1

Utilization Review Manager Jobs in Madison, WI (NOW HIRING)

Risk Manager

Madison, WI

$118K - $143K/yr

... includes utilization of deductibles and large retentions, self-insurance, financial plans, and ... Review Claims and Represent City in Subrogation Claims Review liability and property claims against ...

Retail Staff Pharmacist Hourly

Lodi, WI · On-site

$59.75 - $70.25/hr

As a Staff Pharmacist, you will play a key role in medication therapy management, patient ... Conduct Drug Utilization Reviews (DUR) and evaluate medication orders for safety, appropriateness ...

Risk Manager

Madison, WI · On-site

$118K - $143K/yr

Develop and oversee a risk management program which includes utilization of deductibles and large ... Review Claims and Represent City in Subrogation Claims * Review liability and property claims ...

Retail Staff Pharmacist Hourly

Lodi, WI · On-site

$59.75 - $70.25/hr

As a Staff Pharmacist, you will play a key role in medication therapy management, patient ... Conduct Drug Utilization Reviews (DUR) and evaluate medication orders for safety, appropriateness ...

Retail Staff Pharmacist Hourly

Lodi, WI · On-site

$59.75 - $70.25/hr

As a Staff Pharmacist, you will play a key role in medication therapy management, patient ... Conduct Drug Utilization Reviews (DUR) and evaluate medication orders for safety, appropriateness ...

Project Manager

De Forest, WI · On-site

$100K - $120K/yr

... quality, equipment utilization, and safety objectives. Operating in both a standard office ... reviewing progress reports, conducting performance evaluations, and holding safety meetings.

Management Analyst

Madison, WI · On-site +1

$89K - $116K/yr

Summary This position serves as a Management Analyst for the William S. Middleton Memorial Veterans ... reviews of Service Lines, as requested by the Director or staff, to evaluate resource utilization ...

Review and approve hours worked and PTO using Kronos. * Conduct periodic audits to ensure work is compliant with the established protocols and processes and objectives - meeting customer and branch ...

Review and approve hours worked and PTO using Kronos. * Conduct periodic audits to ensure work is compliant with the established protocols and processes and objectives - meeting customer and branch ...

Review and approve hours worked and PTO using Kronos. * Conduct periodic audits to ensure work is compliant with the established protocols and processes and objectives - meeting customer and branch ...

Warehouse Manager

Madison, WI · On-site

$90K - $100K/yr

Monitor warehouse capacity and optimize storage utilization. * Oversee cycle counting and physical ... Establish performance expectations and conduct performance reviews. * Develop staffing plans to ...

Showing results 41-60

Utilization Review Manager information

See Madison, WI salary details

$39.3K

$91.7K

$168.8K

How much do utilization review manager jobs pay per year?

As of Aug 13, 2026, the average yearly pay for utilization review manager in Madison, WI is $91,706.00, according to ZipRecruiter salary data. Most workers in this role earn between $60,000.00 and $110,300.00 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?

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.

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, WI? The most popular types of Utilization Review jobs in Madison, WI are:
Infographic showing various Utilization Review Manager job openings in Madison, WI as of June 2026, with employment types broken down into 3% As Needed, 56% Full Time, 38% Part Time, and 3% Temporary. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $91,706 per year, or $44.1 per hour.

$118K - $143K/yr

Full-time

Posted 11 days ago


Job description

General Description UPDATE: THE COMPENSATION RANGE FOR THIS POSITION WAS CORRECTED ON 8/5/2026 The Risk Manager is a highly responsible managerial position that works in developing and administering the City's risk management program which includes, but is not limited to: the City's liability, property and workers' compensation programs; employee safety programs; and contract review. The position oversees the City's Safety Coordinator, Administrative Services Supervisor, and Risk Manager Assistant. Work is performed under the general supervision of the City Finance Director and is characterized by considerable independent judgment.

This position is regularly scheduled for 38.75 hours per week. IMPORTANT: A COMPLETE APPLICATION WILL INCLUDE A COVER LETTER (MAXIMUM OF TWO (2) PAGES) THAT ADDRESSES BOTH OF THE FOLLOWING POINTS: 1) Describe how your experience, knowledge, skills, and abilities have prepared you for this role; 2) Describe your approach to leadership. If your submission exceeds two pages, only the first two pages will be considered

**Applications received without the required cover letter will immediately be removed from consideration** For more information about the Finance Department, please visit https://www.cityofmadison.com/finance. Employees may be eligible for loan forgiveness through the Public Service Loan Forgiveness Program. Black, Indigenous, people of color, women, trans, nonbinary, and individuals with disabilities are encouraged to apply

We value the unique blend of lived experiences and diverse perspectives that comes from non-traditional education pathways and the variety of transferrable skills each candidate brings to the table. We value diversity, equity, inclusion, and belonging. Even if every item on the job posting doesn't match your experience perfectly, we encourage you to apply and share how your skills and experience can best serve our community.

Examples of Duties and Responsibilities Develop, Administer, and Oversee the City of Madison Risk Management Program Develop and oversee a risk management program which includes utilization of deductibles and large retentions, self-insurance, financial plans, and reinsurance. Prepare and/or contribute to strategic planning efforts in relationship to the insurance needs of the City. Administer the City's insurance program incorporating the purchase, renewal, claims oversight and policy detail for the City's and Community Development Authority (CDA)'s liability, property, worker's compensation, crime, and other miscellaneous coverages.

Represent the City and CDA in related negotiations. Provide necessary liaison between the City and Wisconsin Municipal Mutual Insurance Company (WMMIC) and Municipal Property Insurance Company (MPIC). Participate in related committee efforts, as assigned.

Review Claims and Represent City in Subrogation Claims Review liability and property claims against the City and CDA for referral to appropriate carrier. Adjust and pay prescribed property damage claims through the City's Insurance Fund. Prepare related information for City attorneys, outside counsel and insurance adjusters.

Represent/oversee City's subrogation efforts related to City vehicles and other property. Follow up to ensure claims are processed in an appropriate and timely manner. Manage the City's workers' compensation program, including managing the City's claim Third-Party Administrator (TPA).

Participate in settlement discussions, mediations, hearings and trials regarding liability, property and workers' compensation claims. Investigate liability and property claims and prepare claims for filing with carriers. Discuss claims with claimants and provide information on how to file a claim and the City's liability.

Review of City Contracts and Ordinances Review City contracts for relevant risk management provisions. Review, approve, and make changes to contracts with language affecting risk management. Review, approve, and make changes to draft contracts for insurance and indemnification language.

Review and offer changes to City ordinances in the area of insurance and indemnification. Review insurance certificates to determine compliance with contract and City permit requirements. Administer the City Insurance and Workers' Compensation Funds Establish premiums for departmental contributions.

Estimate necessary reserves for future claims handling. Process invoices for payment. Monitor fund activity and recommend remedial action as required.

Provide assistance in related budgeting efforts. Coordinate City Loss Prevention Efforts Manage the City's Safety Coordinator. Serve as the City's HIPAA Security Officer.

Coordinate loss prevention efforts within assigned program areas. Meet with agencies to share loss prevention data and recommend methods to reduce risk, both with managers and within appropriate committee structures. Review City loss control policies.

Serve in an advisory capacity on department safety committees. Provide training on City policies and claim reporting policies. Perform other related duties as required Minimum Qualifications Four (4) years of experience in applying the following: Theory, principles, practices, methods, and markets of liability property, casualty, and other types of commercial insurance.

State and federal laws and ordinances relating to insurance management including rules, rates, forms, policy coverage, and statutory regulations. Various methods and systems of governmental insurance and risk management. Computer software applicable to the duties of the position; AND Two (2) years of experience in applying the following: Insurance industry principles, practices, and methods relative to pricing, loss ratios, claims procedures, loss prevention, etc.; AND The full range of principles and practices related to supervision, labor relations, and personnel management

-OR- Four (4) years of responsible professional experience in the administration of a directly related insurance program; AND Associate's (or higher level) degree in insurance, risk management, economics, business administration, or a closely related field. Other equivalent combinations of training and/or experience which can be demonstrated to result in the possession of the knowledge, skills, and abilities necessary to perform the duties of this position will also be considered. The City of Madison strives to provide exceptional customer service to all its residents and visitors.

Therefore, successful candidates will have demonstrated ability to effectively work with multicultural communities. For a complete list of the Knowledge, Skills, and Abilities, please see the class specification. Please note that the class specification is in the process of being updated due to a reclassification of this position from Compensation Group 18/Range 15 to Compensation Group 18/Range 17.

Special Requirements Ability to meet the transportation requirements of the position. The employee may be expected to attend meetings and provide presentations outside the normal work schedule, including evenings and weekends. Physical Requirements: Work in this position is primarily sedentary, requiring the ability to sit/stand at a desk, work on a computer, and use a monitor for extended periods of time.

The employee will be expected to physically visit other City departments and worksites throughout the City in order to meet with staff, assist with safety studies, perform property inspections, take pictures, and perform other needs. This may involve walking over various terrains, including hilly, muddy, and snowy terrain. Work may be performed in all weather conditions and may involve dangerous chemicals, heavy machinery, and other hazardous conditions.