Manager | Utilization Management Services
Posted Sep 29, 2026 · We last checked this listing on Oct 6, 2026
Likely interview questions for this role
Written from this job description, not a generic list. Each one notes what the interviewer is really checking.
About your past
You'd be leading about 20 people through a period of change and new technology. Tell me about a time you led a team through a big shift. What went wrong and what did you do?
What they are checking: Whether they can lead people through change honestly, including the parts that did not go to plan.
Tell me about a time you used denial data to change how your team worked.
What they are checking: Whether they connect payer denials back to root causes in the process and close the loop, which protects revenue.
Tell me about a time you had to address a performance problem with an experienced nurse on your team.
What they are checking: Whether they can give direct feedback to seasoned staff and follow through, rather than avoiding hard conversations.
What would you do
A physician strongly disagrees with a level-of-care determination your team made. How do you handle that conversation?
What they are checking: Whether they can hold a criteria-based position with physicians while staying respectful and using medical director escalation correctly.
We're bringing in new tools to make reviews more efficient. How would you roll out new software to a team that's comfortable with how things are?
What they are checking: Whether they involve staff early, plan training and measure adoption instead of just announcing a go-live date.
The organization is aligning work across sites. If two locations do utilization reviews differently, how would you decide which approach becomes the standard?
What they are checking: Whether they use evidence and outcomes to choose a standard and bring both teams along, not just pick their own way.
How do you balance productivity targets for reviewers with making sure the reviews are accurate?
What they are checking: Whether they understand that rushed reviews create denials and compliance risk, and can manage both speed and quality.
About the work
Walk me through how your team decides between inpatient and observation status for a patient. Where does physician advisor review come in?
What they are checking: Whether they understand level-of-care criteria and the escalation path that protects both compliance and reimbursement.
How do you explain the Two-Midnight Rule to a new nurse reviewer, and what mistakes do people make with it?
What they are checking: Whether they know the Medicare rules that drive status decisions well enough to teach them and spot common errors.
Which measures would you track to know your utilization management team is doing well?
What they are checking: Whether they look at denials, review timeliness, avoidable days and productivity together rather than chasing one number.
How do you keep your team current and compliant with CMS and commercial payer rules that keep changing?
What they are checking: Whether they have a real system for tracking regulatory and payer updates and getting them into daily practice.
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Practice this out loudThe full job description
As published by Bellin Gundersen.