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Utilization Care Manager Jobs in Utah (NOW HIRING)

Imh

$41.20 - $62.17/hr

Demonstrated experience in case management, utilization review, value-based care, and/or discharge planning. * Basic computer skills, including proficiency in word processing and spreadsheet software.

Intermountain Health

RN Care Manager PRN

Salt Lake City, UT · On-site

$41.20 - $62.17/hr

Demonstrated experience in case management, utilization review, value-based care, and/or discharge planning. * Basic computer skills, including proficiency in word processing and spreadsheet software.

Imh

$41.20 - $62.17/hr

Demonstrated experience in case management, utilization review, value-based care, and/or discharge planning. * Basic computer skills, including proficiency in word processing and spreadsheet software.

Imh

$41.20 - $62.17/hr

Demonstrated experience in case management, utilization review, value-based care, and/or discharge planning. * Basic computer skills, including proficiency in word processing and spreadsheet software.

Verisk

Customer Care Manager

Lehi, UT · On-site

Productivity and utilization metrics * Abandon rates and response times * Revenue influence and ... Manages approximately 50% of the Customer Care team * Works in partnership with a peer manager to ...

Verisk

Customer Care Manager

Lehi, UT · On-site

$90K - $110K/yr

Productivity and utilization metrics * Abandon rates and response times * Revenue influence and ... Manages approximately 50% of the Customer Care team * Works in partnership with a peer manager to ...

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All JobsUtilization Care JobsUtilization Care Manager JobsUtilization Care Manager Jobs in Utah

Utilization Care Manager information

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.

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 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 does a utilization care manager do in healthcare?

A utilization care manager in healthcare reviews patient cases to ensure appropriate use of medical services and resources, coordinating care plans to optimize patient outcomes and reduce unnecessary costs. They often work with healthcare providers, insurance companies, and patients, using data and clinical guidelines to make informed decisions about treatment and service utilization.

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

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

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

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

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

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

Utilization Care Manager jobs near you
Infographic showing various Utilization Care Manager job openings in Utah as of August 2026, with employment types broken down into 95% Full Time, and 5% Part Time. Highlights an 90% In-person, and 10% Remote job distribution.

RN Care Manager - Cottonwood, AZ - relocation to COTTONWOOD, Arizona

Northern Arizona Healthcare Corporation

Salt Lake City, UT

$34.16 - $51.25/hr

Full-time

Posted 29 days ago

Northern Arizona Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 59 frontline employees who took The Breakroom Quiz

86th of 889 rated healthcare providers

Job description

Overview

The RN Care Manager is responsible a Registered Nurse with years of diverse nursing experience and success in managing complex situations. The RN is an expert in clinical nursing knowledge for specific populations and chronic diseases. This position requires both internal and external interface with providing care management to populations the connect with health insurance attributed lists, emergency rooms, hospitals, primary care services. The care manager functions across the care continuum, interfacing with the multi-disciplinary team to facilitate the best possible clinical outcomes and optimal level of wellness with the most appropriate resource. This role is essential to the success of meeting high risk patient's needs post- discharge and preventing unnecessary readmissions. The care manager will collaborate with the interdisciplinary team to identify, assess, plan, implement, coordinate, monitor, and evaluate options and services in meeting the needs of high risk individuals and their complex medical needs.


Responsibilities

Patient Care
* Evaluate attributed patients identified to provide clinical care management risk attribution.
* Complete psychosocial assessments and develop care plans with identified patient to lower risk threshold for care delivery.
Care Coordination
* Develop a relationship with primary care, specialty services, emergency and hospital networks required for inter-disciplinary care management.
* Facilitates the progression of care by advancing the care plan identification of outcomes, implementation plan and sets goals that are measurable, realistic, and individualized.
* Utilizes hospital, community and national resources to maintain and enhance knowledge and expertise of the care management team.
* Identifies highest quality, most effective post discharge providers and builds relationship to provide highest quality, lowest cost care at the right stage of patients recovery.
Utilization Management
* Ability to utilize care delivery techniques such as teach back and motivational interviewing to support patient success.
* Supports patient to ensure appropriate compliance and support occurs to avoid readmission or poor quality outcomes.
* Monitors outcomes and develops process change to improve care.
Data Integrity
* Respects and upholds patient rights, demonstrates professional integrity, maintains patient confidentiality, discloses all potential or perceived conflicts of interest when appropriate; accepts responsibility and accountability for professional competence.
* Ensures appropriate documentation in the electronic medical record.
Compliance/Safety
* Stays current and complies with state and federal regulations/statutes and company policies that impact the employees area of responsibility.
* If required for position, ensures all certifications and/or licenses are up-to-date and valid prior to expiration dates.
* Completes all company mandatory modules and required job specific training in the specified time frame.
* Responsible for reporting any safety related incident in a timely fashion through the Midas/RDE tool; attends all safety related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner.

Qualifications

Education
  • Bachelor’s Degree in Nursing- Required if hired after December 2018
  • Master's Degree in Nursing- Preferred
Certification & Licensures
  • Current, unrestricted license in the State of Arizona- Required
  • BLS (American Heart Assoc.)- Required
  • Fingerprint Clearance Card application number- Required upon hire
  • Fingerprint Clearance Card- Required within 90 days of hire
Experience
  • Two years as a Registered Nurse- Required
  • Care Management or Nurse Navigator experience- Preferred

What Northern Arizona Healthcare employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Northern Arizona Healthcare logo

About Northern Arizona Healthcare

Sourced by ZipRecruiter

Northern Arizona Healthcare (NAH) is a preeminent health service provider headquartered in Flagstaff, Arizona, US. Founded on an unwavering commitment to deliver compassionate, world-class care, NAH is a key player in the healthcare industry. The key services include cardiology, oncology, emergency services, surgery, women's health services, among others. With operations established over a century ago, it started serving the community in Flagstaff since 1911 before expanding to other locations. NAH's mission lodges the cornerstone that every individual should have access to top-quality, cost-effective health care. NAH's achievements range from national recognitions in patient safety to infrastructure development, like the opening of the new Children’s Health Center, highlighting their commitment to toddler health.

Industry

Health care and social assistance

Company size

1,001 - 5,000 Employees

Headquarters location

Flagstaff, AZ, US

Year founded

1936

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