Preferred/Desired * Healthcare/Medical-Case Manager Preferred, or Healthcare/Medical - Utilization Review Preferred. Education Minimum Required * Graduate of School of Nursing-Accredited Required.
Preferred/Desired * Healthcare/Medical-Case Manager Preferred, or Healthcare/Medical - Utilization Review Preferred. Education Minimum Required * Graduate of School of Nursing-Accredited Required.
Preferred/Desired * Healthcare/Medical-Case Manager Preferred, or Healthcare/Medical - Utilization Review Preferred. Education Minimum Required * Graduate of School of Nursing-Accredited Required.
Preferred/Desired * Healthcare/Medical-Case Manager Preferred, or Healthcare/Medical - Utilization Review Preferred. Education Minimum Required * Graduate of School of Nursing-Accredited Required.
Administer IV infusions as required for wound management. * Process specimen collections for ... Participate in utilization review processes to evaluate the effectiveness of treatment plans.
Administer IV infusions as required for wound management. * Process specimen collections for ... Participate in utilization review processes to evaluate the effectiveness of treatment plans.
Administer IV infusions as required for wound management. * Process specimen collections for ... Participate in utilization review processes to evaluate the effectiveness of treatment plans.
Administer IV infusions as required for wound management. * Process specimen collections for ... Participate in utilization review processes to evaluate the effectiveness of treatment plans.
Actively participates, collects, analyzes and reports key departmental elements, e.g. avoidable days, utilization review elements, etc. * Works to manage patient flow and safety to assure appropriate ...
Actively participates, collects, analyzes and reports key departmental elements, e.g. avoidable days, utilization review elements, etc. * Works to manage patient flow and safety to assure appropriate ...
Radiation Oncology Field Medical Director
Jackson, MS · On-site
$130 - $145/hr
... utilization management team. We can offer you a meaningful way to make a difference in patients ... Serve as the Physician match reviewer in Radiation Oncology and imaging cases, that do not ...
Radiation Oncology Field Medical Director
Jackson, MS · On-site
$130 - $145/hr
... utilization management team. We can offer you a meaningful way to make a difference in patients ... Serve as the Physician match reviewer in Radiation Oncology and imaging cases, that do not ...
(Orthopedic Surgery) Field Medical Director, MSK Surgery
Jackson, MS · On-site
$135 - $150/hr
As a Field Medical Director, MSK Surgery you will be a key member of the utilization management ... Serve as the Physician match reviewer in Hip/Knee/Shoulder Surgery cases, that do not initially ...
(Orthopedic Surgery) Field Medical Director, MSK Surgery
Jackson, MS · On-site
$135 - $150/hr
As a Field Medical Director, MSK Surgery you will be a key member of the utilization management ... Serve as the Physician match reviewer in Hip/Knee/Shoulder Surgery cases, that do not initially ...
Administer IV infusions as required for wound management. * Process specimen collections for ... Participate in utilization review processes to evaluate the effectiveness of treatment plans.
Administer IV infusions as required for wound management. * Process specimen collections for ... Participate in utilization review processes to evaluate the effectiveness of treatment plans.
Valid RN license Preferred Qualifications: RN experience in clinical nursing with chronic disease, utilization review and/or quality management Knowledge, Skills & Abilities Knowledge, Skills, and ...
New
Valid RN license Preferred Qualifications: RN experience in clinical nursing with chronic disease, utilization review and/or quality management Knowledge, Skills & Abilities Knowledge, Skills, and ...
New
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
Quick apply
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
RN - ICU
Jackson, MS · On-site
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
Quick apply
RN - ICU
Jackson, MS · On-site
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
RN Weekender
Madison, MS · On-site
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
RN Weekender
Madison, MS · On-site
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
Quick apply
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
Quick apply
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
RN - Surgery, PRN
Canton, MS · On-site
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
Quick apply
RN - Surgery, PRN
Canton, MS · On-site
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
RN - Emergency Department, PRN
Canton, MS · On-site
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
Quick apply
RN - Emergency Department, PRN
Canton, MS · On-site
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
Utilization Review Manager information
See Madison, MS salary details
$31.7K - $41.2K
9% of jobs
$48.3K is the 25th percentile. Wages below this are outliers.
$41.2K - $50.7K
22% of jobs
$50.7K - $60.2K
11% of jobs
The median wage is $66.1K / yr.
$60.2K - $69.7K
14% of jobs
$69.7K - $79.3K
12% of jobs
$85.2K is the 75th percentile. Wages above this are outliers.
$79.3K - $88.8K
13% of jobs
$88.8K - $98.3K
13% of jobs
$98.3K - $107.8K
5% of jobs
$107.8K - $117.3K
2% of jobs
$117.3K - $126.8K
0% of jobs
$126.8K - $136.3K
0% of jobs
$31.7K
$74K
$136.3K
How much do utilization review manager jobs pay per year?
As of Aug 15, 2026, the average yearly pay for utilization review manager in Madison, MS is $74,047.00, according to ZipRecruiter salary data. Most workers in this role earn between $48,400.00 and $89,100.00 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?
| Aspect | Utilization Review Manager | Utilization Review Coordinator |
|---|---|---|
| Certifications | Typically requires certifications like CCM or ACU | May require similar certifications but often less advanced |
| Work Environment | Supervises review teams, manages processes in healthcare or insurance settings | Performs case reviews, supports the review process under supervision |
| Employer & Industry | Hospitals, insurance companies, healthcare organizations | Insurance 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 Madison, MS?
The most popular types of Utilization Review jobs in Madison, MS are:
What are popular job titles related to Utilization Review Manager jobs in Madison, MS?
For Utilization Review Manager jobs in Madison, MS, the most frequently searched job titles are:
What job categories do people searching Utilization Review Manager jobs in Madison, MS look for?
The top searched job categories for Utilization Review Manager jobs in Madison, MS are:
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Re-posted yesterday
Job description
Job Summary
Case Managers will apply systems, science, incentives, and information to improve healthcare practice and assist patients and their support systems to become engaged in a collaborative process designed to manage medical/social/mental health conditions more effectively. The case manager's objective is to achieve an optimal level of wellness for patients and improve coordination of care while providing cost effective, non-duplicative services. Performs all other duties as assigned.
Responsibilities
- Assess and document the clinical, psychosocial and financial needs of patients including availability of care support, risk for readmission and safe environment upon discharge/transition and payor benefits. Findings are collected by interviewing patients, caregivers and members of the interdisciplinary team. Aspects of this assessment obtained from the patient record or previous case manager assessment are validated, updated and influence the plan of care. Assess and document the patient's care management and potential discharge needs. 20 %
- Apply InterQual to determine/validate Level of Service and Intensity of Care. Utilize InterQual criteria within the first 24 hours of arrival to complete an initial review. Collaborate with physicians, Manager of Case Management and physician advisors to resolve conflicts. Coordinate with bed control to attain proper placement. Perform concurrent reviews of medical records to ensure continued appropriateness and make recommendations based on the needs of the patient. Escalate and facilitate resolution of unjustifiable aspects of care that vary from InterQual guidelines. 20 %
- With the physician, identify the plan of care, estimated length of stay and transition/discharge plan. Meet with patients and families to engage them in the plan and obtain agreement. Incorporate all processes and procedures into the plan to ensure safe discharge/transition. Coordinate with physician and nurse to make plan adjustments as patient condition indicates. Use best practices and available pathways to anticipate the course of care through discharge/transition. Incorporate ancillary services as needed. Work in collaboration with social work for complex postacute placement and community service resources. 20 %
- In coordination with nursing, ancillary departments, social work, and the physician, monitor and ensure the treatment plan and steps to prepare for transition or discharge are completed as planned, gaps in care are avoided as well as duplicative or unnecessary services. 10 %
- Ensure that patients are discharged/transitioned timely and appropriately and that variances from the plan or target discharge/transition date are documented. 10 %
- Escalate concerns and barriers to appropriate treatment or transition as outlined by the department. 10 %
- Maintain a working knowledge of facilities and resources available to patients and caregivers. 10 %
Experience
Minimum Required
- 3 years Healthcare/Medical-Acute Care Required.
- Healthcare/Medical-Case Manager Preferred, or Healthcare/Medical - Utilization Review Preferred.
Minimum Required
- Graduate of School of Nursing-Accredited Required.
- Bachelor's Degree Nursing Preferred, or Bachelor's Degree Allied Health Preferred.
Minimum Required
Preferred/Desired
Special Skills
Minimum Required
- Must be able to work with acutely & chronically ill patients of all ages and their caregivers. Must have excellent interpersonal communication, multi-tasking, prioritizing & organizational skills. Demonstrated ability to work effectively with teams in a collaborative manner and escalate issues appropriately. Ability to work weekends and flexible hours per the department staffing plan.
Licensure
Minimum Required
- License/Certification/Registries (valid for the State of MS): Registered Nurse (RN) by the State Board of Nursing Required.
- Certification by the Case Management Society of America Preferred, or Equivalent Certification Preferred.