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Utilization Case Manager Jobs in Oregon (NOW HIRING)

Case Manager - Care Management

Gresham, OR ยท On-site

$54.37 - $81.21/hr

... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:

Case Manager - Care Management

Portland, OR ยท On-site

$54.37 - $81.21/hr

... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:

Case Manager - Care Management

Gresham, OR ยท On-site

$54.37 - $81.21/hr

... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:

Case Manager - Care Management

Portland, OR ยท On-site

$54.37 - $81.21/hr

... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:

Case Manager - Care Management

Gresham, OR ยท On-site

$54.37 - $81.21/hr

... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:

... performing Utilization Review and Service Authorizations for members of all books of business ... Certification in case management (CCMC) required or ability to obtain within 24 months of hire.

Case Manager - Care Management

Gresham, OR ยท On-site

$54.37 - $81.21/hr

... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:

Case Manager - Care Management

Portland, OR ยท On-site

$54.37 - $81.21/hr

... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:

... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:

Case Manager - Care Management

Portland, OR ยท On-site

$54.37 - $81.21/hr

... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:

Case Manager - Care Management

Portland, OR ยท On-site

$54.37 - $81.21/hr

... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:

... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:

Case Manager - Care Management

Portland, OR ยท On-site

$54.37 - $81.21/hr

... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:

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Showing results 1-20

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 medical providers and insurance companies. They analyze patient records, coordinate care plans, and ensure compliance with policies, typically using case management software and clinical knowledge. Their goal is to optimize resource use while maintaining quality patient care.

What jobs pay 10,000 a month without a degree?

Utilization Case Managers typically do not earn $10,000 a month without specialized experience or certifications; most roles in this field pay lower salaries. High-paying jobs that can reach this level without a degree include sales, real estate, or entrepreneurship, often requiring strong skills, networking, and industry knowledge. Some trades, like certain construction or technical roles, may also offer high earnings with experience and certifications rather than formal degrees.

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 2000 a day?

Utilization Case Managers typically do not earn $2,000 a day; such high daily earnings are more common in specialized roles like senior executives, certain consulting positions, or high-level medical professionals. Most jobs with high daily pay require advanced skills, certifications, or extensive experience, and earnings can vary based on industry, location, and workload.

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 skills, familiarity with medical terminology, and sometimes certification. It provides experience in healthcare settings and can serve as a stepping stone to more advanced medical roles, but it may have limited responsibilities compared to specialized positions.

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 Oregon? For Utilization Case Manager jobs in Oregon, the most frequently searched job titles are:
What job categories do people searching Utilization Case Manager jobs in Oregon look for? The top searched job categories for Utilization Case Manager jobs in Oregon are:
What cities in Oregon are hiring for Utilization Case Manager jobs? Cities in Oregon with the most Utilization Case Manager job openings:

Travel Nurse RN - Case Management - $2,800 per week

MedCadre

Portland, OR โ€ข On-site

$2.8K/wk

Full-time

Medical, Dental, Vision, Retirement

This job post hasย expired today.ย Applications are no longer accepted.


Job description

MedCadre is seeking a travel nurse RN Case Management for a travel nursing job in Portland, Oregon.

Job Description & Requirements

  • Specialty: Case Management
  • Discipline: RN
  • Duration: 13 weeks
  • 40 hours per week
  • Shift: 8 hours, days
  • Employment Type: Travel

Title: Registered Nurse (RN) โ€“ Case Manager
Location: Portland, OR - 97213
Shift: Days | 5x8-Hour Shifts (7:00 AM โ€“ 3:00 PM)
Duration: 13 Weeks with possible extension
Start Date: 07/06/2026

Position Overview:
Seeking an experienced Registered Nurse (RN) case manager. The ideal candidate will have recent acute care hospital case management and discharge planning experience, strong care coordination skills, and proficiency with Epic charting.

Key Responsibilities:

  • Coordinate patient care throughout hospitalization and discharge planning processes.
  • Conduct patient assessments and develop individualized plans of care.
  • Facilitate care coordination with interdisciplinary teams, including Social Services.
  • Review medical necessity and utilization management requirements.
  • Arrange durable medical equipment (DME) and post-discharge services as needed.
  • Obtain prior authorizations and support regulatory compliance initiatives.
  • Ensure adherence to CMS, HIPAA, OSHA, Joint Commission, and other healthcare regulations.
  • Assist with discharge planning and transitions of care.
  • Float to other units or affiliated facilities as needed based on patient care requirements.

Skills:

  • Strong knowledge of care coordination, utilization review, and discharge planning.
  • Experience with regulatory guidelines including CMS, DRG, HIPAA, and Joint Commission standards.

Requirements:

  • Active OR RN license required.
  • Minimum 2 years of RN case manager experience required.
  • Recent acute care hospital case management/discharge planning experience required.
  • Experience with Epic EMR required.
  • AHA - BLS certification required.
  • Must have reliable personal transportation for assignment-related travel.
  • Covid Card

Application Process: Please submit your resume to manas(at)medcadre.com. Qualified candidates will be contacted promptly for next steps.

About MedCadre

At MedCadre, headquartered in Irvine, California and serving healthcare organizations nationwide, we connect exceptional clinicians with world-class career opportunities while upholding the highest standards of ethics, fairness, and integrity. As a Joint Commissionโ€“accredited and ISO 9001โ€“certified leader in medical staffing, we strictly adhere to healthcare regulations, ensuring trust and peace of mind for both our clinicians and partner facilities.

Guided by our core values; Results, Approachability, Care, and Emergency (RACE), we foster an environment where you can grow professionally, build meaningful relationships, and deliver outstanding patient care. When you join MedCadre, you become part of a broad network dedicated to advancing healthcare, improving lives, and shaping the future of patient outcomes together.

We are an Equal Opportunity Employer and embrace diversity at every level of our organization

Learn more about us https://www.medcadre.com/

Benefits

  • 401k retirement plan
  • Health Care FSA
  • Vision benefits
  • Dental benefits
  • Retention bonus
  • Medical benefits
  • Referral bonus
  • Sick pay
  • Weekly pay

About MedCadre

Sourced by ZipRecruiter

Industry

Recruiting and staffing services

Company size

501 - 1,000 Employees

Headquarters location

Irvine, CA, US

Year founded

2015