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Utilization Case Manager Jobs in Iowa (NOW HIRING)

Cottingham & Butler

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.

Cottingham & Butler

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.

Access Dubuque

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.

Community NeuroRehab

CASE MANAGER

Madrid, IA · On-site

$19.50 - $25/hr

Description: In this position you will be optimizing the utilization of Brookhaven ... case management activities with referral sources, potential patients, family members, and ...

Trinity Health

Case Manager RN

Des Moines, IA · On-site

As an RN Case Manager, you'll partner with physicians, care teams, insurers, and community ... Support Utilization Management & Clinical Review * Perform admission, concurrent, and post ...

Trinity Health

Case Manager RN

Des Moines, IA

As an RN Case Manager, you'll partner with physicians, care teams, insurers, and community ... Support Utilization Management & Clinical Review * Perform admission, concurrent, and post ...

Trinityhealth

Case Manager RN

Des Moines, IA · On-site

As an RN Case Manager, you'll partner with physicians, care teams, insurers, and community ... Support Utilization Management & Clinical Review * Perform admission, concurrent, and post ...

Trinity Health

ED Case Manager RN

Des Moines, IA · On-site

... resource utilization. Key Responsibilities: * Coordinate patient care plans across inpatient ... case management, or acute care preferred) * Strong communication, critical thinking, and ...

Trinityhealth

ED Case Manager RN

Des Moines, IA · On-site

... resource utilization. Key Responsibilities: * Coordinate patient care plans across inpatient ... case management, or acute care preferred) * Strong communication, critical thinking, and ...

Trinity Health

ED Case Manager RN

Des Moines, IA · On-site

... resource utilization. Key Responsibilities: * Coordinate patient care plans across inpatient ... case management, or acute care preferred) * Strong communication, critical thinking, and ...

Trinityhealth

ED Case Manager RN

Des Moines, IA · On-site

... resource utilization. Key Responsibilities: * Coordinate patient care plans across inpatient ... case management, or acute care preferred) * Strong communication, critical thinking, and ...

Trinity Health

ED Case Manager RN

Des Moines, IA · On-site

... resource utilization. Key Responsibilities: * Coordinate patient care plans across inpatient ... case management, or acute care preferred) * Strong communication, critical thinking, and ...

Trinity Health

ED Case Manager RN

Des Moines, IA · On-site

... resource utilization. Key Responsibilities: * Coordinate patient care plans across inpatient ... case management, or acute care preferred) * Strong communication, critical thinking, and ...

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All JobsUtilization Case JobsUtilization Case Manager JobsUtilization Case Manager Jobs in Iowa

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 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:
Utilization Case Manager jobs near you

Bilingual RN Case Manager

Cottingham & Butler

Dubuque, IA • On-site

$20.25 - $25.75/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 4 days ago

Cottingham & Butler rating

8.6

Company rating: 8.6 out of 10

Based on 15 frontline employees who took The Breakroom Quiz

88th of 303 rated insurance

Job description

Bilingual RN Case Manager
Location: Onsite in Dubuque, IA.
We are seeking a compassionate and detail-oriented Bilingual 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. This role is based in our Dubuque office and is also available remotely.
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:
  • Bilingual: the ability to speak Spanish
  • 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.

Full-Time Benefits - 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 Cottingham & Butler:
At Cottingham & Butler, we sell a promise to help our clients through life's toughest moments. To deliver on that promise, we aim to hire, train, and grow the best professionals in the industry. We look for people with an insatiable desire to succeed, are committed to growing, and thrive on challenges. Our culture is guided by the theme of "better every day" constantly pushing ourselves to be better than yesterday - that's who we are and what we believe in.
As an organization, we are tremendously optimistic about the future and have incredibly high expectations for our people and our performance. Our ability to grow as a company, fuels investments in new resources to better serve our clients and provide the amazing career opportunities our employees want and deserve. This is why we are a growth company and why we are committed to being better every day.
Want to learn more? Follow us on www.CottinghamButler.com | LinkedIn | Facebook

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