required / Preferred Education
  • High school diploma or GED required
  • Bachelor's degree preferred
  • Nursing background, clinical background or healthcare knowledge strongly preferred
Experience
  • Minimum 1 year of experience in behavioral health, healthcare, or treatment setting preferred
  • Experience with utilization review, insurance authorization, or medical billing strongly preferred
Core Skills
  • Strong communication (written and verbal)
  • Excellent interpersonal and collaboration skills
  • Strong attention to detail and documentation accuracy
  • Ability to manage multiple cases and deadlines
  • Sound judgment and critical thinking
  • Flexible, team-oriented, and adaptable in a fast-paced environment

Willing to train
Why Join Avenues?
At Avenues, our people are our greatest strength. We foster a culture of support, collaboration, and purpose-driven work, where every team member is valued and empowered to make an impact.
We provide the tools, resources, and benefits needed to help you succeed both personally and professionally.
Comprehensive Benefits
  • 401(k) with employer match
  • Medical, Dental, and Vision Insurance
  • Accident, Critical Illness, and Hospital Indemnity coverage
  • Employer-paid Life and AD&D Insurance
  • Short- and Long-Term Disability options
  • Legal coverage and Identity Theft Protection
  • Pet Insurance
  • Employee Assistance Program (EAP)
  • Flexible Spending Accounts (Medical & Dependent Care)

Join our growing team and discover the magic here at Avenues!
Apply today!
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