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Utilization Care Manager Jobs in Seattle, WA (NOW HIRING)

Care Manager RN ED - Permanent Position - FT Shift: Multiple shifts available Days and Nights ... Accountabilities include assessment and planning, coordination of care, resource utilization ...

Nurse Case Mgr II (US)

Seattle, WA ยท On-site

$79K - $130K/yr

Assists with development of utilization/care management policies and procedures. Minimum Requirements: * Requires BA/BS in a health related field and minimum of 5 years of clinical experience; or any ...

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Utilization Care Manager information

See Seattle, WA salary details

$44.4K

$103.6K

$190.6K

How much do utilization care manager jobs pay per year?

As of Aug 28, 2026, the average yearly pay for utilization care manager in Seattle, WA is $103,573.00, according to ZipRecruiter salary data. Most workers in this role earn between $67,700.00 and $124,600.00 per year, depending on experience, location, and employer.

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 cities near Seattle, WA are hiring for Utilization Care Manager jobs?

Cities near Seattle, WA with the most Utilization Care Manager job openings:

Infographic showing various Utilization Care Manager job openings in Seattle, WA as of August 2026, with employment types broken down into 92% Full Time, and 8% Contract. Highlights an 85% In-person, and 15% Remote job distribution, with an average salary of $103,573 per year, or $49.8 per hour.

RN - Care Manager Utilization Review

Vashon, WA โ€ข On-site

MLee Medical Employment
Recruiting and Staffing Servicesย โ€ขย 11 - 50 employees

Other

Medical, Dental, Vision, Retirement

Re-posted 27 days ago


Job description

Join a dynamic healthcare team in the Pacific Northwest as a Registered Nurse Care Manager specializing in Utilization Review. This role involves coordinating care and managing the utilization of services for patients in acute and post-acute skilled care settings. You will collaborate closely with interdisciplinary teams both inside and outside the organization to enhance patient outcomes and ensure cost-effective care.
Job Summary
As a vital member of the care team, you will continuously assess the appropriateness and timeliness of care levels, ensuring resources are used efficiently. Your daily activities include rounding with patients, conducting assessments, and facilitating smooth transitions from hospital to home or other care facilities. You will also identify and resolve discharge barriers, provide clear documentation, and support peer-to-peer reviews for concurrent denials.
Education and Experience

  • Minimum of 2 years of Registered Nursing experience in acute care or care management/utilization review.
  • Current RN license valid in the region or multistate license.
  • BLS certification is required.
  • Bachelor's degree in Nursing and Care Manager Certification are preferred.
Skills and Abilities
  • Strong organizational and prioritization skills.
  • Excellent written and verbal communication tailored to diverse audiences.
  • Proficiency with technology and software, including intermediate to advanced Microsoft Office skills.
  • Ability to maintain confidentiality and accurate documentation.
  • Demonstrated teamwork, collaboration, and customer service skills in fast-paced environments.
  • Independent problem-solving and sound judgment to complete tasks effectively.

Work Environment and Benefits
This full-time exempt position offers a supportive work environment with opportunities for professional growth. Benefits include competitive compensation, comprehensive medical, dental, and vision coverage, retirement plans with employer contributions, tuition reimbursement, employee wellness programs, and more. The location provides access to numerous outdoor recreational activities such as hiking, kayaking, fishing, and cultural experiences in the Pacific Northwest region.

McCall and Lee logo

About McCall and Lee

Sourced by ZipRecruiter

McCall and Lee is a well-known and reputable company, headquartered in Austin, Texas, United States. Operating in the healthcare industry, their primary services center around professional recruiting and executive search. They cater to the needs of various levels of medical practitioners and executive positions for healthcare establishments. McCall and Lee is founded on the premise of filling healthcare vacancies with the most suitable and competent professionals to ensure top-quality medical service delivery. Their core value revolves around integrity, excellence, commitment, and customer satisfaction.

Industry

Recruiting and staffing services and human resources consulting services

Company size

11 - 50 Employees

Headquarters location

Austin, TX, US

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