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Case Manager Utilization Review Nurse Jobs in Decatur, AL

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Case Manager Utilization Review Nurse information

See Decatur, AL salary details

$18

$44

$75

How much do case manager utilization review nurse jobs pay per hour?

As of Sep 10, 2026, the average hourly pay for case manager utilization review nurse in Decatur, AL is $44.56, according to ZipRecruiter salary data. Most workers in this role earn between $33.12 and $53.85 per hour, depending on experience, location, and employer.

What is a case manager utilization review nurse?

A Case Manager Utilization Review Nurse is a registered nurse who evaluates the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, coordinate with healthcare providers, and ensure that treatments meet established guidelines and insurance requirements. Their goal is to optimize patient outcomes while controlling healthcare costs and ensuring compliance with regulations. These nurses also help facilitate communication between patients, providers, and payers to support effective care management.

How does a case manager utilization review nurse typically collaborate with physicians and other healthcare providers?

Case Manager Utilization Review Nurses regularly work with physicians, social workers, and other healthcare professionals to ensure patients receive appropriate care while managing resource utilization. They often participate in interdisciplinary team meetings to discuss care plans, review patient progress, and address any barriers to discharge. Building strong communication channels and maintaining up-to-date clinical knowledge are essential, as nurses must advocate for patients while also supporting evidence-based practices and regulatory compliance. This collaborative environment helps streamline patient care and optimize outcomes.

What are the key skills and qualifications needed to thrive as a case manager utilization review nurse, and why are they important?

To excel as a Case Manager Utilization Review Nurse, you need a solid background in nursing, strong clinical assessment skills, and a valid RN license, often with case management certification. Familiarity with utilization review software, electronic health record (EHR) systems, and knowledge of insurance and regulatory guidelines is essential. Exceptional communication, critical thinking, and negotiation abilities set top performers apart in this role. These qualifications ensure effective patient advocacy, cost-effective care, and compliance with healthcare standards.

What is the difference between Case Manager Utilization Review Nurse vs Case Manager?

AspectCase Manager Utilization Review NurseCase Manager
CredentialsRN license, certification in utilization review (e.g., URAC)RN license, case management certification (e.g., CCM)
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community health, insurance providers
Primary FocusReviewing medical necessity and appropriateness of careCoordinating patient care and discharge planning

While both roles involve patient care coordination, the Case Manager Utilization Review Nurse primarily focuses on reviewing medical necessity and insurance approvals, whereas the Case Manager handles broader patient care coordination and discharge planning. Both roles require nursing credentials and are vital in healthcare settings, but their specific responsibilities differ.

What are popular job titles related to Case Manager Utilization Review Nurse jobs in Decatur, AL?

For Case Manager Utilization Review Nurse jobs in Decatur, AL, the most frequently searched job titles are:

What job categories do people searching Case Manager Utilization Review Nurse jobs in Decatur, AL look for?

The top searched job categories for Case Manager Utilization Review Nurse jobs in Decatur, AL are:

What cities near Decatur, AL are hiring for Case Manager Utilization Review Nurse jobs?

Cities near Decatur, AL with the most Case Manager Utilization Review Nurse job openings:

Case Manager Utilization Review Nurse jobs near you
Infographic showing various Case Manager Utilization Review Nurse job openings in Decatur, AL as of August 2026, with employment types broken down into 68% Full Time, 22% Part Time, and 10% Contract. Highlights an 90% In-person, and 10% Remote job distribution, with an average salary of $92,685 per year, or $44.6 per hour.

Registered Nurse (RN) Case Manager

Madison, AL

Affinity Hospice
Health Care and Social Assistance • 51 - 200 employees
Learn more about Affinity Hospiceexternal

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 21 days ago

Job description

Job Description:

About Us:Affinity Hospice is one of the fastest growing, privately held hospice organizations in the country. We are passionate about giving exceptional care to our hospice patients and their families. We believe the care we provide trulymattersand we would love to have you join our nationally recognized team!

What We Offer:

  • Paid Time Off (PTO), Sick Time, and Holiday Pay

  • Gas Card and Car Maintenance Stipend

  • BenefitPackage (Medical, Dental, Vision and more) for full-time employees

  • 401K

  • Employee Assistance Program

  • Tuition Reimbursement for eligible employees

  • Internal Company Advancement

  • Free end of life training

Position Summary:

The registered nurse/case manager plans, organizes, directs, and provides hospice care and is experienced in nursing, with emphasis on community health education and experience. The professional nursebuilds fromthe resources of the community to plan and direct services to meet the needs ofindividualand families within their homes and communities.

Hours / Schedule:Full Time; (40) hours / week.

Minimum Qualifications:

  • Graduate of an accredited Diploma, Associate or Baccalaureate School of Nursing.

  • Current State license as a Registered Nurse

  • Current CPR certification

  • Minimum of two years of experience as a Registered Nurse ina clinicalcare, home health or hospice setting preferred.

  • Must be a licensed driver with an automobile that is insuredin accordance withstate and/or organization requirements and is in good working order.

  • Excellent observation, verbal and written communication skills, problem solving skills, basic math skills; nursing skills per competency checklist.

  • Able to lift, position and/or transfer patients.

  • Able to lift supplies and equipment.

Key Responsibilities:

  • Case manages and provides clinical direction to the interdisciplinary team, physician, and family.

  • Implement/develop/document the patient plan of care

  • Provide careutilizinginfection control measures that protect both the staff and the patient (OSHA).

  • Assure continuity of quality patient care delivered withappropriate documentation.

  • Monitor assigned cases to ensure compliance with requirements of third-party payer.

  • Demonstrate commitment, professional growth, and competency.

  • Promote agency philosophy and administrative policies.

  • Perform on-call responsibilities and provide on-call service to patients/families as assigned.

  • Responsible for supervising hospice aides and licensed practical nurses.

  • Perform other nursing duties as assigned by management to support department goals and initiatives.

Affinity Hospice is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

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