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Utilization Case Manager Jobs in Arizona (NOW HIRING)

Centstone HC

Registered Nurse Case Manager

Tuba City, AZ · On-site

$67 - $70/hr

This role supports outpatient and inpatient case management, care transitions, discharge planning, utilization review, and coordination of services for high-risk patients across diverse care needs.

Encompass Health

Case Manager

Yuma, AZ · On-site

$19.75 - $25.50/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...

Encompass Health

Case Manager

Mesa, AZ

$19.75 - $25.50/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...

Encompass Health

Case Manager

Tucson, AZ

$19 - $24.25/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications License or Certification:

Tuba City Regional

RN - Case Manager

Tuba City, AZ · On-site

  • Medical

RN - Case Manager MedWave Healthcare Staffing is currently seeking a Case Manager RN for a travel assignment in Tuba City, Arizona. The candidate that will best match this position will have at least ...

Conflux Systems

RN Case Manager

Tuba City, AZ · On-site

Coordinates care for patients with abuse, chronic pain, and frequent utilization issues. Interacts ... of the case management, contract health, and utilization review processes Shift: Monday to Friday ...

InstantServe LLC

RN Case Manager

Tuba City, AZ · On-site

Coordinates care for patients with abuse, chronic pain, and frequent utilization issues. Interacts ... of the case management, contract health, and utilization review processes Shift: Monday to Friday ...

Source of Hope

Case Manager

Goodyear, AZ · On-site

$18.50/hr

  • PTO

The Case Manager plays a vital role in coordinating services, monitoring client progress, and ... Track provider utilization and communicate with providers regarding available hours and service ...

GQR Global Markets

RN - Case Manager

Tuba City, AZ · On-site

$2.2K - $2.3K/wk

  • Medical

  • Dental

  • Vision

RN - Case Manager Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Tuba City, Arizona Start Date: September 7, 2026 Profession: Registered Nurse (RN) Facility:

UHS

Case Manager - PRN

Phoenix, AZ · On-site

$19 - $24.50/hr

The Case Manager is knowledgeable about and responsible for treatment plans, utilization review, discharge planning, psychoeducation groups, and case management. Benefits for Case Manager include:

UHS

Case Manager - PRN

Phoenix, AZ

$19 - $24.50/hr

The Case Manager is knowledgeable about and responsible for treatment plans, utilization review, discharge planning, psychoeducation groups, and case management. Benefits for Case Manager include:

Applied ABC

Case Manager

Tucson, AZ · On-site

$17.25 - $22.25/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Case Manager - ABA Center (Tucson, AZ) Full-Time | Comprehensive Benefits Lead with Purpose ... Use utilization data to review client programs and ensure consistent, reliable service. * Support ...

Centstone

Registered Nurse Case Manager

Tuba City, AZ · On-site

Knowledge of case management, utilization review, care coordination, and electronic health record systems required. Step into a rewarding RN Case Manager opportunity where your clinical expertise ...

Mission Hospital

RN Case Manager

Tuba City, AZ · On-site

$2.6K/wk

... N Specialty Case Manager Job ID 18889953 Job Title RN Case Manager Weekly Pay $2689.57 Shift ... utilization of resources and services to meet patient needs. Client Details Address 167 N Main ...

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All JobsUtilization Case JobsUtilization Case Manager JobsUtilization Case Manager Jobs in Arizona

Utilization Case Manager information

What is a utilization case manager?

A Utilization Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They review patient cases, coordinate with healthcare providers, and ensure that treatments are in line with established guidelines and insurance requirements. Their goal is to optimize patient outcomes while managing costs and ensuring compliance with regulations. Utilization Case Managers often work in hospitals, insurance companies, or managed care organizations.

How does a utilization case manager typically collaborate with healthcare providers and insurance companies?

Utilization Case Managers play a key role in coordinating care between healthcare providers and insurance companies. They review patient cases to ensure that the recommended treatments are medically necessary and align with insurance policies. This often involves regular communication with doctors, nurses, and insurance representatives to gather information, clarify treatment plans, and advocate for appropriate patient care. Strong collaboration skills are essential, as Utilization Case Managers must balance the needs of patients with organizational guidelines while maintaining positive professional relationships.

What degree do I need for utilization review?

Utilization case managers typically need at least a bachelor's degree in healthcare, nursing, social work, or a related field. Some positions may require a master's degree or professional certification, such as a Certified Case Manager (CCM) or Certified Professional in Healthcare Quality (CPHQ), to advance in the role or handle complex cases.

What are the key skills and qualifications needed to thrive as a utilization case manager?

To thrive as a Utilization Case Manager, you need a background in nursing or social work, strong analytical skills, and a solid understanding of healthcare regulations and insurance processes, often supported by RN licensure or certification in case management (e.g., CCM). Familiarity with utilization management software, electronic health records (EHRs), and payer authorization systems is essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration among patients, providers, and payers. These skills ensure appropriate care delivery, cost management, and compliance with healthcare standards.

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

AspectUtilization Case ManagerUtilization Review Nurse
CredentialsRN license, case management certificationRN license, certification in utilization review
Work EnvironmentCase management teams, hospitals, insurance companiesUtilization review departments, hospitals, insurance providers
Primary FocusCoordinating patient care, discharge planning, resource allocationAssessing medical necessity, reviewing patient records for appropriateness
Common UsageBroader case management roles, patient advocacySpecific review of medical necessity and insurance claims

While both roles require RN licensure and focus on patient care, the Utilization Case Manager primarily coordinates overall patient services and discharge planning, whereas the Utilization Review Nurse concentrates on evaluating the medical necessity of treatments for insurance purposes. Understanding these distinctions helps in choosing the right career path or job search focus.

What are popular job titles related to Utilization Case Manager jobs in Arizona?

For Utilization Case Manager jobs in Arizona, the most frequently searched job titles are:

What job categories do people searching Utilization Case Manager jobs in Arizona look for?

The top searched job categories for Utilization Case Manager jobs in Arizona are:

What cities in Arizona are hiring for Utilization Case Manager jobs?

Cities in Arizona with the most Utilization Case Manager job openings:

Utilization Case Manager jobs near you

Registered Nurse Case Manager

Centstone HC

Tuba City, AZ • On-site

$67 - $70/hr

Contractor

Re-posted 12 days ago

Job description

Registered Nurse Case Manager

Location: Tuba City, Arizona
Pay Rate: $65 to $70/hr
Contract: 13 weeks
Schedule: Monday–Friday, 8:00 AM – 5:00 PM; weekend rotation with call
Guaranteed Hours: Not provided
Experience: Minimum 3 years required

About the Role

We are seeking an experienced Registered Nurse Case Manager for a 13-week contract opportunity in Tuba City, Arizona. This role supports outpatient and inpatient case management, care transitions, discharge planning, utilization review, and coordination of services for high-risk patients across diverse care needs.

Responsibilities

• Coordinate inpatient and outpatient case management services for high-risk patients
• Support care transitions from admission through discharge and post-hospital referrals
• Evaluate ED patients for medical necessity and care coordination needs
• Collaborate with physicians, nursing, ancillary teams, and community resources
• Monitor patient progress, update care plans, and support safe discharge planning

Requirements

• Active unrestricted RN license from any U.S. state, Puerto Rico, or U.S. territory required
• Associate’s or Bachelor’s Degree in Nursing required
• BLS certification through the American Heart Association required
• Minimum 3 years of clinical nursing experience, including 1 year in outpatient/inpatient setting required
• Case management, utilization review, fingerprint clearance, and weekend rotation with call required

Apply today for a meaningful RN Case Manager opportunity where your care coordination experience can support safe transitions and better patient outcomes.