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Utilization Review Manager Jobs in Rio Rancho, NM

Oak St. Health

Grad Pharmacist

Rio Rancho, NM · On-site

$15 - $18.75/hr

... quality assurance drug utilization review (DUR), pharmacy professional standards such as ... the management, oversight, and operations within the pharmacy, including but not limited to:

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CVS Health

Grad Pharmacist

Rio Rancho, NM · On-site

$15.75 - $19.50/hr

... quality assurance drug utilization review (DUR), pharmacy professional standards such as ... the management, oversight, and operations within the pharmacy, including but not limited to:

CVS Health

Grad Pharmacist

Rio Rancho, NM · On-site

$15 - $18.75/hr

... quality assurance drug utilization review (DUR), pharmacy professional standards such as ... the management, oversight, and operations within the pharmacy, including but not limited to:

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All JobsUtilization Review JobsUtilization Review Manager JobsUtilization Review Manager Jobs in Rio Rancho, NM

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 Jul 12, 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:
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Utilization Review Manager jobs near you
Travel RN Case Manager - $1,987 per week

Travel RN Case Manager - $1,987 per week

American Traveler

Albuquerque, NM • On-site

$1.9K/wk

Other

Medical, Dental, Vision, Life, Retirement

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

Job description

American Traveler is seeking a travel nurse RN Case Management for a travel nursing job in Albequerque, New Mexico.

Job Description & Requirements
  • Specialty: Case Management
  • Discipline: RN
  • Start Date: 07/20/2026
  • Duration: 13 weeks
  • 40 hours per week
  • Shift: 8 hours, days
  • Employment Type: Travel
Assignment Overview
  • Shift: Days, 5x8hrs
  • Hours: 40 hrs/wk
  • Start Date: Jul 20, 2026
  • Length: 13 weeks
  • Openings: 1
Description

American Traveler is seeking an experienced RN Case Manager for a 13-week travel contract at a rehabilitation hospital in New Mexico, requiring 1-2 years of case management experience and an active NM or compact RN license.

Details
  • Rehabilitation hospital setting in a Case Management unit
  • Day shift schedule, 5x8-hour shifts (8:00 AM - 5:00 PM)
  • Epic EMR experience is preferred
Requirements
  • Active NM or compact RN license required
  • 1-2 years of case management experience required
  • 2 professional references from a supervisor within the past 2 years required for consideration
Additional Information
  • Candidates must reside more than 50 miles from the facility to be eligible
  • Former permanent staff must have been separated from the facility for at least 1 year before being eligible to return as a traveler
  • No more than 3 days of RTO will be approved, and no RTO is permitted during the first week of orientation
  • Travel pairs or groups will not be considered for this position

American Traveler Job ID #P-726082. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Travel RN - Case Management/Utilization Review - Case Management

About American Traveler

With over 25 years of experience, American Traveler has established a reputation for outstanding customer service. Our team ensures a smooth, worry-free experience for those starting on or expanding their travel nursing and allied careers.

With thousands of travel nursing and allied jobs nationwide, our attentive and approachable recruiters find positions that align perfectly with your career aspirations and personal requirements.

American Traveler offers exceptional benefits, including premium medical, dental, vision and life insurance beginning day one of your assignment, generous 401(k) match, substantial housing stipends, and more. Additionally, with 24/7 support and access to our in-house clinicians, you are assured confidence and comfort throughout your assignment.

With our team behind you, you can relax and enjoy a rewarding travel career.

Why Vivian Health?

Be sure to apply via Vivian Health to increase your chances of landing your perfect job. Just complete your Vivian Health profileonce, and get access to thousands of opportunities across the country. Then keep up to date with your job application process and conversations with our easy to use app.

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