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Utilization Case Manager Jobs in Nebraska (NOW HIRING)

The Salvation Army

Case Manager

Omaha, NE · On-site

$22/hr

Provide case management utilizing a trauma informed, strength-based, person-centered approach ... Administrative skills to include utilization of standard office equipment, data entry, attention to ...

The Salvation Army

Case Manager

Omaha, NE · On-site

$20 - $20.70/hr

Case Managers assist residents with services, housing search and provide the support of residents ... Administrative skills to include utilization of standard office equipment, data entry, 10-key ...

GQR Healthcare

Travel Case Manager RN

Omaha, NE · On-site

$2.3K - $2.4K/wk

  • Medical

  • Dental

  • Vision

Case Management/Utilization Review Shift: Day Shift Details: null Day Job Type: Travel *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible ...

New

P3 Health Partners

Manager Utilization Management

Omaha, NE · On-site

$100K - $140K/yr

P3 Health Partners is seeking a Utilization Management Manager to oversee the daily operations of ... Collaborate with cross-functional teams including Case Management, Clinical Operations, Quality ...

New

MedPro Healthcare Staffing

Travel Case Manager RN

Omaha, NE · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Key Words: RN Travel, Travel Nurse, Contract Nurse, Agency Nurse, Travel Contract, Travel Nursing, Case Manager, Case Management, Utilization Review, Case Manager RN *Weekly payment estimates are ...

New

The Bridge Behavioral Health

Case Manager (Full time)

Lincoln, NE · On-site

$20 - $22/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Case Manager Make Recovery Possible at The Bridge Behavioral Health Now offering a $500 Hiring ... Coordinate continued stay reviews, utilization reviews, and insurance authorizations to support ...

Gphealth

Case Manager - BSW/Bachelors

North Platte, NE

$21 - $27.50/hr

Job Title: Case Manager - BSW/Bachelors Cost Center: Case Management This position provides ... and documents the utilization of resources and progress of the patient through their care ...

The Salvation Army

VA Case Manager

Omaha, NE · On-site

$22/hr

Perform services and case management activities in conjunction with the Veterans Administration ... Administrative skills to include utilization of standard office equipment, data entry, attention to ...

Gphealth

Director of Case Management

North Platte, NE · On-site

Care Facilitation, Transition of Care facilitation, Utilization Management, Discharge Planning, ER Case Management/Medication Assistance, and oncology case management. The Director provides hospital ...

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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.

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

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

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

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

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

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

Utilization Case Manager jobs near you

Case Manager

The Salvation Army Central Territory

Omaha, NE • On-site

$22/hr

Full-time

Re-posted 9 days ago

Salvation Army rating

6.1

Company rating: 6.1 out of 10

Based on 362 frontline employees who took The Breakroom Quiz

571st of 772 rated non-profit organizations

Job description

*** Monday- Friday 9:00 A.M.- 4:00 P.M. Pay Rate: up to $22.00 Per Hour Depending on Experience***
The Salvation Army Mission: The Salvation Army, an international movement, is an evangelical part of the universal Christian church. Its message is based on the Bible. Its ministry is motivated by the love of God. Its mission is to preach the gospel of Jesus Christ and to meet human needs in His name without discrimination.
Mental Health Respite Mission: Through professionalism, nurturance, and empowerment MHR will provide supportive services with the purpose of leading participants in personal growth and improving life skills for transitioning to the least restrictive level of care within the community environment.
Summary/Primary Purpose: Provide case management utilizing a trauma informed, strength-based, person-centered approach designed to promote recovery, promote meaningful participation in the community of choice, resolve crisis and promote stabilization within the community, and prevent need for Emergency Protective Custody, Mental Health Board Commitments, and other utilization of higher levels of care. Mental Health Respite provides a safe, protected, supervised residential environment on a short-term basis. The intent of the service is to support individuals by providing linkages to needed behavioral health services and assist in transition back into the community.
Essential Duties and Responsibilities:
  • Complete strength-based assessments and develop ISP within 3 days of admission in partnership with the consumer and support system that includes a crisis relapse/prevention plan and immediate supports and referrals.
  • Meet a minimum of two times a week or as needed with program participant to monitor progress and barriers with ISP completion and discharge process.
  • Provide program participant advocacy as needed; assist in obtaining benefits such as Social Security Insurance (SSI), housing vouchers, food stamps, Medicaid, etc.; provide referrals to appropriate community-based behavioral health services; develop, activate and/or maintain formal and informal support systems; assist program participant in applying for appropriate financial, residential, mental health, and support resources in the community.
  • Communicate pertinent information to MHR Program Director, Program Manager, Program Supervisors, Community Outreach Coordinator, Behavioral Health Specialists, therapists, psychiatrists, hospitals, police, and client emergency contacts.
  • Complete intakes with participants as needed to support program needs.
  • Collaborate closely with participant, family or significant other as determined by consumer, treatment providers, peer support, law enforcement and local emergency services.
  • Present program participants within two weeks of intake, at time of extension, and as need to Multi-Disciplinary Team to obtain feedback to address any barriers or clinical issues.
  • Maintain case records and complete all required documentation including notes to staff regarding participant and unit issues.
  • Attend staff meetings and participate in performance and quality improvement program, as required.
  • Participate in rotation of on-call responsibilities providing coverage as needed and the ability to work a flexible schedule which may include evenings and weekends, overnights and holidays.
  • All other duties as assigned.

Supervisory Responsibilities: None
Education and/or Experience: Bachelor's degree preferred from four-year college or university in psychology, social work, or related field, or a minimum of two years equivalent experience. At least one year of experience in direct care of participants with severe and persistent mental illness or other mental health services required.
Qualifications: The requirements listed below are representative of the minimal knowledge, skill, and/or ability required for this position.
  • Ability to comply with ethics and professional boundaries.
  • Knowledge of Microsoft Office Suite and the ability to access payroll, timekeeping and personal data via a web-based system.
  • Administrative skills to include utilization of standard office equipment, data entry, attention to detail and filing.
  • Ability to be flexible and able to work on multiple projects or tasks simultaneously
  • Good communication skills both written and spoken, and ability to maintain effective working relationships.
  • Demonstrated ability to handle confidential matters.
  • Demonstrate sensitivity to the service population's cultural and socioeconomic characteristics.

Other Qualifications: Must pass all applicable background checks. Must possess a valid driver's license from the state in which you reside. Must be approved through The Salvation Army Fleet Safety Program to drive either a Salvation Army or personal vehicle on Salvation Army business.
Certificates, Licenses, Registrations: Obtain Medication Aide Certification within 90 days of employment and CPR/First Aid Certification within 6 months of employment. Complete 12 hours of intensive on-going training annually based on program/participant population need such as Emergency Protective Custody training (EPC), Board of Mental Health (BOMH), Behavioral Health Diagnosis, symptomology and interventions annually. Must successfully complete Safe from Harm training within 30 days of hire, as established by The Salvation Army.
Physical Requirements: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to sit, stand, and walk; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee is occasionally required to stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds.
Working Conditions: The noise level in the work environment is usually moderate but will vary from quiet to loud.
All employees recognize that The Salvation Army is a church and agree that they will do nothing as an employee of The Salvation Army to undermine its religious mission.
The Salvation Army is an equal opportunity employer. Candidates who are back-to-work, US Veterans, people with disabilities, people who have been impacted by the justice system, and/or people without a college degree are encouraged to apply.

What Salvation Army employees say

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Benefits

Hours and flexibility

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Get the full story on Breakroom

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About Salvation Army

Sourced by ZipRecruiter

The Salvation Army, an international movement, is an evangelical part of the universal Christian Church. Its message is based on the Bible. Its ministry is motivated by the love of God. Its mission is to preach the gospel of Jesus Christ and to meet human needs in His name without discrimination.

Industry

Non-profits, retail, amusement, gambling, and recreation and religious organizations

Company size

5,001 - 10,000 Employees

Headquarters location

Alexandria, VA, US

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