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Utilization Review Manager Jobs in Rio Rancho, NM

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Utilization Review Manager information

See Rio Rancho, NM salary details

$36.7K

$85.6K

$157.6K

How much do utilization review manager jobs pay per year?

As of Aug 1, 2026, the average yearly pay for utilization review manager in Rio Rancho, NM is $85,606.00, according to ZipRecruiter salary data. Most workers in this role earn between $56,000.00 and $103,000.00 per year, depending on experience, location, and employer.

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, and why are they important?

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 Rio Rancho, NM? The most popular types of Utilization Review jobs in Rio Rancho, NM are:
What are popular job titles related to Utilization Review Manager jobs in Rio Rancho, NM? For Utilization Review Manager jobs in Rio Rancho, NM, the most frequently searched job titles are:
What cities near Rio Rancho, NM are hiring for Utilization Review Manager jobs? Cities near Rio Rancho, NM with the most Utilization Review Manager job openings:
Utilization Review Manager jobs near you

Travel Registered Nurse Utilization Management Job

Healthforce

Albuquerque, NM • On-site

Contractor

Posted 3 days ago

New

Job description

Overview
Registered Nurse - Utilization Management in a Skilled Nursing Facility setting. Albuquerque, New Mexico. Start date 08/03/2026 for a 13-week travel assignment. Weekly pay range $2,298 to $2,435 per week. Guaranteed 40 hours per week. Shift: 5x8 days (8-hour daytime shifts). This travel assignment is with Healthforce Healthcare LLC.
Key Highlights
- Weekly pay: $2,298–$2,435 per week
- Guaranteed hours: 40 per week
- Contract duration: 13 weeks
- Shift: 5x8 days (8-hour daytime shifts)
- Start date: 08/03/2026
- Setting: Skilled Nursing Facility
Responsibilities
- Conduct prospective, concurrent, and retrospective utilization reviews to support appropriate care and resource use.
- Assess medical necessity and level of care, aligning with payer guidelines and facility policies.
- Collaborate with the interdisciplinary team, including case managers and physicians, to optimize care plans and discharge planning.
- Review clinical documentation for accuracy, completeness, and timeliness; ensure compliant coding and record-keeping.
- Communicate findings, recommendations, and escalation points clearly to nursing staff and leadership as needed.
- Monitor utilization trends and participate in ongoing quality and performance improvement activities.
Requirements
- Active RN license (state-specific requirements apply).
- Utilization management or case management experience preferred.
- Knowledge of medical necessity criteria and general payer guidelines.
- Strong documentation and communication skills; ability to collaborate with a multidisciplinary team.
- Ability to work on-site in a Skilled Nursing Facility setting in Albuquerque, NM; reliable for 40 hours per week during the contract.
Benefits and Support
- 24/7 recruiter and travel support
- Credentialing and onboarding assistance
- Assignment support throughout the contract period
- Assistance with scheduling and workflow integration to fit the assignment
- Ongoing access to future assignment opportunities
Find more opportunities
If you’d like to explore additional openings, you can apply at Healthforce Healthcare LLC here: https://healthforce.applytojob.com/apply
Please note: Pay rates and guaranteed hours are estimates and may vary. Final compensation packages and confirmed hours will be discussed during the hiring process.

About Healthforce

Healthforce is a nationwide travel healthcare staffing agency connecting travel nurses and allied health professionals with high-quality contract assignments across the United States.

We specialize in placing clinicians in travel nursing jobs, allied health travel assignments, and local contract opportunities in hospitals, long-term care facilities, and outpatient settings. Whether you are an experienced traveler or taking your first assignment, Healthforce provides the support and opportunities you need to succeed.

Travel Nursing and Allied Health Opportunities Nationwide

Healthforce partners with healthcare facilities across the country to offer a wide range of opportunities for nurses and allied professionals.

  • Travel RN jobs in Med Surg, ICU, ER, LTC, and more
  • Allied health travel jobs including CT Tech, Rad Tech, PT, OT, Respiratory, and more
  • Local contract and per diem opportunities
  • Short-term and 13-week travel assignments

Our goal is simple: match you with the right assignment, in the right location, at the right pay.

What Makes Healthforce Different

We know that travel healthcare professionals have options. That is why we focus on delivering a better experience at every step of the process.

  • Competitive weekly pay packages with transparent breakdowns
  • Fast credentialing support to help you get submitted quickly
  • Dedicated recruiters who stay with you from submission to start
  • 24/7 support while you are on assignment
  • Nationwide job access across multiple specialties and care settings

We do not just place you in a job. We help you build a sustainable travel healthcare career.

Built for Travel Nurses and Allied Professionals

Healthforce is designed around the needs of today’s travel healthcare workforce. We make it easier for clinicians to move quickly, stay informed, and access strong opportunities across the country.

  • Quick submissions to open jobs
  • Access to multiple job options at once
  • Flexible assignment locations
  • Ongoing support throughout your contract

Whether you are searching for your next assignment or planning your first travel job, our team is here to help you move forward with confidence.

Start Your Next Travel Assignment

Healthforce is actively hiring travel nurses and allied healthcare professionals for assignments nationwide.

Apply today to connect with a recruiter and explore current travel nursing and allied health job opportunities.

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