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Utilization Case Manager Jobs in New York (NOW HIRING)

Project Hospitality

Case Manager

Staten Island, NY

$22/hr

SUMMARY: The Case Manager will work in our Transitional Independent Living Program (TIL) and be ... Care Coordination includes making referrals for services, monitoring service utilization, case ...

Project Hospitality

Case Manager

Staten Island, NY · On-site

$20.25 - $26.25/hr

SUMMARY: The Case Manager will work in our Transitional Independent Living Program (TIL) and be ... Care Coordination includes making referrals for services, monitoring service utilization, case ...

Project Hospitality, Inc.

Case Manager

Staten Island, NY · On-site

$42K - $43K/yr

SUMMARY: TheCase Manager will work in our Transitional Independent Living Program (TIL) and be ... Care Coordination includes making referrals for services, monitoring service utilization, case ...

BronxCare Health System

Assistant Director

Bronx, NY · On-site

$152K/yr

Overview Assists the Director to administer operations and activities of the Utilization Case Management Department in support of policies, goals and objectives established by the Hospital by ...

BronxCare Health System

Assistant Director

Bronx, NY · On-site

$152K/yr

Assists the Director to administer operations and activities of the Utilization Case Management Department in support of policies, goals and objectives established by the Hospital by providing direct ...

BronxCare Health System

Assistant Director

Bronx, NY · On-site

Overview Assists the Director to administer operations and activities of the Utilization Case Management Department in support of policies, goals and objectives established by the Hospital by ...

ATD Technology LLC

Case Manager

Morristown, NJ · On-site

$54 - $56/hr

Performs utilization management and quality screenings In- Patient Case Management is required Skills: * 2 years of acute care experience strongly preferred * Case Management, Managed Care. In ...

RiverSpring Living

Case Manager

Bronx, NY · On-site

$30.22 - $35.71/hr

) Case Manager - Immediate Full Time Opportunity Bronx, New York RiverSpring Living is seeking a Case ... and over utilization of emergency departments as outlined in our ESSHI work plan. Under the ...

The Hebrew Home at Riverdale

Case Manager

Bronx, NY · On-site

$30.22 - $35.71/hr

Case Manager - Immediate Full Time Opportunity Bronx, New York RiverSpring Living is seeking a Case ... and over utilization of emergency departments as outlined in our ESSHI work plan. Under the ...

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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 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.

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 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 degree do I need for utilization case manager?

Utilization case managers typically need at least a bachelor's degree in healthcare, social work, nursing, or a related field. Some positions may prefer or require a master's degree or relevant certifications, such as Certified Case Manager (CCM) or Certified Professional in Healthcare Quality (CPHQ).

What are popular job titles related to Utilization Case Manager jobs in New York?

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

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

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

What cities in New York are hiring for Utilization Case Manager jobs?

Cities in New York with the most Utilization Case Manager job openings:

Utilization Case Manager jobs near you
Infographic showing various Utilization Case Manager job openings in New York as of August 2026, with employment types broken down into 89% Full Time, 10% Part Time, and 1% Contract. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution.

Case Manager

Project Hospitality

Staten Island, NY

$22/hr

Part-time

Re-posted 17 days ago

Project Hospitality rating

5.8

Company rating: 5.8 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

Job description

SUMMARY:

The Case Manager will work in our Transitional Independent Living Program (TIL) and be responsible for ensuring client safety and providing care coordination and case management services in an effective and efficient manner for all youth ages 16 -20 living in the facility.

Work Schedule: Full time, Monday - Friday, 10:00 a.m. - 6:00 p.m.

RESPONSIBILITIES:

  • Manage and counsel clients staying in the Transitional Living Program. Assist clients in developing independent living skills through one-on-one sessions and weekly group sessions.
  • Determine any immediate need and link clients to appropriate services. Monitor engagement in services and escort clients to appointments as needed.
  • Provide client crisis intervention and stabilization services.
  • Provide ongoing care coordination around housing, savings, medical, employment, education, mental health, and substance abuse. Care Coordination includes making referrals for services, monitoring service utilization, case conferencing with internal and external providers, and follow-up.
  • Case conference weekly with the staff psychiatrist, vocational counselor, and social worker regarding the youth's progress and ongoing needs.
  • Provide weekly groups (topics are to include ADL skills, budgeting, employment, health awareness, and housing readiness).
  • Make regular entries in the staff communication log according to policy/procedure and ensure proper charting of all client information is done on a timely basis. Responsible to maintain up-to-date documentation including intakes, service plan, weekly progress notes, savings forms, and medicals.
  • Participate in scheduled supervision and all team meetings.

QUALIFICATIONS NEEDED:

  • BA/BS Required.
  • One to two years of case management/crisis intervention/social services background is needed.
  • Knowledge regarding housing services and entitlements is needed.
  • A clean, valid Drivers License is required.
  • Must have excellent communication skills, both orally and in writing, with individuals and groups regarding complex and sensitive issues.

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