> Markdown version of [/jobs/ext/577527-manager-utilization-management](https://www.wearedevelopers.com/jobs/ext/577527-manager-utilization-management). Every page supports `.md` or `Accept: text/markdown`. Links point to the HTML versions so they work for humans too. Agent guide: [/agents.md](https://www.wearedevelopers.com/agents.md). --- # Manager, Utilization Management - **Company:** Toney HealthCare Consulting, LLC - **Location:** United States (Remote available) - **Experience:** Experienced - **Salary:** $100,000.0 - $130,000.0 - **Contract:** Permanent contract - **Skills:** Data Analysis, Performance Monitor - **Published:** June 12, 2026 - **Apply:** https://www.indeed.com/viewjob?jk=3621c9511995d4d3 ## About the Role Do you have experience in Utilization review?, * Minimum 5 years of Utilization Management experience. * At least 2 years of leadership or team management in a UM setting. * Active, unrestricted RN license required * Strong understanding of InterQual and/or MCG criteria. * Experience managing remote clinical teams across multiple engagements * Familiarity with Medicare, Medicaid, and commercial payer UM requirements. * Excellent communication, data analysis, and problem-solving skills. Preferred education, certifications and/or experience: * Consulting or project-based experience preferred. Physical Requirements/Work environment: * Remote role with occasional travel (Less than 5%) * Must have a home office, mobile phone, computer with security requirements met. * Prolonged periods of sitting at a desk and working on a computer. * Ability to speak, hear, and comprehend both written and verbal communications., * Utilization Management: 5 years (Required) * leadership (UM setting): 2 years (Required) License/Certification: * RN License (Required) ## Description The Manager of Utilization Management is responsible for overseeing day-to-day operations across multiple client UM projects. This role combines project management with hands-on leadership of clinical teams, ensuring compliance, performance, and client satisfaction. The manager serves as a resource and SME to internal teams and acts as the key point of contact for client leadership., * Lead and manage assigned UM projects, including oversight of W2 and 1099 nurse teams. * Serve as the UM subject matter expert and escalation point for clinical guidance. * Act as the primary liaison to client leadership, providing updates and demonstrating value. * Ensure productivity, audit compliance, turnaround times, and quality standards are met. * Conduct regular audits and coach team members to maintain clinical excellence. * Support staffing alignment and placement strategies with internal leadership. * Monitor team engagement and proactively manage to reduce turnover. * Deliver performance reporting and insights to internal and external stakeholders. * Support onboarding and training of new team members. * Partner with SVP to identify areas for process improvement and operational efficiency. Competencies: * Leads by example, motivates others, and manages team dynamics effectively. * Thrives in fast paced, evolving environments and adjusts quickly to changing client needs. * Applies sound clinical reasoning to support decision making and guidance. * Builds trust with clients, anticipates their needs, and delivers high value outcomes. * Sets clear expectations, measures performance, and takes ownership of outcomes. * Works cross functionally with internal teams and client stakeholders to achieve aligned goals. * Anticipates challenges, investigates root causes and develops solutions. * Provides regular feedback and mentors team. * Champions operational efficiency. ## Related Videos - [Why Your Next Best Talent Might Not Be in Your Neighborhood](https://www.wearedevelopers.com/videos/1861-why-your-next-best-talent-might-not-be-in-your-neighborhood) - [Data Science in Retail](https://www.wearedevelopers.com/videos/586-data-science-in-retail) - [Automate everything via NodeJS and Puppeteer](https://www.wearedevelopers.com/videos/322-automate-everything-via-nodejs-and-puppeteer) - [Remote Work Is a Revolution — Not a Perk](https://www.wearedevelopers.com/videos/2013-remote-work-is-a-revolution-not-a-perk) - [Data Science on Software Data](https://www.wearedevelopers.com/videos/162-data-science-on-software-data) - [From Doubt to Confidence: How Sentry Uses Verdaccio to Bulletproof SDK Releases](https://www.wearedevelopers.com/videos/739-from-doubt-to-confidence-how-sentry-uses-verdaccio-to-bulletproof-sdk-releases) ## Related Articles - [From developer to manager – what does it take to become an engineering manager?](https://www.wearedevelopers.com/magazine/42-from-developer-to-manager-what-does-it-take-to-become-an-engineering-manager) - [Best Paying Remote Jobs](https://www.wearedevelopers.com/magazine/255-best-paying-remote-jobs) - [Mastering Remote Work: Tips for Developers](https://www.wearedevelopers.com/magazine/558-mastering-remote-work-tips-for-developers) - [Trading Remote Work For Salary Reduction](https://www.wearedevelopers.com/magazine/334-trading-remote-work-for-salary-reduction) - [Remote Work: Best Practices for Developers](https://www.wearedevelopers.com/magazine/315-remote-work-best-practices-for-developers) - [Should Tech Managers Be Developers First? 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