RN Case Manager
Asbury, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Asbury, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Dubuque, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Dubuque, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Dubuque, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Dubuque, IA · On-site
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.
Quick apply
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Dubuque, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Dubuque, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Asbury, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Asbury, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Des Moines, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Des Moines, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Dubuque, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Dubuque, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Des Moines, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
Quick apply
RN Case Manager
Des Moines, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Dubuque, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Dubuque, IA · On-site
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.
RN Case Manager
Des Moines, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Des Moines, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Des Moines, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Des Moines, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Dubuque, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
Quick apply
RN Case Manager
Dubuque, IA · On-site
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 · 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 · 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
$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.
Quick apply
Bilingual RN Case Manager
$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 · 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 · 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 · 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.
Bilingual RN Case Manager
Des Moines, IA · 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.
Bilingual RN Case Manager
Des Moines, IA · 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.
Quick apply
Bilingual RN Case Manager
Des Moines, IA · 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
Asbury, IA · 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
Asbury, IA · 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.
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?
| 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 job categories do people searching Utilization Case Manager jobs in Iowa look for? The top searched job categories for Utilization Case Manager jobs in Iowa are:
What cities in Iowa are hiring for Utilization Case Manager jobs? Cities in Iowa with the most Utilization Case Manager job openings:
Other
Medical, Dental, Vision, Life, Retirement, PTO
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Job description
RN Case Manager
Dubuque, Iowa, United States
We are seeking a compassionate and detail-oriented 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.
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.
- Education: RN licensure in the State of Iowa required. BSN or higher preferred.
- Experience: Minimum 2 years of clinical practice. Case management or utilization review experience strongly preferred.
- Skills: Strong communication, problem-solving, and computer skills. Ability to work independently.
- 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
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.
About HealthCheck360
Sourced by ZipRecruiter
Industry
Fitness and sports centers
Company size
201 - 500 Employees
Headquarters location
Dubuque, IA, US
Year founded
2007