ZipRecruiter

Log In

1

Utilization Review Manager Jobs in Reading, PA (NOW HIRING)

Tower Behavioral Health

Case Manager

Reading, PA · On-site

$19.25 - $24.75/hr

Previous experience in case management and/or utilization review preferred. LICENSES/DESIGNATIONS/CERTIFICATIONS: Current license required within the state the facility is operating in if required.

Acadia Healthcare

Case Manager

Reading, PA · On-site

$19.25 - $24.75/hr

... utilization review preferred. LICENSES/DESIGNATIONS/CERTIFICATIONS: • Current license required within the state the facility is operating in if required. • CPR and de-escalation/restraint ...

Encompass Health

Case Manager

Reading, PA · On-site

$19.25 - $24.75/hr

Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...

Encompass Health Corporation

Case Manager

Reading, PA · On-site

$19.25 - $24.75/hr

Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...

Acadia Healthcare

Admissions Counselor

Reading, PA

$37K - $49K/yr

... utilization review processes to assure continuity for the most appropriate level of care for ... Maintain knowledge of milieu management. * Communicate projected admissions to designated internal ...

Corvel

Field Medical Case Manager I

Pottsville, PA · On-site

$63K - $95K/yr

A cost containment background, such as utilization review or managed care is helpful * Strong interpersonal, time management, and organizational skills * Computer proficiency and technical aptitude ...

Acadia Healthcare

Admissions Counselor

Reading, PA · On-site

$37K - $49K/yr

... utilization review processes to assure continuity for the most appropriate level of care for ... Maintain knowledge of milieu management. * Communicate projected admissions to designated internal ...

Tower Behavioral Health

Admissions Counselor

Reading, PA · On-site

$37K - $49K/yr

... utilization review processes to assure continuity for the most appropriate level of care for ... Maintain knowledge of milieu management. * Communicate projected admissions to designated internal ...

Weis Markets

Pharmacist

Lebanon, PA · On-site

$57.25 - $68.75/hr

... Drug Utilization Review and Final Quality Assurance, applicable to state and federal Board of ... Works with the pharmacy manager on controlling inventories by helping track weekly sales, may order ...

Weis Markets

Pharmacist

Lebanon, PA · On-site

$57.25 - $68.75/hr

... Drug Utilization Review and Final Quality Assurance, applicable to state and federal Board of ... Works with the pharmacy manager on controlling inventories by helping track weekly sales, may order ...

Weis

Pharmacist

Lebanon, PA

$57.25 - $68.75/hr

... Drug Utilization Review and Final Quality Assurance, applicable to state and federal Board of ... Works with the pharmacy manager on controlling inventories by helping track weekly sales, may order ...

Weis

Pharmacist

Lebanon, PA · On-site

$57.25 - $68.75/hr

... Drug Utilization Review and Final Quality Assurance, applicable to state and federal Board of ... Works with the pharmacy manager on controlling inventories by helping track weekly sales, may order ...

next page

Showing results 1-20

All JobsUtilization Review JobsUtilization Review Manager JobsUtilization Review Manager Jobs in Reading, PA

Utilization Review Manager information

See Reading, PA salary details

$37.5K

$87.4K

$160.9K

How much do utilization review manager jobs pay per year?

As of Aug 16, 2026, the average yearly pay for utilization review manager in Reading, PA is $87,403.00, according to ZipRecruiter salary data. Most workers in this role earn between $57,100.00 and $105,200.00 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.

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 the most commonly searched types of Utilization Review jobs in Reading, PA?

The most popular types of Utilization Review jobs in Reading, PA are:

What are popular job titles related to Utilization Review Manager jobs in Reading, PA?

For Utilization Review Manager jobs in Reading, PA, the most frequently searched job titles are:

What job categories do people searching Utilization Review Manager jobs in Reading, PA look for?

The top searched job categories for Utilization Review Manager jobs in Reading, PA are:

What cities near Reading, PA are hiring for Utilization Review Manager jobs?

Cities near Reading, PA with the most Utilization Review Manager job openings:

Utilization Review Manager jobs near you

Board-Certified Neuropsychologist

Dane Street, LLC

Reading, PA

Full-time

Re-posted 19 days ago

Job description

Dane Street is expanding our physician panel! We are seeking a skilled and board-certified Neuropsychology Specialist in Reading, PA to join our team for Independent Medical Examinations (IMEs). This role offers flexible scheduling, allowing you to select or decline assignments based on your availability. Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case basis.

Dane Street is a national leader in Independent Medical Examinations (IMEs) and peer review services, trusted by insurance carriers and organizations across the country for objective, high-quality medical evaluations.

Key Responsibilities:

  • Thorough review of Medical Records
  • Perform in-person evaluations of patients with (specialty)  issues
  • Respond to clinical queries to support claims management
  • Deliver detailed IME reports within an expected turnaround time of 5 days

Benefits

  • Robust opportunity for supplemental income
  • Schedule flexibility and predictable work hours-conduct exams and reviews based on your schedule availability
  • No doctor/patient relationship is established, and no treatment is provided. These are advisory-only opinions.
  • Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise
  • Expanded credentials as an expert in Independent Medical Exams 
  • Fully prepped cases, streamlined case flow, transcription services at no cost, and a user-friendly work portal

Qualifications:

  • Board-certification required.
  • Previous experience in performing IMEs is preferred.
  • Strong analytical skills and excellent communication abilities are a plus

If you are a dedicated Neuropsychology Specialist looking for a flexible opportunity to apply your expertise in an IME capacity, we encourage you to apply.

Apply