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Utilization Case Manager Jobs in Calgary, AB (NOW HIRING)

Lifeworks

Sr Disability Claims Manager

Calgary, AB · On-site +1

CA$70K - CA$90K/yr

Disability Case Manager (CM2) - TELUS Health Absence and Disability Management TELUS Health ... interventions, utilization of specialized resources or consultations etc. * Determine an ...

Amrize

CAPEX Coordinator

Calgary, AB

... utilization reviews, and business case development to drive asset optimization, cost savings, and growth opportunities. This role also involves adjacent activities such as lease management and some ...

All JobsUtilization Case JobsUtilization Case Manager JobsUtilization Case Manager Jobs in Calgary, AB

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.

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 degree do I need for utilization review?

Utilization case managers typically need at least a bachelor's degree in healthcare, nursing, social work, or a related field. Some positions may require a master's degree or professional certification, such as a Certified Case Manager (CCM) or Certified Professional in Healthcare Quality (CPHQ), to advance in the role or handle complex cases.

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.

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

Supervisor, Case Management and Search Analysis

Canadian Blood Services

Calgary, AB • On-site

CA$99K - CA$117K/yr

Other

Retirement, PTO

Posted 5 days ago

Job description

This role requires a minimum of 40% on-site presence. Additional on-site work may be required based on business needs. On-site expectations are subject to change and may be adjusted on a temporary or permanent basis. 

Job posting ID: 9059

Employment status: Temporary full-time
Position's anticipated end date: 2028-02-29 

Salary/Rate of pay: $99,600 - $117,200

Application deadline: 2026-08-11 

  • This external job posting may close earlier than the advertised deadline. We recommend applying as soon as possible.

Application requirements:

  • Your up-to-date resume.
  • Job specific cover letter.
  • We recommend you save a copy of the job posting for reference throughout the recruitment process.

Do you currently work for Canadian Blood Services? All employees must apply via the internal career page.

Together, the work we do connects people and changes lives - including your own. 

Be part of a dynamic, collaborative and caring organization committed to saving and improving lives. Thousands of patients depend on us every day for reliable access to safe blood, plasma, stem cells and organs and tissues.

About the role

Canadian Blood Services is looking for a Temporary full-time Supervisor, Case Management and Search Analysis to join our dynamic Stem Cells team in our Medical Affairs division.

The Medical Affairs, Stem Cells team is responsible for supporting Canadian Blood Services by providing oversight for the Centre for Innovation, organ and stem cell donation and transplantation, utilization, donor and clinical services, medical microbiology, and epidemiology. The team ensures that Canadian Blood Services' medical and scientific support is provided to the ongoing operations of every aspect of their work.

In this role, you will lead teams that support stem cell donor case management and search activities, helping ensure safe, timely, and compliant processes for donors and patients. You will provide day-to-day leadership, guide complex case decisions, and contribute to operational improvements, making this a strong fit for someone who enjoys balancing people leadership, regulatory oversight, and continuous improvement.

Formula for success
  • Using your leadership skills, you will guide and coach case management and search analysis teams to deliver high-quality service while maintaining compliance with regulatory and accreditation requirements.
  • Drawing on your ability to manage complex and sensitive situations, you will identify risks early, resolve operational issues, and support safe outcomes for donors and patients.
  • Your strong communication skills will help you build effective relationships with national and international partners, ensuring clear coordination throughout the donor assessment and search process.
  • By monitoring performance, providing coaching, and supporting employee development, you will help create a capable and engaged team that consistently meets operational goals.
  • Leveraging your analytical thinking, you will evaluate processes, recommend improvements, and contribute to quality, efficiency, and system enhancement initiatives.
  • Your commitment to confidentiality, customer service, and attention to detail will support trusted interactions with donors, patients, healthcare partners, and colleagues. 
Desired education and skills
  • Post-secondary level education in a relevant discipline from a recognized academic institution, preferably a University Degree in Health Management/Public Administration, or equivalent.
  • Specialized courses or certification in Project Management will be considered an asset.
  • At least 3 to 5 years of related experience, ideally within a regulated environment is required.
  • SAP experience will be required.
  • Strong computer literacy in SAP, Microsoft Word, Excel, and Web Browsers.
  • Demonstrated planning, organization, interpersonal, team building, and communication skills will be essential to deal with a variety of internal and external agencies with tact and discretion.
  • Knowledge of the stem cell registry will be considered an asset.
  • An equivalent combination of education, training and experience may be considered.
What we offer you
  • Payment in lieu of vacation.  
  • Annual performance award up to 8%.
  • Payment in lieu of benefits.  
  • Defined benefit pension plan. 
  • Employee discounts, wellness program, professional resources. 
What you can expect
  • This role will work in a hybrid environment with requirements to be onsite at Canadian Blood Services location 40% of the time/2 days of the week.
  • You will be expected to travel a couple of times per year, and as required.


If this role resonates with you, we encourage you to apply by providing your up-to-date resume. This could be your first step towards a meaningful and inspiring career. Come to work each day knowing that you save lives. 

We acknowledge that the work of Canadian Blood Services spans many Territories and Treaty areas across the country, and we are grateful for the Traditional Knowledge Keepers and Elders who have guided us in this important work. We recognize the land and waters that have inspired our work and offer gratitude to those Indigenous peoples on whose territory we work, live and play.

Diversity and inclusion play a vital role in ensuring health equity for patients across Canada. We are committed to reflecting Canada's population in our organization and fostering an environment where all employees can be their authentic selves, with equal opportunities to succeed and contribute.  

We thank all applicants for their interest. However, only those considered for an interview or those invited to participate in an assessment will be contacted. Emails are sent directly from our system, to ensure you receive them please add donotreply@blood.ca and system@successfactors.com to your safe senders list. 

Applicants who require accommodation should discuss their needs with us.

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