1

Utilization Case Manager Jobs in Utah (NOW HIRING)

Case Manager

Salt Lake City, UT ยท On-site

$19.25 - $25/hr

Case management services include monitoring patient care to ensure progress toward desired outcome ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

Case Manager

Salt Lake City, UT ยท On-site

$19.25 - $25/hr

Case management services include monitoring patient care to ensure progress toward desired outcome ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

Case Manager

Salt Lake City, UT ยท On-site

$19.25 - $25/hr

Case management services include monitoring patient care to ensure progress toward desired outcome ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

Case Manager

Salt Lake City, UT ยท On-site

$19.25 - $25/hr

Case management services include monitoring patient care to ensure progress toward desired outcome ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

Case Manager

Salt Lake City, UT ยท On-site

$19.25 - $25/hr

Case management services include monitoring patient care to ensure progress toward desired outcome ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

Case Manager

Salt Lake City, UT ยท On-site

$19.25 - $25/hr

Case management services include monitoring patient care to ensure progress toward desired outcome ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

Case Manager

Salt Lake City, UT ยท On-site

$19.75 - $25.50/hr

Case management services include monitoring patient care to ensure progress toward desired outcome ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

Integrate CM and utilization management (UM) and integrating nursing case management with social work case management. * Maintain liaison with appropriate community agencies and organizations.

next page

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 Utah? For Utilization Case Manager jobs in Utah, the most frequently searched job titles are:
What cities in Utah are hiring for Utilization Case Manager jobs? Cities in Utah with the most Utilization Case Manager job openings:

Full-time

Posted 13 days ago


Job description

The Case Manager is responsible for coordinating and monitoring day to day operations of the Case Management and Utilization Management programs. He/She directs the activities necessary to ensure appropriate utilization of the Hospital and its resources while maintaining optimal achievable standards of patient care.

  1. Registered Nurse, graduate from an accredited school of nursingย ย ย ย ย ย ย ย ย 
  2. Must hold a current state license and must maintain license renewal in accordance with the standards of the State Board of Nursing
  3. Bachelorโ€™s degree in nursing or healthcare administration preferred
  4. Three years acute care clinical nursing experience
  5. Minimum of 1-year Case Management experience
  6. Additional education in the area of Quality Management and Joint Commission Standards
  7. Long term acute care and rehabilitation experience is preferred
  8. Demonstration of leadership, manageability, and the application of interpersonal and principles of supervision and administration
  9. Must be able to read, write, and speak English, as well as possess good verbal and written communications skills
  10. Good computer skills with minimal guidance
  11. Certification in Case Management (CCM) preferred
  12. BLS required