Participates as an active management member of the Mount Carmel Health Plan representing the Utilization Review Department in collaboratively meeting operational, budget, and strategic planning goals ...
Participates as an active management member of the Mount Carmel Health Plan representing the Utilization Review Department in collaboratively meeting operational, budget, and strategic planning goals ...
These are just a few of the many reasons to join our team. SUMMARY The Utilization Management Specialist is responsible for coordinating and managing all prior authorization activities for clinical ...
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These are just a few of the many reasons to join our team. SUMMARY The Utilization Management Specialist is responsible for coordinating and managing all prior authorization activities for clinical ...
Knowledge of the functional operations of utilization management, discharge planning, care coordination and transitions of care * Understanding of pre-acute and post-aute venues of care and post ...
Knowledge of the functional operations of utilization management, discharge planning, care coordination and transitions of care * Understanding of pre-acute and post-aute venues of care and post ...
Case Manager/Social Worker - Substance Abuse Program Coordinator
$20.75 - $27.25/hr
... of utilization management, discharge planning, business office and third party payers preferred. Possesses excellent verbal and written communication skills. Willing to take call in order to ...
Case Manager/Social Worker - Substance Abuse Program Coordinator
$20.75 - $27.25/hr
... of utilization management, discharge planning, business office and third party payers preferred. Possesses excellent verbal and written communication skills. Willing to take call in order to ...
Utilization Review LVN/RN
Columbus, OH · On-site
Provider Claims, Appeals and Denials - certain services require prior authorization (PA) from the Utilization Management (UM) department * 6 + months of Interqual experience * 6+ months of Coding ...
Utilization Review LVN/RN
Columbus, OH · On-site
Provider Claims, Appeals and Denials - certain services require prior authorization (PA) from the Utilization Management (UM) department * 6 + months of Interqual experience * 6+ months of Coding ...
Care Review Nurse
Columbus, OH · On-site
Must have Utilization Review or Management. Utilization Review (1 year +), Past hospital experience (3-4 years of experience, less experience is ok if they have more Utilization Review experience ...
Care Review Nurse
Columbus, OH · On-site
Must have Utilization Review or Management. Utilization Review (1 year +), Past hospital experience (3-4 years of experience, less experience is ok if they have more Utilization Review experience ...
Performs pre-certifications, pre-authorizations, re-authorization, concurrent utilization reviews, retrospective reviews, and denial management. Interacts with staff and departments of the hospital ...
Performs pre-certifications, pre-authorizations, re-authorization, concurrent utilization reviews, retrospective reviews, and denial management. Interacts with staff and departments of the hospital ...
UR Manager
Columbus, OH · On-site
Job Duties Review medical records to determine appropriateness of admissions, procedures and ... Maintain compliancy with regulation changes affecting utilization management. PositionRequirements ...
UR Manager
Columbus, OH · On-site
Job Duties Review medical records to determine appropriateness of admissions, procedures and ... Maintain compliancy with regulation changes affecting utilization management. PositionRequirements ...
Care Review Nurse
Columbus, OH · On-site
Must have Utilization Review or Management. Utilization Review (1 year +), Past hospital experience (3-4 years of experience, less experience is ok if they have more Utilization Review experience ...
Care Review Nurse
Columbus, OH · On-site
Must have Utilization Review or Management. Utilization Review (1 year +), Past hospital experience (3-4 years of experience, less experience is ok if they have more Utilization Review experience ...
... management within the plan of care. * Demonstrates compliance with facility-wide Utilization Management policies and procedures. * Coordinates UR compliance with Quality Management to assure all ...
... management within the plan of care. * Demonstrates compliance with facility-wide Utilization Management policies and procedures. * Coordinates UR compliance with Quality Management to assure all ...
... management within the plan of care. * Demonstrates compliance with facility-wide Utilization Management policies and procedures. * Coordinates UR compliance with Quality Management to assure all ...
... management within the plan of care. * Demonstrates compliance with facility-wide Utilization Management policies and procedures. * Coordinates UR compliance with Quality Management to assure all ...
... management within the plan of care. * Demonstrates compliance with facility-wide Utilization Management policies and procedures. * Coordinates UR compliance with Quality Management to assure all ...
... management within the plan of care. * Demonstrates compliance with facility-wide Utilization Management policies and procedures. * Coordinates UR compliance with Quality Management to assure all ...
Directing all activities in a clinical focused area of expertise (Utilization Management (UM) or Quality Improvement) to ensure alignment with the department's population health strategies, health ...
Directing all activities in a clinical focused area of expertise (Utilization Management (UM) or Quality Improvement) to ensure alignment with the department's population health strategies, health ...
Clinical Management Manager
Hartford, OH · On-site
$94K - $293K/yr
Minimum of 2 years of experience in care delivery operations, utilization management, or clinical performance improvement * Bachelor's Degree Preferred Qualifications: * Clinical background (RN, MD ...
Clinical Management Manager
Hartford, OH · On-site
$94K - $293K/yr
Minimum of 2 years of experience in care delivery operations, utilization management, or clinical performance improvement * Bachelor's Degree Preferred Qualifications: * Clinical background (RN, MD ...
Case Manager Extender
Columbus, OH · On-site
... utilization management/clinical decisions beyond level of authority to care coordination/UM team and Manager/Director of UM team for review and decision. 7. Provides general office and clerical ...
Case Manager Extender
Columbus, OH · On-site
... utilization management/clinical decisions beyond level of authority to care coordination/UM team and Manager/Director of UM team for review and decision. 7. Provides general office and clerical ...
Clinical Management Manager
Columbus, OH · On-site
$94K - $293K/yr
Minimum of 2 years of experience in care delivery operations, utilization management, or clinical performance improvement * Bachelor's Degree Preferred Qualifications: * Clinical background (RN, MD ...
Clinical Management Manager
Columbus, OH · On-site
$94K - $293K/yr
Minimum of 2 years of experience in care delivery operations, utilization management, or clinical performance improvement * Bachelor's Degree Preferred Qualifications: * Clinical background (RN, MD ...
... Management System (Ninth Brain) and education records; improves utilization and efficiency within the product. Coordinates instructor schedules, educational resources, and training calendars.
... Management System (Ninth Brain) and education records; improves utilization and efficiency within the product. Coordinates instructor schedules, educational resources, and training calendars.
Reporting to the Director of Clinical and Quality Services, this position ensures educational ... the Learning Management System (Ninth Brain) and education records; improves utilization and ...
Reporting to the Director of Clinical and Quality Services, this position ensures educational ... the Learning Management System (Ninth Brain) and education records; improves utilization and ...
Manager of Family Services
Columbus, OH · On-site
Key Responsibilities Leadership and Workforce Management * Directly supervise, coach, mentor, and ... Provide leadership and oversight of authorization practices and donor family support services.
Manager of Family Services
Columbus, OH · On-site
Key Responsibilities Leadership and Workforce Management * Directly supervise, coach, mentor, and ... Provide leadership and oversight of authorization practices and donor family support services.
Key Responsibilities Leadership and Workforce Management * Directly supervise, coach, mentor, and ... Provide leadership and oversight of authorization practices and donor family support services.
Key Responsibilities Leadership and Workforce Management * Directly supervise, coach, mentor, and ... Provide leadership and oversight of authorization practices and donor family support services.
Manager Of Utilization Management information
See salary details
$39K - $50.7K
9% of jobs
$59.3K is the 25th percentile. Wages below this are outliers.
$50.7K - $62.4K
22% of jobs
$62.4K - $74K
11% of jobs
The median wage is $81.2K / yr.
$74K - $85.7K
14% of jobs
$85.7K - $97.4K
12% of jobs
$104.7K is the 75th percentile. Wages above this are outliers.
$97.4K - $109.1K
13% of jobs
$109.1K - $120.8K
13% of jobs
$120.8K - $132.5K
5% of jobs
$132.5K - $144.1K
2% of jobs
$144.1K - $155.8K
0% of jobs
$155.8K - $167.5K
0% of jobs
$39K
$91K
$167.5K
How much do manager of utilization management jobs pay per year?
As of Aug 26, 2026, the average yearly pay for manager of utilization management in the United States is $91,011.00, according to ZipRecruiter salary data. Most workers in this role earn between $59,500.00 and $109,500.00 per year, depending on experience, location, and employer.
What cities are hiring for Manager Of Utilization Management jobs?
Cities with the most Manager Of Utilization Management job openings:
What states have the most Manager Of Utilization Management jobs?
States with the most job openings for Manager Of Utilization Management jobs include:
What are the most commonly searched types of Of Utilization Management jobs?
The most popular types of Of Utilization Management jobs are:
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 7 days ago
Trinity Health rating
6.6
Based on 354 frontline employees who took The Breakroom Quiz
569th of 893 rated healthcare providers
Job description
Employment Type:
Full timeShift:
Day Shift
Description:
Why MediGold?
MediGold is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare beneficiaries across the United States. We're dedicated to providing excellent customer service, cost-effective care, and exceptional healthcare coverage. We rely on talented colleagues in a wide variety of professional roles including information technology, financial analysis, audit, provider relations and more.
Position Purpose:
Director Utilization Review directs the department's activities and resources to ensure alignment with the mission, values, and objectives of the department and organization
What you will do:
Minimum Qualifications:
Position Highlights and Benefits:
Ministry/Facility Information:
Mount Carmel, a member of Trinity Health, has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our five hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohio's largest undergraduate, graduate, and doctor of nursing programs. If you're seeking a rewarding career where your purpose, passion, and desire to make a difference come alive, we invite you to consider joining our team. Here, care is provided by all of us For All of You!
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
Full timeShift:
Day Shift
Description:
Why MediGold?
MediGold is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare beneficiaries across the United States. We're dedicated to providing excellent customer service, cost-effective care, and exceptional healthcare coverage. We rely on talented colleagues in a wide variety of professional roles including information technology, financial analysis, audit, provider relations and more.
Position Purpose:
Director Utilization Review directs the department's activities and resources to ensure alignment with the mission, values, and objectives of the department and organization
What you will do:
- Develops and implements departmental strategic goals, plans, and standards consistent with the clinical, administrative, legal, and ethical requirements/objectives of the organization. Oversees compliance with regulations, laws and ethics via audits and direct observation. Provides leadership in developing and implementing standardized tools, roles and systems to support Utilization Review
- Directs and evaluates departmental operations. Leads operational improvements to facilitate standardization of utilization review practices. Establishes metrics to achieve service targets. Oversees and evaluates programs and services focused on continuous quality improvement. Participates in review of contracts and agreement of services
- Plans and monitors staffing activities, including hiring, orienting, evaluating, disciplinary and continuing education initiatives. Develops network of high performing teams
- Prepares, monitors, and evaluates departmental budgets, and ensures that the department operates within the allocated funding
- Participates as an active management member of the Mount Carmel Health Plan representing the Utilization Review Department in collaboratively meeting operational, budget, and strategic planning goals
Minimum Qualifications:
- Education: Bachelor of Science Degree in Nursing, Business or other Healthcare related field. Master's Degree preferred
- Licensure/ Certification: RN License through the State of Ohio
- Experience: 10+ years experience in clinical nursing and utilization management with at least 3+ years of utilization management experience at a Managed Care organization.
- Working knowledge of utilization review practices related to regulatory and accreditation requirements.
- Proven team leader with the ability to interact with all levels of staff members and physicians and other healthcare providers.
- Ability to prioritize issues and solve complex problems.
- Proficient computer, written and verbal communication skills including presentation skills.
- Innovative and self-directed.
- Demonstrates a high tolerance for ambiguity and change and provides leadership to department colleagues and others to adapt effectively to meet changing environment.
Position Highlights and Benefits:
- Competitive compensation and benefits packages including medical, dental, and vision with coverage starting on day one.
- Retirement savings account with employer match starting on day one.
- Generous paid time off programs.
- Employee recognition programs.
- Tuition/professional development reimbursement starting on day one.
- RN to BSN tuition 100% paid at Mount Carmel's College of Nursing.
- Relocation assistance (geographic and position restrictions apply).
- Employee Referral Rewards program.
- Mount Carmel offers DailyPay - if you're hired as an eligible colleague, you'll be able to see how much you've made every day and transfer your money any time before payday. You deserve to get paid every day!
- Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups.
Ministry/Facility Information:
Mount Carmel, a member of Trinity Health, has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our five hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohio's largest undergraduate, graduate, and doctor of nursing programs. If you're seeking a rewarding career where your purpose, passion, and desire to make a difference come alive, we invite you to consider joining our team. Here, care is provided by all of us For All of You!
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
What Trinity Health employees say
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About Trinity Health
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Trinity Health Ann Arbor is a 537 -bed teaching hospital located on 340 acre campus. Recognized by IBM Watson as a Top 100 Hospital and #1 Teaching Hospital, Trinity Health Ann Arbor has been a leading health care provider for more than 100 years. Trinity Health has received numerous local and national awards in recognition of our leadership, quality outcomes, and clinical excellence.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Livonia, MI, US