RN Case Manager - Oncology
Portland, OR · On-site
Communicate data on population case managed, utilization and outcomes. Education of staff/clinicians. Development and distribution of education, tools and materials for member coordination.
RN Case Manager - Oncology
Portland, OR · On-site
Communicate data on population case managed, utilization and outcomes. Education of staff/clinicians. Development and distribution of education, tools and materials for member coordination.
Travel ED Case Manager RN
Portland, OR · On-site
$2.3K - $2.4K/wk
Travel Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Portland, Oregon Start Date: September 21, 2026 Profession: Registered Nurse (RN) Facility: Hospital ...
New
Travel ED Case Manager RN
Portland, OR · On-site
$2.3K - $2.4K/wk
Travel Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Portland, Oregon Start Date: September 21, 2026 Profession: Registered Nurse (RN) Facility: Hospital ...
New
Partner with insurance providers to secure authorizations and ensure appropriate utilization of ... Case Management Certification (CCM or equivalent) * Experience with discharge planning or case ...
Quick apply
Partner with insurance providers to secure authorizations and ensure appropriate utilization of ... Case Management Certification (CCM or equivalent) * Experience with discharge planning or case ...
Discharge Coord/Case Manager RN ARRMC (Case Management)
Medford, OR · On-site
$49.33 - $67.84/hr
Minimum 2 years of progressive nursing experience in an acute care setting, preferably within discharge, utilization, and/or case management - or the equivalent in education and/or experience - is ...
Discharge Coord/Case Manager RN ARRMC (Case Management)
Medford, OR · On-site
$49.33 - $67.84/hr
Minimum 2 years of progressive nursing experience in an acute care setting, preferably within discharge, utilization, and/or case management - or the equivalent in education and/or experience - is ...
Travel Nurse RN - Utilization Review - $3,160 per week
Hillsboro, OR · On-site
$3.1K/wk
Medlivo is seeking a travel nurse RN Utilization Review for a travel nursing job in Hillsboro ... Case Manager or Patient Care Coordinator (PCC) experience - EPIC experience - Experience with ...
Travel Nurse RN - Utilization Review - $3,160 per week
Hillsboro, OR · On-site
$3.1K/wk
Medlivo is seeking a travel nurse RN Utilization Review for a travel nursing job in Hillsboro ... Case Manager or Patient Care Coordinator (PCC) experience - EPIC experience - Experience with ...
Discharge Coord/Case Manager RN ATRMC (Case Management)
Grants Pass, OR · On-site
$49.33 - $67.84/hr
Minimum 2 years of progressive nursing experience in an acute care setting, preferably within discharge, utilization, and/or case management - or the equivalent in education and/or experience - is ...
Discharge Coord/Case Manager RN ATRMC (Case Management)
Grants Pass, OR · On-site
$49.33 - $67.84/hr
Minimum 2 years of progressive nursing experience in an acute care setting, preferably within discharge, utilization, and/or case management - or the equivalent in education and/or experience - is ...
Case Manager - Care Management
$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
$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 · 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 · 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 · 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 · 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 · 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 · 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
$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
$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:
RN Case Manager
Portland, OR · On-site
$71K - $89K/yr
... 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.
RN Case Manager
Portland, OR · On-site
$71K - $89K/yr
... 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
Portland, OR · On-site
$54.37/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 · On-site
$54.37/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 · 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 · 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 · On-site
$54.37/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 · On-site
$54.37/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:
Travel Nurse RN - Utilization Review - $3,160 per week
Portland, OR · On-site
$3.1K/wk
Medlivo is seeking a travel nurse RN Utilization Review for a travel nursing job in Portland ... Case Manager or Patient Care Coordinator (PCC) experience - EPIC experience - Experience with ...
Travel Nurse RN - Utilization Review - $3,160 per week
Portland, OR · On-site
$3.1K/wk
Medlivo is seeking a travel nurse RN Utilization Review for a travel nursing job in Portland ... Case Manager or Patient Care Coordinator (PCC) experience - EPIC experience - Experience with ...
RN, Care Management
Portland, OR · On-site
Intensity of service is dependent on individual patient needs as assessed by the case manager. RN case managers practice robust utilization and resource management. RN case managers also frequently ...
RN, Care Management
Portland, OR · On-site
Intensity of service is dependent on individual patient needs as assessed by the case manager. RN case managers practice robust utilization and resource management. RN case managers also frequently ...
Travel ED Case Manager RN
Portland, OR · On-site
Travel RN - Case Management/Utilization Review - Case Management About American Traveler With over 25 years of experience, American Traveler has established a reputation for outstanding customer ...
New
Travel ED Case Manager RN
Portland, OR · On-site
Travel RN - Case Management/Utilization Review - Case Management About American Traveler With over 25 years of experience, American Traveler has established a reputation for outstanding customer ...
New
Discharge Coord/Case Manager RN ATRMC (Case Management)
Grants Pass, OR · On-site
$103 - $141/hr
Minimum 2 years of progressive nursing experience in an acute care setting, preferably within discharge, utilization, and/or case management - or the equivalent in education and/or experience - is ...
Discharge Coord/Case Manager RN ATRMC (Case Management)
Grants Pass, OR · On-site
$103 - $141/hr
Minimum 2 years of progressive nursing experience in an acute care setting, preferably within discharge, utilization, and/or case management - or the equivalent in education and/or experience - is ...
CASE MGR, RN-DUAL BLS
Portland, OR · On-site
$53.28 - $79.02/hr
Communicate data on population case managed, utilization and outcomes. Education of staff/clinicians. Development and distribution of education, tools and materials for member coordination.
New
CASE MGR, RN-DUAL BLS
Portland, OR · On-site
$53.28 - $79.02/hr
Communicate data on population case managed, utilization and outcomes. Education of staff/clinicians. Development and distribution of education, tools and materials for member coordination.
New
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?
| 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 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 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:
Other
Medical, Vision
Re-posted 3 days ago
Kaiser Permanente rating
8.2
Based on 927 frontline employees who took The Breakroom Quiz
55th of 898 rated healthcare providers
Job description
Job Summary:
The RN Case Manager functions in a self-directed role with a high degree of autonomy in an expanded clinical role guiding appropriate use of resources for a variety of chronic conditions. RN Case Management Services will have accountability for a designated population defined in conjunction with the clinicians in the medical home, and assists the organization in meeting regulatory service and care needs for these populations. The RN Case Manager works collaboratively as a member of the health care team to deliver high quality health care to patients supporting Kaiser Permanentes mission, vision and values. The RN Case Manager provides a variety of nursing services both in person, by phone and via electronic media utilizing nursing process and leadership skills to address acute and chronic needs of Health Plan members and other patients of the Kaiser Permanente Health Care Program. He/she works under the general direction of the designated supervisor and may function in multiple settings within the system, the community and home to provide support for a high risk population. Essential Responsibilities:
The RN Case Manager functions in a self-directed role with a high degree of autonomy in an expanded clinical role guiding appropriate use of resources for a variety of chronic conditions. RN Case Management Services will have accountability for a designated population defined in conjunction with the clinicians in the medical home, and assists the organization in meeting regulatory service and care needs for these populations. The RN Case Manager works collaboratively as a member of the health care team to deliver high quality health care to patients supporting Kaiser Permanentes mission, vision and values. The RN Case Manager provides a variety of nursing services both in person, by phone and via electronic media utilizing nursing process and leadership skills to address acute and chronic needs of Health Plan members and other patients of the Kaiser Permanente Health Care Program. He/she works under the general direction of the designated supervisor and may function in multiple settings within the system, the community and home to provide support for a high risk population. Essential Responsibilities:
- Utilize regional population stratification information and processes to identify appropriate members for enrollment into case management in collaboration with clinicians and health care team.
- Independently and proactively complete chart reviews, screening calls and full assessments related to the anticipated level of care and document findings using standardized approved documentation tools.
- Triage findings from member assessments, identifying needs and issues, engage patients to define a plan of care and appropriate level of self management and interventions. Determine Level of Care. Communicate findings and actions to involved care providers through succinct summaries that include findings, actions and further recommendations.
- With the member/family and appropriate KP staff and providers, develop and document a patient-centered care plan that addresses short term goals that are specific, attainable and measurable.
- Provide care coordination and management services for members with identified needs: Creatively using available and appropriate resources, including KP staff and providers, to support the unique needs of each member; Facilitating access to internal and external services; Monitoring the effectiveness of the interventions; and reinforces the treatment plan. Advising and coaching patients and families; Succinctly document interventions in KP HealthConnect as needed by other providers to ensure coordination of care and services.
- Strengthen and improve Case Management Services: Establish strong relationships with clinicians and other health care team members. Communicate data on population case managed, utilization and outcomes. Education of staff/clinicians. Development and distribution of education, tools and materials for member coordination. Contributing to ongoing process improvement including related procedures, policies, patient support and documentation tools.
- Act as a liaison between the patient and appropriate care delivery team.
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About Kaiser Permanente
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Industry
Health care and social assistance, hospitals and arts, entertainment, and recreation
Company size
10,000+ Employees
Headquarters location
Oakland, CA, US