Utilization Manager Jobs
Utilization Manager jobs are open from entry-level care coordinators to senior and director roles across health insurance, managed care, hospital systems, and behavioral health, with specializations in clinical review, case management, and concurrent review. Scan the live roles below and apply to whichever ones fit.
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Showing 5 of 56+ Utilization Manager jobs
Love + medicine is who we are, it's what we do, it's why people want to work here. If you’re looking for a job to love, apply today.
Scheduled Weekly Hours:
40We’re not just filling positions, we’re building careers. At Emplify Health, we care for our teams, while they care for their communities. Whether you are just starting out or looking for a change, Emplify Health supports you now and into the future. Join us and find out how a little empathy changes everything.
Help shape medication use across our health system. The Program Manager of Medication Utilization is a new leadership role on our growing pharmacy team. This position leads pharmacists and pharmacy technicians in overseeing medication utilization through formulary management, evidence-based decision-making, and interdisciplinary collaboration.
What you will do:
- Full-time salaried position
- Oversee medication utilization through formulary management
What you Get:
- $125,486-$188,219/year (salary based on years of experience)
- Top-notch benefits: 401(k) with matching, paid time off, competitive health insurance, wellness programs to keep you and your family healthy, tuition reimbursement, and more
- Career Growth/CDC - Growth opportunities and access to Emplify Health’s Career Development Center to help you navigate your career
What you need:
- Pharmacy degree (B.S. and/or Pharm.D.) from an ACPE accredited College of Pharmacy.
- 1+ years of relevant professional experience or specialized residency training in pharmacy administration.
- Pharmacist license to practice in the state of Wisconsin
Emplify Health, a partnership of Bellin Health and Gundersen Health System, is a leading not-for-profit, patient-centered healthcare network based in Green Bay and La Crosse, Wisconsin. With 11 hospitals and over 100 clinics, we serve 67 cities across Wisconsin, Iowa, Minnesota, and Michigan's Upper Peninsula. Join us in making a meaningful difference in the lives of our patients and communities.
I f you need assistance with any portion of the application or have questions about the position, please contact HR-Recruitment@gundersenhealth.org or call 608-775-0267.
We inspire your best life by relentlessly caring, learning and innovating. This is our purpose. Together with our values — belonging, respect, excellence, accountability, teamwork and humility — our pillars set our foundation and our future.
Equal Opportunity Employer
Love + medicine is who we are, it's what we do, it's why people want to work here. If you’re looking for a job to love, apply today.
Scheduled Weekly Hours:
40We’re not just filling positions, we’re building careers. At Emplify Health, we care for our teams, while they care for their communities. Whether you are just starting out or looking for a change, Emplify Health supports you now and into the future. Join us and find out how a little empathy changes everything.
Help shape medication use across our health system. The Program Manager of Medication Utilization is a new leadership role on our growing pharmacy team. This position leads pharmacists and pharmacy technicians in overseeing medication utilization through formulary management, evidence-based decision-making, and interdisciplinary collaboration.
What you will do:
- Full-time salaried position
- Oversee medication utilization through formulary management
What you Get:
- $125,486-$188,219/year (salary based on years of experience)
- Top-notch benefits: 401(k) with matching, paid time off, competitive health insurance, wellness programs to keep you and your family healthy, tuition reimbursement, and more
- Career Growth/CDC - Growth opportunities and access to Emplify Health’s Career Development Center to help you navigate your career
What you need:
- Pharmacy degree (B.S. and/or Pharm.D.) from an ACPE accredited College of Pharmacy.
- 1+ years of relevant professional experience or specialized residency training in pharmacy administration.
- Pharmacist license to practice in the state of Wisconsin
Emplify Health, a partnership of Bellin Health and Gundersen Health System, is a leading not-for-profit, patient-centered healthcare network based in Green Bay and La Crosse, Wisconsin. With 11 hospitals and over 100 clinics, we serve 67 cities across Wisconsin, Iowa, Minnesota, and Michigan's Upper Peninsula. Join us in making a meaningful difference in the lives of our patients and communities.
I f you need assistance with any portion of the application or have questions about the position, please contact HR-Recruitment@gundersenhealth.org or call 608-775-0267.
We inspire your best life by relentlessly caring, learning and innovating. This is our purpose. Together with our values — belonging, respect, excellence, accountability, teamwork and humility — our pillars set our foundation and our future.
Equal Opportunity Employer
See All 56 Utilization Manager Jobs
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Find Utilization Manager JobsUtilization Manager Job Market
Who's Hiring
Top Industries Hiring
- Technology & Software
- Healthcare & Medical Services
- Education
- Insurance
What Employers Look For
The qualifications that appear most often in utilization manager jobs.
- Active RN, LCSW, or other clinical licensure required by most employers
- Experience applying InterQual or MCG clinical criteria for prior authorizations and concurrent review
- Minimum of three years clinical experience in acute care, managed care, or case management
- Proficiency with electronic health records and payer or hospital utilization management platforms
- Certified Case Manager or CPHM certification preferred by health plan and managed care employers
- Strong working knowledge of Medicare, Medicaid, and commercial payer coverage guidelines
Tips for Your Utilization Manager Job Search
Tailor your resume to clinical criteria
Highlight your experience applying InterQual or MCG criteria in every review role you list. Hiring managers scan for these tools immediately, and a resume that names them in context beats a generic clinical background every time.
Lead with your licensure front and center
Put your RN, LCSW, or other active clinical license in your resume header, not buried in a credentials section. Many applicant tracking systems filter on licensure before a human ever reads your application.
Apply early to roles that fit
Migrate Mate lists utilization manager openings from across the United States in one place, so you can find roles that match and apply directly to each listing.
Filter for payer versus provider settings
Payer-side roles at health plans emphasize denial rationale and appeals, while provider-side roles focus on concurrent inpatient review and discharge planning. Target your search to the setting where your experience is strongest and frame your resume accordingly.
Prepare a denial rationale walkthrough for interviews
Interviewers frequently ask you to walk through a denial decision you made, including the criteria you applied and how you communicated it. Rehearse two specific examples with the clinical reasoning spelled out before your first screening call.
Negotiate schedule flexibility, not just base pay
Many utilization manager roles have on-call or weekend review responsibilities that vary widely by employer. Ask directly about review volume, on-call rotation frequency, and turnaround time expectations before accepting any offer.
Utilization Manager Jobs: Frequently Asked Questions
Which companies are hiring the most utilization managers?
BJC HealthCare, Kaiser Permanente, and MetroPlusHealth are hiring the most utilization managers right now, with openings concentrated in California, Texas, and New Jersey, based on current listings on Migrate Mate as of November 2026. Health plans, managed care organizations, and large hospital systems consistently post the highest volumes of utilization manager roles.
How many utilization manager jobs are remote?
About 65% of utilization manager openings are fully remote or hybrid as of November 2026, making it one of the more remote-accessible clinical roles available. Prior authorization review and telephonic concurrent review positions are most likely to be fully remote, while on-site concurrent review and discharge planning roles typically require facility presence.
How do you become a utilization manager?
Start by earning an active clinical license, most commonly as an RN or LCSW, and building at least a few years of direct patient care experience in acute care, case management, or a managed care setting. From there, seek roles with utilization review responsibilities, learn to apply InterQual or MCG criteria, and pursue a Certified Case Manager credential to strengthen your candidacy for dedicated utilization management positions.
Can you get hired as a utilization manager with little experience?
You can get hired in a junior or associate utilization management role if you have an active clinical license and some exposure to chart review, discharge planning, or prior authorization work, even from a staff nurse or care coordinator role. Emphasize any experience you have documenting clinical necessity, communicating with payers, or applying coverage criteria, since those tasks map directly to utilization management work.
What does the utilization manager interview process look like?
Most utilization manager interviews begin with a recruiter or HR screening call focused on licensure, years of clinical experience, and familiarity with review criteria tools. A hiring manager interview follows, typically including scenario-based questions where you walk through a denial decision or a complex concurrent review case. Some employers add a brief written or verbal clinical scenario assessment before extending an offer.
Where can I find and apply to utilization manager jobs?
You can find and apply to utilization manager jobs on Migrate Mate, which lists current openings from across the United States in one place. Search for roles that match your license, setting preference, and experience level, then apply directly to each listing that fits.
See All 56 Utilization Manager Jobs
Find roles that match your experience and apply in just a few clicks.
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