Utilization Management (UM) Case Manager Salary

With just below three-fifths of Utilization Management Case Managers in the United States reporting more than 10 years of experience in the field, this area is heavily weighted toward experienced professionals. Pay ranges from $44K to $90K per year and averages out to $66K per year. Career duration and the particular city each impact pay for this group, with the former having the largest influence. Medical benefits are awarded to a large number, and a fair number earn dental coverage. Job satisfaction is reported as high by the vast majority of workers. The data for this snapshot was collected from individuals who took PayScale's salary survey.
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$48,119 - $87,614
(Median)
$48K
$66K
$88K
MEDIAN: $66,428
10%
50%
90%

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$18.70 - $43.83
(Median)
$19
$30
$44
MEDIAN: $30
10%
50%
90%

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National Salary Data (?
XAll compensation data shown are gross 10th to 90th percentile ranges. Take the PayScale Survey to find out how location influences pay for this job.
)
$0$30K$60K$90K
Salary
$48,119 - $87,614  
   
Bonus
$0.00 - $5,872  
Profit Sharing
$2,457  
Total Pay (?
XTotal Pay combines base annual salary or hourly wage, bonuses, profit sharing, tips, commissions, overtime pay and other forms of cash earnings, as applicable for this job. It does not include equity (stock) compensation, cash value of retirement benefits, or the value of other non-cash benefits (e.g. healthcare).
)
$44,149 - $89,537  
Country: United States | Currency: USD | Updated: 12 Jan 2016 | Individuals Reporting: 241
National Hourly Rate Data (?
XAll compensation data shown are gross 10th to 90th percentile ranges. Take the PayScale Survey to find out how location influences pay for this job.
)
$0$28$56$84
Hourly Rate
$18.70 - $43.83  
   
Overtime
$0.39 - $81.44  
National Annualized Data (?
XAll compensation data shown are gross 10th to 90th percentile ranges. Take the PayScale Survey to find out how location influences pay for this job.
)
$0$60K$120K$180K
Bonus
$0.00 - $5,872  
   
Profit Sharing
$2,457  
Total Pay (?
XTotal Pay combines base annual salary or hourly wage, bonuses, profit sharing, tips, commissions, overtime pay and other forms of cash earnings, as applicable for this job. It does not include equity (stock) compensation, cash value of retirement benefits, or the value of other non-cash benefits (e.g. healthcare).
)
$44,149 - $89,537  
Country: United States | Currency: USD | Updated: 12 Jan 2016 | Individuals Reporting: 144
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Job Description for Utilization Management (UM) Case Manager

A utilization management case manager generally works for an insurance entity and analyzes individual medical cases to determine eligibility for medical care. The case manager will obtain pre-certification for patients and conduct reviews to determine if patients are eligible for inpatient or outpatient services or home care based on patient benefit and coverage rules. When patients are not covered for certain services, the case manager will review the cases and determine if the care is needed by analyzing medical records.

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Utilization Management (UM) Case Manager Tasks

  • Recommend process and policies to improve quality of patient services and increase revenue.
  • Analyze information gathered by investigation; report findings and recommendations.
  • Interview or correspond with physicians to correct errors or omissions and to investigate questionable claims.
  • Compile, audit and analyze patient records to document condition and treatment and to provide data for cost control and care improvement efforts.

Common Career Paths for Utilization Management (UM) Case Manager


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Utilization Management Case Managers who transition into an upper level Utilization Management Registered Nurse position will not necessarily make much more than they do in their current role. The average Utilization Management Registered Nurse makes $66K a year.

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Utilization Management Case Managers who responded to the survey report just a handful of professional skills. Utilization Review and Case Management are considered valuable skills and can increase employee pay. Competency in Case Management frequently indicates knowledge of Utilization Review.

Pay by Experience Level for Utilization Management (UM) Case Manager

Median of all compensation (including tips, bonus, and overtime) by years of experience.


Experience and pay tend to be weakly linked for Utilization Management Case Managers — those with more experience do not necessarily bring in higher earnings. Survey participants with less than five years' experience report a median income of $58K, and earnings aren't much higher for respondents who have five to 10 years under their belts; respondents in the latter group report a median of just $61K. For Utilization Management Case Managers, 10 to 20 years of experience on the job amounts to an average salary of $68K. In the end, the overall pattern seems to be that more experience generally corresponds to higher pay; an Utilization Management Case Manager with more than 20 years of experience can earn $76K on average.

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Experience Affects Utilization Management (UM) Case Manager Salaries

Late-Career
up arrow 16%

Experienced
up arrow 3%

National Average
$65,000

Mid-Career
up arrow 7%

Entry-Level
up arrow 12%

Skills That Affect Utilization Management (UM) Case Manager Salaries

Utilization Review (UR)
up arrow 4%

Case Management
up arrow 1%

National Average
$65,000

Job Satisfaction

Extremely satisfied
Rated 5 out of 5
based on 52 votes.

Gender

Female
93 %
Male
7 %

Years of Experience

Less than 1 year
2%
1-4 years
25%
5-9 years
17%
10-19 years
30%
20 years or more
27%

Common Health Benefits

medical benefits
Medical: 85%
dental benefits
Dental: 78%
medical benefits
Vision: 71%
dental benefits
None: 13%
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