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Utilization Care Manager Jobs in Alaska (NOW HIRING)

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Utilization Care Manager information

How does a utilization care manager collaborate with medical and administrative teams to ensure effective patient care?

Utilization Care Managers work closely with physicians, nursing staff, and administrative teams to review patient cases, determine medical necessity, and coordinate appropriate care plans. They frequently participate in interdisciplinary meetings, communicate with insurance providers regarding authorizations, and ensure compliance with regulatory guidelines. This collaborative approach helps to optimize resource utilization, improve patient outcomes, and support smooth transitions of care. Being proactive in communication and documentation is key to success in this role.

What is a utilization care manager?

Utilization Care Managers are healthcare professionals responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They work to ensure that patients receive the right care at the right time, while also helping healthcare organizations manage costs and comply with regulations. Utilization Care Managers often review patient cases, coordinate with medical staff, and interact with insurance companies to authorize or deny services. Their goal is to optimize healthcare delivery, reduce unnecessary procedures, and improve patient outcomes.

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

To thrive as a Utilization Care Manager, you need a background in healthcare, typically as a registered nurse or social worker, with expertise in care coordination and utilization review. Familiarity with utilization management software, medical necessity guidelines (such as Milliman or InterQual), and knowledge of insurance regulations are important. Strong analytical thinking, attention to detail, and effective communication skills help you advocate for patients while working with healthcare teams and payers. These skills ensure appropriate resource use, quality patient outcomes, and compliance with regulatory standards.

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

AspectUtilization Care ManagerUtilization Review Nurse
CredentialsRN, case management certificationRN, certification in utilization review
Work EnvironmentHealthcare facilities, insurance companiesHospitals, insurance companies, outpatient clinics
Primary FocusCoordinating patient care, managing resourcesReviewing medical necessity, approving treatments

Utilization Care Managers focus on coordinating patient care and managing resources, while Utilization Review Nurses primarily evaluate medical necessity for treatments. Both roles require nursing credentials and work within healthcare or insurance settings, but their core responsibilities differ in scope and focus.

What are popular job titles related to Utilization Care Manager jobs in Alaska?

For Utilization Care Manager jobs in Alaska, the most frequently searched job titles are:

What job categories do people searching Utilization Care Manager jobs in Alaska look for?

The top searched job categories for Utilization Care Manager jobs in Alaska are:

What cities in Alaska are hiring for Utilization Care Manager jobs?

Cities in Alaska with the most Utilization Care Manager job openings:

Pediatric Care Manager RN (Children's Hospital)

Providence Health and Services

Anchorage, AK • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 9 days ago


Providence Health & Services rating

7.6

Company rating: 7.6 out of 10

Based on 844 frontline employees who took The Breakroom Quiz

189th of 887 rated healthcare providers


Job description

Description

We are hiring for Care Manager RN positions at Providence Alaska Children's Hospital in Anchorage, AK!

Join us as a Care Manager to play a vital, hands‐on role during a transformational time in our department. Work at the top of your scope, gain broad clinical and operational experience, and be supported as you expand your scope of influence throughout the organization and beyond. Providence Alaska Children's Hospital values flexibility, teamwork, and stepping in where you're needed most—creating meaningful opportunities to develop as a well-rounded leader. If you're driven by purpose, energized by challenge, and looking for long‐term growth in an extraordinary Alaska setting, Providence Alaska Children's Hospital is where your career can thrive.

The Inpatient Registered Nurse (RN) Care Manager provides professional, comprehensive, patient centric care management services for at risk patients in an acute care environment. Accountabilities include assessment and planning, coordination of care, resource utilization management and/ or review, discharge planning, documentation of interventions, regulatory compliance and patient advocacy. The goal of the Inpatient Care Management RN is to ensure the use of appropriate healthcare resources throughout the continuum, so that the care provided is the right care, at the right time, in the right setting.

Providence caregivers are not simply valued – they're invaluable. Join our team at Providence Alaska Children's Hospital thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Currently available positions:

  • Care Manager RN - Full-Time (1.0 FTE, Day Shift, 40 Hours Per Week)
  • $10,000 Hiring Bonus for eligible external hires that meet required qualifications and conditions for payment.
  • Relocation Assistance available for eligible hires that meet required qualifications and conditions for payment.

Apply today! Applicants that meet qualifications will receive an invite with additional screening questions from our HireVue system!

Required Qualifications:

  • Associate's Degree in Nursing degree/diploma upon hire
  • Upon hire: Alaska Registered Nurse License
  • 2 years of Acute care experience in a Medical Surgical or Inpatient setting
  • IRR or annual competency testing in Utilization Review

Preferred Qualifications:

  • Bachelor's Degree in Nursing or higher within 3 years of hire
  • National Certification in area of specialty
  • 1 year of experience in care management or utilization review in any setting or successful completion of TIPS program or Case Management Orientation Program

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

The Providence family of organizations has a vision of health for a better world. As such, we are called to care wisely for our communities, resources, and earth. Our organizations strive to become carbon negative by 2030.

Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.

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About Providence

At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.

Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

About the Team

Providence has a long history of serving Alaska, beginning when the Sisters of Providence first brought health care to Nome in 1902 during the Gold Rush. This pioneering spirit set the standard for modern health care in Alaska and formed the foundation for Providence's growth as the state's largest private employer and leading health care provider.

Our award-winning and comprehensive medical centers are located in Anchorage, Eagle River, Kodiak Island, Mat-Su, Seward, and Valdez. Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, outreach programs, and hospice and home care.

Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

Requsition ID: 442003

Company: Providence Jobs

Job Category: Care Management

Job Function: Clinical Care

Job Schedule: Full time

Job Shift: Multiple shifts available

Career Track: Nursing

Department: 1017 AK PAMC CASE MGMT

Address: AK Anchorage 3200 Providence Dr

Work Location: Providence Alaska Medical Ctr-Anchorage

Workplace Type: On-site

Pay Range: $43.29 - $76.06

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

PandoLogic. Category:Healthcare, Keywords:Medical Case Manager, Location:Anchorage, AK-99503

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