1–3 jobs· newest first
$19–$29Full-time · Associate
$39–$51Full-time
Remote · Full-time · Director
+10K new in the last hour
The Utilization Management Specialist is a critical member of the Utilization Management team, responsible for the timely, accurate, and clinically appropriate management of referrals, authorizations, and benefit determinations for capitated and value-based health plan populations.
The compensation for this role includes a base pay range of, with the actual $19.07- $28.61 pay determined by factors such as skills, experience, education, certifications, geographic location, and internal equity. Additional compensation may be available through shift differentials, bonuses, and other incentives.
Capital Health (US) · Posted Jul 28, 2026
Performs utilization and resource management activities to promote quality, clinical and cost effective outcomes.
Pay Range: $39.40 - $51.47
Lead clinical review and utilization management for a Medicare Advantage Health Plan, ensuring compliance with CMS regulations and optimizing patient care outcomes.