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Utilization Case Manager Jobs in Iowa (NOW HIRING)

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Bilingual RN Case Manager

Dubuque, IA

$20.25 - $25.75/hr

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Bilingual RN Case Manager

Des Moines, IA ยท Remote

$21 - $26.50/hr

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Bilingual RN Case Manager

Dubuque, IA ยท On-site

$20.25 - $25.75/hr

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Bilingual RN Case Manager

Dubuque, IA ยท On-site

$20.25 - $25.75/hr

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Bilingual RN Case Manager

Des Moines, IA ยท Remote

$21 - $26.50/hr

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Bilingual RN Case Manager

Des Moines, IA ยท On-site

$21 - $26.50/hr

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Day Shift Description: RN Case Manager (Onsite) Shift: Monday-Friday (8 hours) No Weekends General ... Perform admission, concurrent, and post-discharge utilization reviews in accordance with the ...

Day Shift Description: RN Case Manager (Onsite) Shift: Monday-Friday (8 hours) No Weekends General ... Perform admission, concurrent, and post-discharge utilization reviews in accordance with the ...

Bilingual RN Case Manager

Dubuque, IA ยท On-site

$20.25 - $25.75/hr

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

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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 insurance companies and healthcare providers. They analyze patient records, coordinate care plans, and ensure compliance with policies, typically using case management software and requiring strong communication skills.

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 4000 a week without a degree?

Utilization Case Managers typically do not earn $4,000 weekly without relevant experience or certifications; most roles in healthcare or social services pay less. High-paying jobs that can reach this level without a degree are rare and often involve specialized skills, sales, or entrepreneurship. Generally, achieving such income without a degree requires significant experience, licensing, or working in high-demand fields like real estate or certain trades.

What is the highest paid case manager?

The highest paid case managers are often those with advanced certifications, specialized skills, or experience in high-demand fields such as healthcare or insurance. Senior or managerial roles, such as Utilization Review Managers, can earn salaries exceeding $80,000 to $100,000 annually. Compensation varies based on location, industry, and level of responsibility.

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 and clinical skills. It provides experience with medical records, patient communication, and office procedures, which can serve as a foundation for advancing in healthcare careers. However, the job's suitability depends on individual career goals and the specific workplace environment.

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?

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 Iowa? For Utilization Case Manager jobs in Iowa, the most frequently searched job titles are:
What cities in Iowa are hiring for Utilization Case Manager jobs? Cities in Iowa with the most Utilization Case Manager job openings:
RN Case Manager

RN Case Manager

HealthCheck360

Dubuque, IA โ€ข On-site

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 14 days ago


Job description

RN Case Manager

Location: Onsite in Dubuque, IA.ย 

We are seeking a compassionate and detail-orientedย RN Case Manager to join our team. This role is responsible for delivering comprehensive case management services across the continuum of care. The RN Case Manager will assess, plan, implement, coordinate, monitor, and evaluate care for assigned consumers, ensuring quality outcomes and cost-effective treatment.ย 

Key Responsibilities:

  • Provide telephonic case management and utilization review for assigned consumers.
  • Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
  • Collaborate with healthcare providers, payors, and internal teams to coordinate care.
  • Serve as a liaison between consumers and benefit administrators, ensuring clear communication and support.
  • Track and report case outcomes, including cost savings and quality improvements.

Qualifications:

  • Education:ย RN licensure in the State of Iowa required. BSN or higher preferred.
  • Experience:ย Minimum 2 years of clinical practice. Case management or utilization review experience strongly preferred.
  • Skills:ย Strong communication, problem-solving, and computer skills. Ability to work independently.

Full-Time Benefits -ย Most benefits start day 1

  • Medical, Dental, Vision Insurance
  • Flex Spending or HSA
  • 401(k) with company match
  • Profit-Sharing/Defined Contribution (1-year waiting period)
  • PTO/Paid Holidays
  • Company-paid ST and LT Disability
  • Maternity Leave/Parental Leave
  • Subsidized Parking
  • Company-paid Term Life/Accidental Death Insurance

About HealthCheck360

HealthCheck 360 was created with the employer's needs and the participant's experience in mind. We focus on reducing medical costs, while increasing employee engagement and productivity. This is accomplished by providing onsite biometric screenings, engaging participants through technology and programming, educating the participant with risk-specific targeted communications, and supporting positive behavior change through our Health Coaching and Condition Management programs.