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Utilization Review Manager information

See Monroe, LA salary details

$37.5K

$87.5K

$161.1K

How much do utilization review manager jobs pay per year?

As of Aug 13, 2026, the average yearly pay for utilization review manager in Monroe, LA is $87,547.00, according to ZipRecruiter salary data. Most workers in this role earn between $57,200.00 and $105,300.00 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.
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Utilization Review Manager jobs near you
Infographic showing various Utilization Review Manager job openings in Monroe, LA as of July 2026, with employment types broken down into 80% Full Time, 19% Part Time, and 1% Contract. Highlights an 82% Physical, 2% Hybrid, and 16% Remote job distribution, with an average salary of $87,547 per year, or $42.1 per hour.

Utilization Review/Case Manager

Freedom Behavioral Hospital of Monroe

West Monroe, LA • On-site

Full-time

Medical, Dental, Vision, Life, Retirement

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

Job description

The Utilization Review/Case Manager is responsible for coordinating patient care services and managing utilization review functions to ensure appropriate level of care, timely insurance authorization, and effective discharge planning. This role serves as the primary liaison between the hospital, payor sources, patients, families, and referral partners to support optimal clinical and financial outcomes.

In accordance with The Joint Commission standards, federal and state regulations, and Freedom’s mission, policies, and Performance Improvement (PI) program, the Case Manager facilitates the continuum of care from admission through discharge.

Key Responsibilities:

  • Coordinates with Admissions and Clinical staff to ensure patient treatment needs are identified and met throughout the stay
  • Conducts utilization review activities, including securing initial and continued stay authorizations from insurance providers
  • Serves as the primary point of contact with payors, communicating medical necessity, level of care, and continued stay criteria
  • Develops, implements, and manages discharge plans to ensure safe and appropriate transitions of care
  • Communicates effectively with patients, families, and referral sources to support positive treatment outcomes
  • Gathers and presents clinical information to the multidisciplinary treatment team; actively participates in treatment team meetings
  • Maintains consistent communication with physicians, nursing, social services, and other disciplines to ensure coordinated care delivery
  • Documents all utilization review and discharge planning activities accurately and timely in the medical record, supporting intensity of service and medical necessity
  • Collaborates with external agencies and providers to coordinate aftercare services and continuity of care
  • Ensures patient rights, ethical standards, and confidentiality are upheld at all times
  • Participates in Performance Improvement (PI) and Quality Management (QM) activities, including data collection and process improvement initiatives

Qualifications & Skills:

  • Strong understanding of behavioral health levels of care, medical necessity criteria, and insurance authorization processes
  • Ability to effectively communicate with multidisciplinary teams, payors, patients, and families in a professional manner
  • Excellent organizational, documentation, and time management skills
  • Knowledge of regulatory and accreditation standards related to case management and utilization review
  • Ability to manage multiple priorities while maintaining accuracy and compliance


Excellent Benefit Package Offered for Full-Time Employees:

Medical

Dental

Vision

401k

Life and Disability


Freedom Behavioral Hospital of Monroe provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity, or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.