The Certified Case Manager (CCM) serves as a key member of the interdisciplinary team and actively manages and directs resource utilization to achieve the highest quality outcomes during a patient ...
The Certified Case Manager (CCM) serves as a key member of the interdisciplinary team and actively manages and directs resource utilization to achieve the highest quality outcomes during a patient ...
Certified Case Manager
Middletown, DE · On-site
The Certified Case Manager (CCM) serves as a key member of the interdisciplinary team and actively manages and directs resource utilization to achieve the highest quality outcomes during a patient ...
Certified Case Manager
Middletown, DE · On-site
The Certified Case Manager (CCM) serves as a key member of the interdisciplinary team and actively manages and directs resource utilization to achieve the highest quality outcomes during a patient ...
ACT Case Manager
Claymont, DE · On-site
$20/hr
The Case Manager also manages case planning, utilization, data collection, and ongoing assessment to ensure clients receive the right level of care. RESPONSIBILITIES * Build relationships with ...
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ACT Case Manager
Claymont, DE · On-site
$20/hr
The Case Manager also manages case planning, utilization, data collection, and ongoing assessment to ensure clients receive the right level of care. RESPONSIBILITIES * Build relationships with ...
Certified Case Manager
Middletown, DE · On-site
The Certified Case Manager (CCM) serves as a key member of the interdisciplinary team and actively manages and directs resource utilization to achieve the highest quality outcomes during a patient ...
Certified Case Manager
Middletown, DE · On-site
The Certified Case Manager (CCM) serves as a key member of the interdisciplinary team and actively manages and directs resource utilization to achieve the highest quality outcomes during a patient ...
RN Case Manager - Weekend - Day Shift
Newark, DE · On-site
$40/hr
Utilization Management - Reviews patient status for appropriateness and anticipated payer coverage ... Case Management Certification (CCM) required within 18 months of eligibility. This is a flat-rate ...
RN Case Manager - Weekend - Day Shift
Newark, DE · On-site
$40/hr
Utilization Management - Reviews patient status for appropriateness and anticipated payer coverage ... Case Management Certification (CCM) required within 18 months of eligibility. This is a flat-rate ...
Utilization Management - Reviews patient status for appropriateness and anticipated payer coverage ... Case Management Certification (CCM) required within 18 months of eligibility. This is a flat-rate ...
Utilization Management - Reviews patient status for appropriateness and anticipated payer coverage ... Case Management Certification (CCM) required within 18 months of eligibility. This is a flat-rate ...
Community Reintegration Case Manager
Claymont, DE · On-site
$20/hr
The Case Manager also manages case planning, utilization, data collection, and ongoing assessment to ensure clients receive the right level of care. RESPONSIBILITIES * Build relationships with ...
Quick apply
Community Reintegration Case Manager
Claymont, DE · On-site
$20/hr
The Case Manager also manages case planning, utilization, data collection, and ongoing assessment to ensure clients receive the right level of care. RESPONSIBILITIES * Build relationships with ...
RN / REGISTERED NURSE - LEAD NURSE CASE MANAGER
Lewes, DE · On-site
$79K - $122K/yr
Leading case management activities, including staff recommendations, space utilization, and performance improvement initiatives. * Overseeing and mentoring case management processes, from assessment ...
RN / REGISTERED NURSE - LEAD NURSE CASE MANAGER
Lewes, DE · On-site
$79K - $122K/yr
Leading case management activities, including staff recommendations, space utilization, and performance improvement initiatives. * Overseeing and mentoring case management processes, from assessment ...
ACT Team Case Manager
Dover, DE · On-site
$17.38/hr
The Case Manager also manages case planning, utilization, data collection, and ongoing assessment to ensure clients receive the right level of care. RESPONSIBILITIES * Build relationships with ...
Quick apply
ACT Team Case Manager
Dover, DE · On-site
$17.38/hr
The Case Manager also manages case planning, utilization, data collection, and ongoing assessment to ensure clients receive the right level of care. RESPONSIBILITIES * Build relationships with ...
S/he is responsible for case planning, utilization management, data collection, and continual assessment to ensure that persons served are receiving the right level of care to meet their needs, and ...
Quick apply
S/he is responsible for case planning, utilization management, data collection, and continual assessment to ensure that persons served are receiving the right level of care to meet their needs, and ...
S/he is responsible for case planning, utilization management, data collection, and continual assessment to ensure that persons served are receiving the right level of care to meet their needs, and ...
Quick apply
S/he is responsible for case planning, utilization management, data collection, and continual assessment to ensure that persons served are receiving the right level of care to meet their needs, and ...
S/he is responsible for case planning, utilization management, data collection, and continual assessment to ensure that persons served are receiving the right level of care to meet their needs, and ...
Quick apply
S/he is responsible for case planning, utilization management, data collection, and continual assessment to ensure that persons served are receiving the right level of care to meet their needs, and ...
S/he is responsible for case planning, utilization management, data collection, and continual assessment to ensure that persons served are receiving the right level of care to meet their needs, and ...
Quick apply
S/he is responsible for case planning, utilization management, data collection, and continual assessment to ensure that persons served are receiving the right level of care to meet their needs, and ...
S/he is responsible for case planning, utilization management, data collection, and continual assessment to ensure that persons served are receiving the right level of care to meet their needs, and ...
Quick apply
S/he is responsible for case planning, utilization management, data collection, and continual assessment to ensure that persons served are receiving the right level of care to meet their needs, and ...
S/he is responsible for case planning, utilization management, data collection, and continual assessment to ensure that persons served are receiving the right level of care to meet their needs, and ...
Quick apply
S/he is responsible for case planning, utilization management, data collection, and continual assessment to ensure that persons served are receiving the right level of care to meet their needs, and ...
RESIDENTIAL CASE MANAGER - PART TIME
DE · On-site
S/he is responsible for case planning, utilization management, data collection, and continual assessment to ensure that persons served are receiving the right level of care to meet their needs, and ...
Quick apply
RESIDENTIAL CASE MANAGER - PART TIME
DE · On-site
S/he is responsible for case planning, utilization management, data collection, and continual assessment to ensure that persons served are receiving the right level of care to meet their needs, and ...
Telephonic Nurse Case Manager II
Wilmington, DE · On-site
$83K - $130K/yr
Telephonic Nurse Case Manager II Telephonic Nurse Case Manager II Location: This role enables ... Assists with development of utilization/care management policies and procedures. Minimum ...
Telephonic Nurse Case Manager II
Wilmington, DE · On-site
$83K - $130K/yr
Telephonic Nurse Case Manager II Telephonic Nurse Case Manager II Location: This role enables ... Assists with development of utilization/care management policies and procedures. Minimum ...
The Case Manager performs reviews of all inpatient admission records to ensure proper utilization of hospital resources and determination of admission for appropriate level of care. Assesses and ...
The Case Manager performs reviews of all inpatient admission records to ensure proper utilization of hospital resources and determination of admission for appropriate level of care. Assesses and ...
The Case Manager performs reviews of all inpatient admission records to ensure proper utilization of hospital resources and determination of admission for appropriate level of care. Assesses and ...
The Case Manager performs reviews of all inpatient admission records to ensure proper utilization of hospital resources and determination of admission for appropriate level of care. Assesses and ...
The Case Manager performs reviews of all inpatient admission records to ensure proper utilization of hospital resources and determination of admission for appropriate level of care. Assesses and ...
The Case Manager performs reviews of all inpatient admission records to ensure proper utilization of hospital resources and determination of admission for appropriate level of care. Assesses and ...
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 does a utilization case manager do?
A utilization case manager reviews and authorizes healthcare services to ensure they are necessary and appropriate, often working with medical providers and insurance companies. They analyze patient records, coordinate care plans, and ensure compliance with policies, typically using case management software and clinical knowledge. Their goal is to optimize resource use while maintaining quality patient care.
What jobs pay 10,000 a month without a degree?
Utilization Case Managers typically do not earn $10,000 a month without specialized experience or certifications; most roles in this field pay lower salaries. High-paying jobs that can reach this level without a degree include sales, real estate, or entrepreneurship, often requiring strong skills, networking, and industry knowledge. Some trades, like certain construction or technical roles, may also offer high earnings with experience and certifications rather than formal degrees.
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 jobs pay 2000 a day?
Utilization Case Managers typically do not earn $2,000 a day; such high daily earnings are more common in specialized roles like senior executives, certain consulting positions, or high-level medical professionals. Most jobs with high daily pay require advanced skills, certifications, or extensive experience, and earnings can vary based on industry, location, and workload.
Is being a MOA a good entry level job?
A Medical Office Assistant (MOA) role is often considered an entry-level position in healthcare, requiring basic administrative skills, familiarity with medical terminology, and sometimes certification. It provides experience in healthcare settings and can serve as a stepping stone to more advanced medical roles, but it may have limited responsibilities compared to specialized positions.
What are the key skills and qualifications needed to thrive as a Utilization Case Manager, and why are they important?
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?
| Aspect | Utilization Case Manager | Utilization Review Nurse |
|---|---|---|
| Credentials | RN license, case management certification | RN license, certification in utilization review |
| Work Environment | Case management teams, hospitals, insurance companies | Utilization review departments, hospitals, insurance providers |
| Primary Focus | Coordinating patient care, discharge planning, resource allocation | Assessing medical necessity, reviewing patient records for appropriateness |
| Common Usage | Broader case management roles, patient advocacy | Specific 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 Delaware? For Utilization Case Manager jobs in Delaware, the most frequently searched job titles are:
What job categories do people searching Utilization Case Manager jobs in Delaware look for? The top searched job categories for Utilization Case Manager jobs in Delaware are:
What cities in Delaware are hiring for Utilization Case Manager jobs? Cities in Delaware with the most Utilization Case Manager job openings:
Encompass Health rating
6.9
Based on 410 frontline employees who took The Breakroom Quiz
444th of 877 rated healthcare providers
Job description
The Certified Case Manager (CCM) serves as a key member of the interdisciplinary team and actively manages and directs resource utilization to achieve the highest quality outcomes during a patient's rehabilitation experience. The CCM coordinates and advocates for the patient during their hospitalization and from admission to post discharge. As an effective communicator, the CCM manages information to effectively oversee health care delivery and facilitate interdisciplinary plan of care decisions. The CCM facilitates timely communication regarding the patient's care, establishes and monitors the discharge plan implementation while identifying and addressing patient's psychosocial and support systems issues. The CCM oversees the effective coordination of services and manages issues in the following main areas: admission and discharge, team conference and interdisciplinary plan of care communication, patient and family education, payor relations and total fiscal management. The CCM performs ongoing utilization review and acts as a liaison to the payor while assuring that cost effective treatment is provided by the team. The CCM assures that regulations regarding patient's rights are fulfilled.
The Encompass Health Way
We proudly set the standard in care by leading with empathy, doing what's right, focusing on the positive, and standing stronger together. Encompass Health is a trusted leader in post-acute care with over 150 nationwide locations and a team of 36,000 exceptional individuals and growing!
At Encompass Health, we celebrate and welcome diversity in our inclusive culture. We provide equal employment opportunities regardless of race, ethnicity, gender, sexual orientation, gender identity or expression, religion, national origin, color, creed, age, mental or physical disability, or any other protected classification.
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About Encompass Health
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Helping patients regain hope and independence, Encompass Health is a national leader in post-acute care. We operate rehabilitation hospitals in 36 states as well as Puerto Rico. Following the Encompass Way, we are driven by our core values: We proudly set the standard, lead with empathy, do what's right, focus on the positive, and remain stronger together.
Industry
Hospitals
Company size
10,000+ Employees
Headquarters location
Birmingham, AL, US
Year founded
1984