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Utilization Review Manager Jobs in Riverside, NJ

National Medical Reviews

Review Coordinator

Warminster, PA · On-site

$65K - $70K/yr

Experience in health insurance, utilization review, quality management and/or managed care * Pursues excellence while achieving results within defined parameters * Listens effectively and expresses ...

National Medical Reviews

Review Coordinator

Warminster, PA · On-site

$65K - $70K/yr

Experience in health insurance, utilization review, quality management and/or managed care * Pursues excellence while achieving results within defined parameters * Listens effectively and expresses ...

Virtua

Outcomes Manager - UR (Per Diem)

Pennsauken, NJ · On-site

$38.33 - $59.58/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Utilization Management • Utilizes Payer specific screening tools as a resource to assist in the ... Documentation • Appropriate and complete documentation of clinical review and denial management ...

Cooper University Hospital

Clinical Review RN PRN

Camden, NJ · On-site

$61/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Experience in utilization management or review preferred. Knowledge and understanding of disease protocols and clinical pathways for commercial and government payors. Familiarity with Interqual and ...

Cooper University Hospital

Clinical Review RN PRN

Camden, NJ · On-site

$37 - $61/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Experience in utilization management or review preferred. Knowledge and understanding of disease protocols and clinical pathways for commercial and government payors. Familiarity with Interqual and ...

Cooper University Hospital

Clinical Review RN PRN

Camden, NJ

$61/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Experience in utilization management or review preferred. Knowledge and understanding of disease protocols and clinical pathways for commercial and government payors. Familiarity with Interqual and ...

Cooper University Hospital

Clinical Review RN PRN

Camden, NJ · On-site

$61/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Experience in utilization management or review preferred. Knowledge and understanding of disease protocols and clinical pathways for commercial and government payors. Familiarity with Interqual and ...

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Showing results 21-40

All JobsUtilization Review JobsUtilization Review Manager JobsUtilization Review Manager Jobs in Riverside, NJ

Utilization Review Manager information

See Riverside, NJ salary details

$39.4K

$91.9K

$169.2K

How much do utilization review manager jobs pay per year?

As of Aug 19, 2026, the average yearly pay for utilization review manager in Riverside, NJ is $91,921.00, according to ZipRecruiter salary data. Most workers in this role earn between $60,100.00 and $110,600.00 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.

How much does a utilization review manager make?

A utilization review manager typically earns between $70,000 and $110,000 annually, depending on experience, location, and the size of the organization. They often require knowledge of healthcare policies, insurance processes, and may hold certifications such as URAC or CCM.

Is utilization review manager a stressful job?

Utilization review managers often work in a fast-paced healthcare environment, which can be stressful due to the need to meet strict deadlines, ensure accurate assessments, and handle complex cases. The role requires strong organizational skills and attention to detail, and some individuals may find the responsibility and workload challenging, especially during high-volume periods.

What are popular job titles related to Utilization Review Manager jobs in Riverside, NJ?

For Utilization Review Manager jobs in Riverside, NJ, the most frequently searched job titles are:

What cities near Riverside, NJ are hiring for Utilization Review Manager jobs?

Cities near Riverside, NJ with the most Utilization Review Manager job openings:

Utilization Review Manager jobs near you
Infographic showing various Utilization Review Manager job openings in Riverside, NJ as of August 2026, with employment types broken down into 90% Full Time, 9% Part Time, and 1% Contract. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution, with an average salary of $91,921 per year, or $44.2 per hour.

RN Case Manager - Utilization Review (Temple Hospital Jeanes Campus)

Temple Health

Philadelphia, PA • On-site

Other

Posted 13 days ago

Temple University Health System rating

8.1

Company rating: 8.1 out of 10

Based on 76 frontline employees who took The Breakroom Quiz

69th of 888 rated healthcare providers

Job description

Utilization Management Nurse

Utilizing InterQual and other appropriate criteria, responsible for reviewing all admissions and continued stay of patients in conformance with the established criteria set forth in the hospital's utilization management and quality assurance plan. Will determine the medical necessity for admission and continued stays for patients within department's scope of service and to meet the hospital's objectives for assuring a high quality of patient care as well as assuring the effective and efficient utilization of available health services. Identifies appropriate level of care for inpatients and outpatients requiring overnight care.

Education

  • Graduate of an accredited school of nursing Required
  • Bachelor's Degree BSN Required

Experience

  • 2 years experience in clinical nursing preferably in acute care Preferred
  • General Experience in utilization review, case management, PreCertification, or discharge planning Preferred
  • General Experience and knowledge of Medicare, Medicaid, and commercial insurance guidelines Preferred
  • General Experience and knowledge of MCG and InterQual criteria tools Preferred

Licenses

  • PA Registered Nurse License Required or
  • Multi State Compact RN License Required

This position follows a hybrid schedule of 8:00 AM to 4:30 PM and includes a rotating requirement to work every third weekend.

What Temple University Health System employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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About Temple Health

Sourced by ZipRecruiter

Temple Health is a major Philadelphia-based academic health system that is driving medical advances through clinical innovation, pioneering research and world-class education. The health system’s 1,550+ physicians and scientists share a common mission of bringing tomorrow’s treatments to the bedside today, helping them achieve outcomes once thought impossible.

Industry

Hospitals

Company size

5,001 - 10,000 Employees

Headquarters location

Philadelphia, PA, US

Year founded

1995

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