Utilization Review (UR) Manager Salary
Women comprise the majority of Utilization Review Managers in the United States. Individuals in this line of work make around $66K annually on average. Most report receiving medical coverage from their employers and a large number collect dental insurance. Most Utilization Review Managers like their work and job satisfaction is high. This snapshot results from replies to PayScale's salary survey.
Job Description for Utilization Review (UR) Manager
Utilization review (UR) managers are responsible for the planning, administration, and oversight of an organization's UR program. These managers ensure full adherence to all applicable regulatory guidelines and statutory requirements, and this is typically a collaborative position in an acute care setting with a variety of clinicians and administrative personnel to improve customer satisfaction, contain costs, and meet organizational goals.Read More...
UR managers are responsible for coordinating utilization review programs; maintaining detailed databases of admission and discharge information; performing weekly, monthly, and quarterly reviews of compiled data to assess progress for particular programs; communicating new protocols and procedures to clinicians and supervisory personnel; identifying potential and emerging challenges with resource utilization, billing procedures, out-of-network referrals, and patient satisfaction; referring providers and patients to appropriate care organizations; and supervising and interacting with supporting UR staff on a daily basis.
Strong written and verbal communication skills are important in this position, and UR managers must be able to excel in a busy medical environment and maintain confidentiality and compliance with HIPAA regulations. They should also have an understanding of admittance, discharge, and billing procedures, as well as cost-benefit principles.
A bachelor's degree, active clinical certification as an RN, LICSW, or LMHC, at least three years of experience in a clinical environment, and at least one year in a utilization review position are generally required for UR managers. Some employers may prefer those who also have a master's degree or prior supervisory experience.
Utilization Review (UR) Manager Tasks
- Manage the selection, training and development of staff.
- Ensure patient services are in compliance with utilization professional standards, state and federal regulatory requirements.
- Monitor and analyze admissions, operational resources, and other indicators within the utilization and quality program.
- Conduct audits to ensure quality patient care and appropriateness of services within contracts.
- Oversee day-to-day operational and clinical activities to ensure quality patient care.
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Pay by Experience Level for Utilization Review (UR) Manager
Median of all compensation (including tips, bonus, and overtime) by years of experience.
Utilization Review Managers do not generally earn higher incomes from more experience in the field. Folks who are navigating the first five years of their careers have a median salary of approximately $59K in this position. Those who have been around for five to 10 years don't get much more, though; the median salary in that group is $62K. Utilization Review Managers with one to two decades of relevant experience report an average salary of approximately $66K. 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 $81K.
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