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Utilization Case Manager Jobs in Amherst, MA (NOW HIRING)

Mission Hospital

RN - Case Manager

Springfield, MA · On-site

$2.0K/wk

Strong assessment, discharge planning, and utilization review skills Description: The RN Case Manager coordinates patient care plans and services across the continuum of care. Works closely with ...

Encompass Health

Case Manager

Ludlow, MA · On-site

$21 - $27/hr

Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...

Baystate Health

RN Case Manager

Springfield, MA · On-site

Leads the team to ensure appropriate utilization of patient resources and directs care to other settings when appropriate * Collaborates with community case managers and other health care advisors to ...

Baystate Health

RN Case Manager

Springfield, MA · On-site

Leads the team to ensure appropriate utilization of patient resources and directs care to other settings when appropriate * Collaborates with community case managers and other health care advisors to ...

Baystate Health

RN Case Manager

Springfield, MA · On-site

Leads the team to ensure appropriate utilization of patient resources and directs care to other settings when appropriate * Collaborates with community case managers and other health care advisors to ...

Holyoke Hospital

Hospice RN Case Manager

Holyoke, MA · On-site

$72K - $91K/yr

Registered Nurse Case Manager The Holyoke Visiting Nurses Association, Inc. is looking to hire a ... Proactively facilitate coordination of services and utilization of community resources.

Home Base

Case Manager RN, per diem

Northampton, MA · On-site

$59.76 - $103.24/hr

... utilization of resources, and patient advocacy. This position reports to the Director, Case Management and Social Work and operates within established organizational and departmental policies and ...

Massgeneralbrigham

Case Manager RN, per diem

Northampton, MA · On-site

$43.38 - $74.94/hr

... utilization of resources, and patient advocacy. This position reports to the Director, Case Management and Social Work and operates within established organizational and departmental policies and ...

Valley Health Systems

Hospice RN Case Manager

Holyoke, MA · On-site

$72K - $91K/yr

The Registered Nurse Case Manager carries full and ultimate responsibility for quality of nursing ... coordination of services and utilization of community resources. • Coordinate care and ...

Valley Health System

Hospice RN Case Manager

Holyoke, MA · On-site

$72K - $91K/yr

The Registered Nurse Case Manager carries full and ultimate responsibility for quality of nursing ... coordination of services and utilization of community resources. • Coordinate care and ...

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All JobsUtilization Case JobsUtilization Case Manager JobsUtilization Case Manager Jobs in Amherst, MA

Utilization Case Manager information

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How much do utilization case manager jobs pay per hour?

As of Aug 27, 2026, the average hourly pay for utilization case manager in Amherst, MA is $35.93, according to ZipRecruiter salary data. Most workers in this role earn between $29.13 and $37.88 per hour, depending on experience, location, and employer.

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 job categories do people searching Utilization Case Manager jobs in Amherst, MA look for?

The top searched job categories for Utilization Case Manager jobs in Amherst, MA are:

What cities near Amherst, MA are hiring for Utilization Case Manager jobs?

Cities near Amherst, MA with the most Utilization Case Manager job openings:

Utilization Case Manager jobs near you

Travel RN Case Manager

Springfield, MA • On-site

AMN Healthcare Revenue Cycle
See more jobs at AMN Healthcare Revenue Cycleexternal

$1.8K - $2.5K/wk

Contractor

Medical, Dental, Vision, Life, Retirement

This job post has expired 1 day ago. Applications are no longer accepted.

Job description

AMN Healthcare Revenue Cycle is seeking a travel nurse RN Case Management for a travel nursing job in Springfield, Massachusetts.

Job Description & Requirements
  • Specialty: Case Management
  • Discipline: RN
  • Start Date: 08/31/2026
  • Duration: 13 weeks
  • 36 hours per week
  • Shift: 12 hours
  • Employment Type: Travel

Job Description & Requirements
RN Case Manager
StartDate: 8/31/2026 Pay Rate: $1800.00 - $2500.00

POSITION SUMMARY – RN Case Manager

POSITION DUTIES – Coordinate patient care from admission through discharge, ensuring that treatments, services, and resources align with each patient’s medical needs and recovery goals. Collaborate closely with physicians, nurses, and external providers to remove barriers to care, streamline transitions, and support safe, efficient discharge planning.

MINIMUM REQUIRED QUALIFICATIONS –

  • MA RN license
  • BLS
  • 2 years recent acute hospital case management experience

LENGTH OF ASSIGNMENT – 10/31 end date

SHIFT / HOURS PER WEEK – 8a-4:30p with every third weekend

START DATE – ASAP


Facility Location
Springfield riverfront provides wonderful opportunities for bikers, runners, walkers or those who like to rollerblade. They will have a stunning view of the Connecticut River, as well as Springfield city’s natural skyline, and the historic Memorial Bridge. The Connecticut River Walk and Bikeway includes 3.7 miles of scenery which is breathtaking, and there is even a Riverfront Park which leads via a pedestrian bridge to the newly constructed Basketball Hall of Fame.
Job Benefits
Becoming an AMN Healthcare professional gives you the incredible opportunity to gain critical career experience, work with new people, and earn a highly competitive salary—but the perks don't stop there. There are many additional benefits to enjoy, including:
  • Medical, dental and vision benefits
  • Earned time off and paid holidays
  • Paid continuing education time
  • 401(K) retirement planning
  • Short-term disability, life insurance, paid jury duty
  • Access to the largest network of facilities and providers in the country
  • Industry experienced workforce management team
  • Licensure and certification reimbursement

About the Company
At AMN Healthcare, we strive to be recognized as the most trusted, innovative, and influential force in helping healthcare organizations provide quality patient care that continually evolves to make healthcare more human, more effective, and more achievable.

AMN Healthcare Revenue Cycle Job ID #3542293. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN Case Manager

About AMN Healthcare Revenue Cycle

AMN Healthcare is a leading force in the healthcare industry, committed to being the most trusted, innovative, and influential partner for healthcare organizations. With a focus on providing quality patient care, AMN Healthcare offers holistic solutions that reduce costs, streamline processes, and improve efficiencies. The company boasts over 30 years of experience and takes pride in staffing leading healthcare facilities with the nation's best travelers. As an industry leader, AMN Healthcare offers a diverse team dedicated to supporting healthcare workers and facilities, ensuring a personalized and supportive experience for both clients and candidates.

Benefits
  • Medical benefits
  • Dental benefits
  • Company provided housing options
  • Continuing Education

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