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Utilization Case Manager Jobs in Connecticut (NOW HIRING)

Registered Nurse RN Case Manager

Hartford, CT ยท On-site

$75K - $121K/yr

Position Purpose At Saint Francis Hospital our RN Case Manager are responsible for coordinating ... utilization criteria, HCFA/OBRA and state of Connecticut regulatory compliance issues, and JCAHO ...

Showing results 21-40

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.

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.

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 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 degree do I need for utilization case manager?

Utilization case managers typically need at least a bachelor's degree in healthcare, social work, nursing, or a related field. Some positions may prefer or require a master's degree or relevant certifications, such as Certified Case Manager (CCM) or Certified Professional in Healthcare Quality (CPHQ).

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

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

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

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

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

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

Infographic showing various Utilization Case Manager job openings in Connecticut as of August 2026, with employment types broken down into 17% As Needed, and 83% Full Time. Highlights an 100% In-person job distribution.

Supervising Case Manager

Community Partners in Action

Waterbury, CT โ€ข On-site

$66K/yr

Full-time

Posted 5 days ago


Job description

JOB TITLE: Supervising Case Manager, Waterbury Alternative in the Community (AIC)

LOCATION: Waterbury, CT

SALARY: $66,300 Annually

AGENCY DESCRIPTION

One of the oldest organizations of its kind in the country, Community Partners in Action (CPA) was founded nearly 150 years ago to champion criminal justice reform and advocate for preserving the dignity of those in and out of prison. Through our programs that include reentry and housing, youth initiatives, a nationally recognized Prison Arts Program, and holistic alternatives to incarceration, we provide a long-term impact that positively transforms individuals and society at large. Annually serving over 4,000 individuals throughout Connecticut, our work is possible due to partnerships with and support from individuals, government, private funders, organizations, and businesses.

CPA is guided by our BEDI (Belonging, Equity, Diversity, and Inclusion) culture. WE ARE COMMITTED to building and maintaining an inclusive, equitable workplace and COMPELLED to have a constructive impact on criminal justice reform in CT that ends racial inequities and ensures the humanity and dignity of those interacting with the system. Read more about our BEDI culture at https://cpa-ct.org/our-bedi-journey/

PROGRAM DESCRIPTION

The Waterbury Alternative in the Community (WAIC) serves male and female clients aged 18 and above who are involved in the Connecticut criminal justice system. The mission of the program is to reduce recidivism by delivering interventions that affect behavior change among its clients. The program utilizes an evidence-based Cognitive Behavioral Theory/Motivational model designed to provide clients with the skills necessary to make those changes.

POSITION REQUIREMENTS

Reporting to the AIC Program Manager, the Supervising Case Manager is responsible for overseeing all AIC case management services, including staffing and handling of new referrals, to ensure compliance with the funder contractual agreement. The Supervising Case Manager supports the Program Manager in setting the program tone, coordinating and collaborating with management teams, managing complex decisions, building relationships and multi-tasking. The Supervising Case Manager also plays a role in ensuring that a strength-based culture is embraced, that client/program outcomes are consistently met, and that the program is positioned for success internally and externally. Strong emotional intelligence, written and verbal communication skills, decision-making and knowledge of cognitive-behavioral approaches are critical. Bachelor's degree, preferably in social science field and two years of experience in case management and staff supervision. Equivalent work experience will be considered in lieu of bachelor's degree. Counseling background preferred. Valid Driver's License and reliable transportation required. Bilingual (English/Spanish) preferred.

Key Responsibilities

  1. Commit to the agency mission and program goals.
  2. Promote a culture of respect, empathy, mutual support, belonging and works to eliminate any unconscious bias or discrimination in our beliefs, rules and support systems.
  3. Provide ongoing leadership and supervision for direct reports.
  4. Oversee assigned day to day operations.
  5. Assist in hiring, training, development and termination of staff.
  6. Conduct weekly team meetings.
  7. Conduct formal monthly supervision with direct reports utilizing ISL's.
  8. Ensure program compliance with contract and funder requirements for assigned functions.
  9. As appropriate, serve as point of contact for program's referral sources.
  10. Share on call responsibilities with program leadership team.
  11. Maintain clear and open communication/collaboration with referral sources/funder network.
  12. Assign cases to staff according to the AIC File Assignment Structure.
  13. Review client files to ensure accuracy, completion and thoroughness.
  14. Review and provide input for Individual Service Plans.
  15. Ensure that accurate client data is entered in CDCS and reports are submitted on a timely basis.
  16. Manage CDCS ques.
  17. Assist with utilization and maintenance of CDCS.
  18. Pull the following CDCS reports weekly and respond accordingly to all issues:
    • Active Client List
    • Data Quality Check List
    • Timelines
  19. As needed, solicit client satisfaction feedback.
  20. Attend monthly AIC Leadership meeting.
  21. Participate in Quality Assurance reviews as required.
  22. Adhere to PREA Standards and ensure PREA compliance.
  23. Conduct urinalysis as requested.
  24. Assume Program Manager duties as needed.
  25. Represent program and/or agency at request of Program Manager.
  26. Regular and Reliable attendance.
  27. Perform all other leadership tasks and duties as required.

An Equal Opportunity Employer Committed to Affirmative Action

Employment Type: FULL_TIME