A little over a half of Utilization Management Case Managers in the United States have been in the field for more than 10 years. Pay can fall anywhere from $39K to $90K per year, but median earnings come to around $66K annually. Experience level is the biggest factor affecting pay for this group, followed by geography. Most enjoy medical while a strong majority get dental coverage. Vision coverage is also available to the greater part. Job satisfaction is reported as high by the vast majority of workers. The figures in this overview were provided by individuals who took PayScale's salary questionnaire.
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$41,349 - $88,189
(Median)
$41K
$66K
$88K
MEDIAN: $65,903
10%
50%
90%

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$17.16 - $48.59
(Median)
$17
$31
$49
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$31K$62K$93K
Salary
$41,349 - $88,189  
   
Bonus
$2,500  
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).
)
$39,007 - $90,406  
Country: United States | Currency: USD | Updated: 28 Oct 2016 | Individuals Reporting: 125
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$32$64$96
Hourly Rate
$17.16 - $48.59  
   
Overtime
$1.52 - $94.19  
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$70K$140K$210K
Bonus
$2,500  
   
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).
)
$39,007 - $90,406  
Country: United States | Currency: USD | Updated: 28 Oct 2016 | Individuals Reporting: 74

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United States (change)

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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

  • 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.
  • Recommend process and policies to improve quality of patient services and increase revenue.
  • Analyze information gathered by investigation; report findings and recommendations.

Common Career Paths for Utilization Management (UM) Case Manager


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Utilization Management Case Managers who go on to become Utilization Management Registered Nurses may see somewhat stagnant compensation. On average, an Utilization Management Registered Nurse, an upper-level role, pays $66K.

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

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


For many Utilization Management Case Managers, extensive experience does not lead to significantly more money. Individuals who have worked for fewer than five years bring in approximately $58K on average. Those in the five-to-10 year range can expect an average that is only a touch bigger at $58K. Utilization Management Case Managers see a median salary of $71K after reaching one to two decades on the job. Old hands boasting more than twenty years of relevant experience report pay that is more or less commensurate with that extensive experience; average earnings for this group come out to approximately $77K.

Related Job Salaries

Location:
Years in Fields/Career:
United States (change)

Experience Affects Utilization Management (UM) Case Manager Salaries

Late-Career
up arrow 18%

Experienced
up arrow 7%

National Average
$66,000

Mid-Career
up arrow 11%

Entry-Level
up arrow 12%

Skills That Affect Utilization Management (UM) Case Manager Salaries

Utilization Review (UR)
up arrow 2%

Case Management
up arrow 1%

National Average
$66,000

Job Satisfaction

Extremely satisfied
Rated 5 out of 5
based on 14 votes.

Gender

Female
97 %
Male
3 %

Years of Experience

Less than 1 year
3%
1-4 years
28%
5-9 years
15%
10-19 years
29%
20 years or more
26%

Common Health Benefits

medical benefits
Medical: 84%
dental benefits
Dental: 73%
medical benefits
Vision: 68%
dental benefits
None: 13%
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