Utilization Review Manager Salary in United States

To get your salary data, use the search bar below or browse by job, city, or state.
loading...

Job title is required

loading...

Job location is required.

Average Salary for Utilization Review Manager in United States

The average salary of a(n) Utilization Review Manager in United States is $45,691.

The average hourly rate of a(n) Utilization Review Manager in United States is $21.97.

The average bonus of a(n) Utilization Review Manager in United States is $1,499.00.

Job Description:

Manages a department responsible for the determination of medical necessity and appropriateness of care based on predetermined criteria and/or guidelines. Manages the utilization review function to ensure accurate and timely prior authorization of designated healthcare services, concurrent review, and retrospective review activity. Typically requires licensure as a Registered Nurse with clinical and managed care experience. Hires, develops, and motivates a qualified utilization review department staff. Plans, organizes, implements, and evaluates departmental outcomes. Performs regular data analysis of hospital census, authorization information, and medical cost reports to identify variances and root causes so that areas of focus may be identified and resources may be appropriately deployed. Ensures that benefits and policies are properly interpreted and that care is rendered in the most appropriate site of service with a focus on quality care and cost efficient outcomes. Assures timely response to provider requests for services per department standards. Conducts regular clinical reviews for utilization management activities based on guidelines and standards for patients in a variety of settings. Prepares and manages the departmental budget. Less

Manages a department responsible for the determination of medical necessity and appropriateness of care based on predetermined criteria and/or guidelines. Manages the utilization review function to ensure accurate and timely prior authorization of designated healthcare services, concurrent review, and retrospective... More

How helpful is this page?

Are you a(n) Utilization Review Manager?

Get a more personalized salary report now. Get Report

Average Salaries for Similar Jobs in United States

Job Openings by Indeed job search

Results for Utilization Review Manager in United States

Health and Wellness Manager - New York, NY

NYC Health + Hospitals

Identifies service utilization trends and potential needs of the membership by means of reviewing encounter data, pharmacy/prescription data, the review of...

View job on Indeed.com

Review Nurse, Restrospective Review - Schenectady, NY

MVP Health Care

Performs DRG and Retrospective medical necessity review for inpatient/outpatient dates of service and claim review for all regions....

View job on Indeed.com

Case Manager Utilization RN - Woodland Hills, CA

Kaiser Permanente

Reviews, analyses & identifies utilization patterns & trends, problems or inappropriate utilization of resources & participates in the collection & analysis of...

View job on Indeed.com

Utilization Case Manager - Dearborn, MI

Oakwood Hospital Dearborn

3-5 years clinical nursing experience or 5-7 years clinical LPN experience in Case Management, Quality Management, Utilization Review, Home Care or Discharge...

View job on Indeed.com

Utilizath Review Nurse - Quincy, MA

Harvard Pilgrim Health Care

The Utilization Review Nurse is responsible for the administration of Harvard Pilgrim’s prior authorization review process as consistent with medical policies...

View job on Indeed.com

Discover How Much You
Should Be Paid

Work in Compensation or HR?    x