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Utilization Review Manager Jobs in New Port Richey, FL

Dane Street, LLC

Chiropractor

Tampa, FL · On-site

$72K - $88K/yr

Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams

Dane Street, LLC

Chiropractor

Tampa, FL · On-site

$72K - $88K/yr

Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams

Dane Street, LLC

Chiropractor

Tampa, FL

$72K - $88K/yr

Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams

Dane Street

Chiropractor

Tampa, FL · On-site

$69K - $85K/yr

Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams

Tampa General Hospital

Pool Case Manager RN

Tampa, FL · On-site

The Case Manager RN is responsible for ensuring patient progression through the acute episode of ... Ability to accurately document care plans, utilization review findings, avoidable days, anticipated ...

paradigm

Clinical Navigator

Tampa, FL · Remote

$61K - $84K/yr

Experience with DME, utilization review, EMRs, care management platforms, and Microsoft Office applications is strongly preferred. This role is well-suited for a forward-thinking clinical ...

paradigm

Clinical Navigator

Tampa, FL · Remote

$61K - $84K/yr

Experience with DME, utilization review, EMRs, care management platforms, and Microsoft Office applications is strongly preferred. This role is well-suited for a forward-thinking clinical ...

Incredible Health

Nurse Case Manager (RN)

Clearwater, FL · On-site

$59K - $83K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Nurse Case Manager (RN). Nurses with experience in any of the following areas are strongly ... Clinical pathway, Navigator, or Utilization Review. * Shift(s) available: day shift * Job types ...

Paradigm

Clinical Navigator

Tampa, FL · On-site

$73K - $88K/yr

  • Medical

  • Life

  • Retirement

  • PTO

Experience with DME, utilization review, EMRs, care management platforms, and Microsoft Office applications is strongly preferred. This role is well-suited for a forward-thinking clinical ...

Evara Health

Review Nurse- Value Based Services

Clearwater, FL · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Minimum two (2) years of experience as an LPN in healthcare * Minimum one (1) year of experience as a Utilization Review Nurse or Case Manager Licenses, certification, or registration: * Active and ...

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Showing results 21-40

All JobsUtilization Review JobsUtilization Review Manager JobsUtilization Review Manager Jobs in New Port Richey, FL

Utilization Review Manager information

See New Port Richey, FL salary details

$34.7K

$81.1K

$149.2K

How much do utilization review manager jobs pay per year?

As of Aug 17, 2026, the average yearly pay for utilization review manager in New Port Richey, FL is $81,063.00, according to ZipRecruiter salary data. Most workers in this role earn between $53,000.00 and $97,500.00 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 New Port Richey, FL?

The most popular types of Utilization Review jobs in New Port Richey, FL are:

What are popular job titles related to Utilization Review Manager jobs in New Port Richey, FL?

For Utilization Review Manager jobs in New Port Richey, FL, the most frequently searched job titles are:

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The top searched job categories for Utilization Review Manager jobs in New Port Richey, FL are:

What cities near New Port Richey, FL are hiring for Utilization Review Manager jobs?

Cities near New Port Richey, FL with the most Utilization Review Manager job openings:

Utilization Review Manager jobs near you
Infographic showing various Utilization Review Manager job openings in New Port Richey, FL as of July 2026, with employment types broken down into 83% Full Time, 15% Part Time, and 2% Contract. Highlights an 82% Physical, 2% Hybrid, and 16% Remote job distribution, with an average salary of $81,063 per year, or $39 per hour.

Physician Advisor - UM MSQ

BayCare Health System

Tampa, FL • On-site

Part-time

Re-posted 10 days ago

BayCare Health System rating

7.5

Company rating: 7.5 out of 10

Based on 401 frontline employees who took The Breakroom Quiz

236th of 887 rated healthcare providers

Job description

Why BayCare?
At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that's built on a foundation of trust, dignity, respect, responsibility and clinical excellence.
Summary:
  • Charged with meeting the organization's goals and objectives for assuring the effective, efficient utilization of health care services. Is a physician serving the hospital through teaching, consulting, and advising the care management and utilization review departments and the hospital leadership.
  • Develop expertise on matters regarding physician practice patterns, over and under-utilization of resources, medical necessity, levels of care, care progression, denial management, compliance with governmental and private payer regulations, appropriate physician coding and documentation requirements.
  • Works closely with the medical staff leadership, the entire medical staff, including resident physician house staff, all areas of resource management, case management, social services, discharge planning, and utilization management to develop and implement methods to optimize use of hospital services for all patients while also ensuring the quality of care provided.
  • This includes working with hospital leadership in developing care management protocols with physicians and others to optimize length of hospital stay and efficient management of resources, insuring patients are in the appropriate level of care, supporting documentation, coding improvements and compliance, and monitoring the appropriate use of diagnostic and therapeutic modalities.

Minimum Qualifications:
Education:
  • Required - Doctorate - Medical Doctor; Or - Doctorate - Osteopathic Medicine

Credentials:
  • Required - Medical Board - License

Experience:
  • 5 years Clinical Related
  • 1 year Education

Preferred qualifications:
  • Member of the American College of Physician Advisors (ACPA), Board Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP), Physician Advisor Sub-Specialty Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP).

Facility: BayCare Health System, Physician Advisor Services-HSS
Location: St Josephs Main and Childrens
Status: Part Time, Exempt: Yes
Shift Hours: 8:00 AM - 4:00 PM
Weekend Work: None
On Call: No
How often will this team member be working remotely? Hybrid
Equal Opportunity Employer Veterans/Disabled

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