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Pediatric Utilization Management Jobs in Iowa (NOW HIRING)

CHI Health Mercy Council Bluffs

Charge RN

Council Bluffs, IA · On-site

$36.94 - $53.56/hr

... Management * Assists with budget goals, payroll monitoring, and responsible resource utilization ... Pediatric Advanced Life Support, within 5 - months and * Neonatal Resuscitation Program, within 6 - ...

CHI Health Mercy Council Bluffs

Charge RN

Council Bluffs, IA · On-site

$36.94 - $53.56/hr

... Management * Assists with budget goals, payroll monitoring, and responsible resource utilization ... Pediatric Advanced Life Support, within 5 - months and * Neonatal Resuscitation Program, within 6 - ...

Imh

Registered Nurse Care Manager

George, IA · On-site

... from pediatrics to adult. Provides information on health insurance resources. Supervises and ... Experience in case management, utilization review, or discharge planning. * Cardiac Background ...

University of Iowa

NICU ARNP/PA - 50-100%

Iowa City, IA · On-site

$117K - $153K/yr

... patients to manage care and length of stay, improve resource utilization and decrease costs to ... Current certification as a pediatric nurse practitioner (CPNP - AC or CPNP - PC) and licensure as ...

University of Iowa

NICU ARNP/PA - 50-100%

Iowa City, IA · On-site

$117K - $153K/yr

... patients to manage care and length of stay, improve resource utilization and decrease costs to ... Current certification as a pediatric nurse practitioner (CPNP - AC or CPNP - PC) and licensure as ...

The University of Iowa

NICU ARNP/PA - 50-100%

Iowa City, IA · On-site

$90 - $150/hr

... patients to manage care and length of stay, improve resource utilization and decrease costs to ... Current certification as a pediatric nurse practitioner (CPNP - AC or CPNP - PC) and licensure as ...

The University Of Iowa

NICU ARNP/PA - 50-100%

Iowa City, IA · On-site

$117K - $153K/yr

... patients to manage care and length of stay, improve resource utilization and decrease costs to ... Current certification as a pediatric nurse practitioner (CPNP - AC or CPNP - PC) and licensure as ...

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Pediatric Utilization Management information

What is pediatric utilization management?

Pediatric Utilization Management (UM) is a healthcare process that reviews and evaluates the medical necessity, efficiency, and appropriateness of healthcare services provided to children. Professionals in this field assess treatment plans, hospital stays, procedures, and medications to ensure they align with evidence-based guidelines and are truly needed for a pediatric patient's care. The goal is to optimize health outcomes for children while managing healthcare costs and resources efficiently. Pediatric UM often involves collaboration between healthcare providers, insurance companies, and families to make informed decisions about a child's medical care.

What are some common challenges faced by professionals in pediatric utilization management, and how can they be addressed?

Professionals in Pediatric Utilization Management often encounter challenges such as balancing cost-effective care with the unique needs of pediatric patients, staying updated with evolving clinical guidelines, and communicating effectively with both providers and families. Navigating insurance requirements while advocating for appropriate treatments requires strong clinical knowledge and negotiation skills. Building collaborative relationships with multidisciplinary teams and ongoing professional development can help address these challenges and ensure the best outcomes for young patients.

What are the key skills and qualifications needed to thrive as a pediatric utilization management nurse, and why are they important?

To thrive in Pediatric Utilization Management, you need a solid background in pediatric nursing, critical thinking, and knowledge of healthcare regulations, generally supported by an RN license and experience in pediatrics. Familiarity with utilization review software, electronic medical records (EMRs), and certification such as Certified Case Manager (CCM) or Utilization Review Accreditation Commission (URAC) is often required. Excellent communication, attention to detail, and strong organizational skills are crucial for collaborating with medical teams and advocating for appropriate patient care. These competencies ensure effective care coordination, regulatory compliance, and optimal outcomes for pediatric patients.

What is the difference between Pediatric Utilization Management vs Pediatric Case Management?

AspectPediatric Utilization ManagementPediatric Case Management
CredentialsRN, licensed healthcare professionals, certifications in utilization reviewRN, social worker, case management certification
Work EnvironmentInsurance companies, healthcare organizations, utilization review departmentsHospitals, clinics, community health settings
Employer & Industry UsageInsurance providers, managed care organizationsHospitals, outpatient clinics, social services
FocusReviewing medical necessity, approving services, optimizing resource useCoordinating care, supporting patient needs, discharge planning

While both roles involve working with pediatric patients, Pediatric Utilization Management primarily focuses on reviewing and approving healthcare services for medical necessity within insurance or managed care settings. Pediatric Case Management emphasizes coordinating ongoing patient care and support services across healthcare providers and community resources.

What are popular job titles related to Pediatric Utilization Management jobs in Iowa?

For Pediatric Utilization Management jobs in Iowa, the most frequently searched job titles are:

What job categories do people searching Pediatric Utilization Management jobs in Iowa look for?

The top searched job categories for Pediatric Utilization Management jobs in Iowa are:

What cities in Iowa are hiring for Pediatric Utilization Management jobs?

Cities in Iowa with the most Pediatric Utilization Management job openings:

Pediatric Utilization Management jobs near you
Infographic showing various Pediatric Utilization Management job openings in Iowa as of June 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution.

Charge RN

CHI Health Mercy Council Bluffs

Council Bluffs, IA • On-site

$36.94 - $53.56/hr

Full-time

Re-posted 2 days ago

Job description


Job Summary and Responsibilities

As a Charge RN, you'll oversee a department of frontline nurses caring for patients. Your previous experience in acute care, LTC, or nursing homes adds tremendous value to our nursing team.
Every day you will advocate for your fellow nurses as you support them in reaching their full potential, which aligns with your department's operational goals and objectives.
To thrive in this role, you need to be accountable and confident. You're an excellent communicator in 1:1 interactions and in front of groups. It's also important for you to be comfortable holding tough conversations, as you are responsible for the performance of your people and your unit.

Human Resources Management

  • Supports staffing, scheduling, staff development, certification tracking, and performance management activities.

Fiscal Management

  • Assists with budget goals, payroll monitoring, and responsible resource utilization.

Leadership

  • Promotes departmental goals, quality outcomes, regulatory compliance, staff communication, education, and continuous improvement initiatives.

Clinical Competence

  • Maintains clinical expertise, serves as a specialty resource, and models professional and clinical excellence while ensuring quality patient care.
Job Requirements

Required

  • Graduate of an RN nursing program, upon hire
  • Registered Nurse: NE, upon hire and
  • Basic Life Support - CPR, upon hire and
  • Advanced Cardiac Life Support, within 5 - months and
  • Pediatric Advanced Life Support, within 5 - months and
  • Neonatal Resuscitation Program, within 6 - months
Where You'll Work

At CHI Health Mercy Council Bluffs, patients are at the heart of our care. Our campus is designed to heal the body, mind and spirit of every person in a more comfortable, less stressful hospital environment. Our full range of medical services include a new pavilion featuring enhancements in heart and vascular care, surgery, maternity, cancer care, and diagnostic imaging.


Pay Range
$36.94 - $53.56 /hour

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