The majority of Utilization Management Case Managers in the United States — around half — boast more than 10 years of experience in their profession. Salaries stretch from $38K to $91K per year, and the median is $65K annually. Career length is the biggest factor affecting pay for this group, followed by geography. The majority of Utilization Management Case Managers claim high levels of job satisfaction. Most enjoy medical while a strong majority get dental coverage. Vision coverage is also available to a majority. The numbers in this rundown were provided by PayScale's salary survey participants.
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$40,825 - $88,629
$41K
$65K
$89K
MEDIAN: $65,227
10%
50%
90%

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$16.11 - $48.06
$16
$31
$48
MEDIAN: $30.80
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
$40,825 - $88,629  
   
Bonus
$2,600  
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).
)
$38,150 - $90,909  
Country: United States | Currency: USD | Updated: 18 Jan 2017 | Individuals Reporting: 119
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
$16.11 - $48.06  
   
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
$2,600  
   
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).
)
$38,150 - $90,909  
Country: United States | Currency: USD | Updated: 18 Jan 2017 | Individuals Reporting: 68

Find Out Exactly What You Should Be Paid

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 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 $67K a year.

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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.


Utilization Management Case Managers with a lot of experience do not necessarily enjoy more money. At career start (within the first five years), average income sits near $59K, and the average for folks who have worked for five to 10 years is only slightly higher at $61K. The average pay reported by folks with 10 to 20 years of experience is around $71K. As Utilization Management Case Managers reach more than two decades on the job, compensation remains commensurate with experience; the average pay in this group is $76K.

Related Job Salaries

Key Stats for Utilization Management (UM) Case Manager

Gender

Female
96 %
Male
4 %

Job Satisfaction

Extremely satisfied
Rated 5 out of 5
based on 14 votes.
028
Less than 1 year
4%
1-4 years
28%
5-9 years
17%
10-19 years
28%
20 years or more
23%
Location:
Years in Fields/Career:
United States (change)

Experience Affects Utilization Management (UM) Case Manager Salaries

Late-Career
up arrow 16%

Experienced
up arrow 8%

National Average
$65,000

Mid-Career
up arrow 6%

Entry-Level
up arrow 9%

Skills That Affect Utilization Management (UM) Case Manager Salaries

Utilization Management (UM)
up arrow 6%



National Average
$65,000

Job Satisfaction

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

Gender

Female
96 %
Male
4 %

Years of Experience

Less than 1 year
4%
1-4 years
28%
5-9 years
17%
10-19 years
28%
20 years or more
23%

Common Health Benefits

medical benefits
Medical: 85%
dental benefits
Dental: 76%
vision benefits
Vision: 69%
dental benefits
None: 11%
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