LPN Case Manager
Richmond, VA · On-site
$75K/yr
... and manage utilization review • Facilitate timely and safe discharge planning • Serve as ... case management and discharge planning • Collaborate with admissions to review referrals and ...
LPN Case Manager
Richmond, VA · On-site
$75K/yr
... and manage utilization review • Facilitate timely and safe discharge planning • Serve as ... case management and discharge planning • Collaborate with admissions to review referrals and ...
LPN Case Manager
Richmond, VA · On-site
... and manage utilization review • Facilitate timely and safe discharge planning • Serve as ... case management and discharge planning • Collaborate with admissions to review referrals and ...
LPN Case Manager
Richmond, VA · On-site
... and manage utilization review • Facilitate timely and safe discharge planning • Serve as ... case management and discharge planning • Collaborate with admissions to review referrals and ...
LPN Case Manager
Richmond, VA · Remote
$75K/yr
Case Manager At Prestige Healthcare Services , we are committed to delivering exceptional care and ... Monitor length of stay and levels of care to ensure appropriate resource utilization * Maintain ...
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LPN Case Manager
Richmond, VA · Remote
$75K/yr
Case Manager At Prestige Healthcare Services , we are committed to delivering exceptional care and ... Monitor length of stay and levels of care to ensure appropriate resource utilization * Maintain ...
Medical Case Manager
Glen Allen, VA · On-site +1
$62K - $96K/yr
In addition, this person will develop an initial plan outlining the action the case manager will take to ensure timely resolution of injury(s) through utilization of established guidelines to ...
Medical Case Manager
Glen Allen, VA · On-site +1
$62K - $96K/yr
In addition, this person will develop an initial plan outlining the action the case manager will take to ensure timely resolution of injury(s) through utilization of established guidelines to ...
Virginia-RN Case Manager
Richmond, VA · On-site
$45 - $60/hr
... utilization while enhancing quality metrics (HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform infusion therapies and acute pain management, including IV ...
Virginia-RN Case Manager
Richmond, VA · On-site
$45 - $60/hr
... utilization while enhancing quality metrics (HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform infusion therapies and acute pain management, including IV ...
Field Case Manager I
$63K - $95K/yr
As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...
Field Case Manager I
$63K - $95K/yr
As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...
Field Case Manager I
Glen Allen, VA · On-site
$63K - $95K/yr
As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...
Quick apply
Field Case Manager I
Glen Allen, VA · On-site
$63K - $95K/yr
As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...
Field Case Manager I
Glen Allen, VA · On-site
$63K - $95K/yr
As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...
Field Case Manager I
Glen Allen, VA · On-site
$63K - $95K/yr
As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...
Virginia-RN Case Manager
Richmond, VA · On-site
... utilization while enhancing quality metrics (HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform infusion therapies and acute pain management, including IV ...
Virginia-RN Case Manager
Richmond, VA · On-site
... utilization while enhancing quality metrics (HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform infusion therapies and acute pain management, including IV ...
Nurse Case Manager I
Richmond, VA · On-site
$67K - $100K/yr
Nurse Case Manager I Nurse Case Manager I Locations: Richmond or Norfolk, VA Virtual : This role ... Utilization Management; discharge planning in an inpatient setting, home health and/or a skilled ...
Nurse Case Manager I
Richmond, VA · On-site
$67K - $100K/yr
Nurse Case Manager I Nurse Case Manager I Locations: Richmond or Norfolk, VA Virtual : This role ... Utilization Management; discharge planning in an inpatient setting, home health and/or a skilled ...
Nurse Case Manager I
Richmond, VA · On-site
$67K - $100K/yr
Nurse Case Manager I Nurse Case Manager I Locations: Richmond or Norfolk, VA Virtual : This role ... Utilization Management; discharge planning in an inpatient setting, home health and/or a skilled ...
Nurse Case Manager I
Richmond, VA · On-site
$67K - $100K/yr
Nurse Case Manager I Nurse Case Manager I Locations: Richmond or Norfolk, VA Virtual : This role ... Utilization Management; discharge planning in an inpatient setting, home health and/or a skilled ...
... utilization while enhancing quality metrics (HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform infusion therapies and acute pain management, including IV ...
... utilization while enhancing quality metrics (HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform infusion therapies and acute pain management, including IV ...
... utilization while enhancing quality metrics (HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform infusion therapies and acute pain management, including IV ...
... utilization while enhancing quality metrics (HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform infusion therapies and acute pain management, including IV ...
Nurse Case Manager I
Richmond, VA · On-site
$67K - $100K/yr
Nurse Case Manager I Locations: Richmond or Norfolk, VA Virtual : This role enables associates to ... Utilization Management; discharge planning in an inpatient setting, home health and/or a skilled ...
Nurse Case Manager I
Richmond, VA · On-site
$67K - $100K/yr
Nurse Case Manager I Locations: Richmond or Norfolk, VA Virtual : This role enables associates to ... Utilization Management; discharge planning in an inpatient setting, home health and/or a skilled ...
... utilization while enhancing quality metrics (HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform infusion therapies and acute pain management, including IV ...
... utilization while enhancing quality metrics (HEDIS/STAR) and member satisfaction. As needed, this role travels to patients' homes to perform infusion therapies and acute pain management, including IV ...
Knowledge of care management principles, utilization management, and community-based resources. * Certified Case Manager (CCM) certification preferred or willingness to obtain. Knowledge, Skills, and ...
Knowledge of care management principles, utilization management, and community-based resources. * Certified Case Manager (CCM) certification preferred or willingness to obtain. Knowledge, Skills, and ...
Registered Nurse RN Case Manager
Richmond, VA · On-site
$32.95 - $49.42/hr
Previous case management or utilization review experience preferred. Benefits Chippenham Hospital, offers a total rewards package that supports the health, life, career and retirement of our ...
Registered Nurse RN Case Manager
Richmond, VA · On-site
$32.95 - $49.42/hr
Previous case management or utilization review experience preferred. Benefits Chippenham Hospital, offers a total rewards package that supports the health, life, career and retirement of our ...
Registered Nurse RN Case Manager
Tuckahoe, VA · On-site
$32.95 - $49.42/hr
Previous case management or utilization review experience preferred. Benefits Chippenham Hospital, offers a total rewards package that supports the health, life, career and retirement of our ...
Registered Nurse RN Case Manager
Tuckahoe, VA · On-site
$32.95 - $49.42/hr
Previous case management or utilization review experience preferred. Benefits Chippenham Hospital, offers a total rewards package that supports the health, life, career and retirement of our ...
Registered Nurse RN Case Manager
Mechanicsville, VA · On-site
$32.95 - $49.42/hr
Previous case management or utilization review experience preferred. Benefits Chippenham Hospital, offers a total rewards package that supports the health, life, career and retirement of our ...
Registered Nurse RN Case Manager
Mechanicsville, VA · On-site
$32.95 - $49.42/hr
Previous case management or utilization review experience preferred. Benefits Chippenham Hospital, offers a total rewards package that supports the health, life, career and retirement of our ...
Case Manager Registered Nurse RN PRN
Richmond, VA · On-site
$32.95 - $49.42/hr
Required minimum of five years of recent clinical experience as a RN * Commercial Utilization Management and/or Case Management experience; Quality Management Experience preferred * Graduate of an ...
Case Manager Registered Nurse RN PRN
Richmond, VA · On-site
$32.95 - $49.42/hr
Required minimum of five years of recent clinical experience as a RN * Commercial Utilization Management and/or Case Management experience; Quality Management Experience preferred * Graduate of an ...
Utilization Case Manager information
See Chesterfield, VA salary details
$15.77 - $19.53
3% of jobs
$19.53 - $23.29
1% of jobs
$23.29 - $27.05
6% of jobs
$28.87 is the 25th percentile. Wages below this are outliers.
$27.05 - $30.81
30% of jobs
The median wage is $32.16 / hr.
$30.81 - $34.57
26% of jobs
$36 is the 75th percentile. Wages above this are outliers.
$34.57 - $38.33
22% of jobs
$38.33 - $42.09
3% of jobs
$42.09 - $45.85
0% of jobs
$45.85 - $49.61
5% of jobs
$49.61 - $53.37
2% of jobs
$53.37 - $57.13
1% of jobs
$15
$34
$57
How much do utilization case manager jobs pay per hour?
As of Aug 31, 2026, the average hourly pay for utilization case manager in Chesterfield, VA is $34.69, according to ZipRecruiter salary data. Most workers in this role earn between $28.12 and $36.59 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?
| 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 job categories do people searching Utilization Case Manager jobs in Chesterfield, VA look for?
The top searched job categories for Utilization Case Manager jobs in Chesterfield, VA are:
What cities near Chesterfield, VA are hiring for Utilization Case Manager jobs?
Cities near Chesterfield, VA with the most Utilization Case Manager job openings:
$75K/yr
Full-time
Medical, Dental, Vision, Retirement, PTO
Re-posted 2 days ago
Job description
) Case Manager
At Prestige Healthcare Services, we are committed to delivering exceptional care and support to our patients and their families. Our skilled facilities offer a range of short-term and long-term skilled rehabilitation services to meet the diverse needs of our patients. We are seeking a dedicated and compassionate Case Manager to join our team.
Responsibilities:
• Develop, implement, and monitor individualized care plans in collaboration with the interdisciplinary team (nursing, therapy, social services, dietary)
• Coordinate and communicate with insurance companies and managed care organizations to obtain authorizations and manage utilization review
• Facilitate timely and safe discharge planning
• Serve as primary point of contact for residents and families regarding care plans, insurance coverage, and discharge options
• Monitor length of stay and levels of care to ensure appropriate resource utilization
• Maintain accurate and timely documentation in the electronic health record (EHR) in compliance with state and federal regulations
• Ensure compliance with CMS, state survey, and facility policies related to case management and discharge planning
• Collaborate with admissions to review referrals and support smooth transitions into the facility
What We Offer:
This is a Remote Position.
Requirements
If you are a motivated and compassionate healthcare professional looking for a new challenge, we encourage you to apply for this exciting opportunity.
To learn more about this role and how you can make a difference at Prestige Healthcare Services, please apply today!
Prestige Healthcare Services is an equal opportunity employer.
At Prestige Healthcare Services, we are committed to delivering exceptional care and support to our patients and their families. Our skilled facilities offer a range of short-term and long-term skilled rehabilitation services to meet the diverse needs of our patients. We are seeking a dedicated and compassionate Case Manager to join our team.
Responsibilities:
• Develop, implement, and monitor individualized care plans in collaboration with the interdisciplinary team (nursing, therapy, social services, dietary)
• Coordinate and communicate with insurance companies and managed care organizations to obtain authorizations and manage utilization review
• Facilitate timely and safe discharge planning
• Serve as primary point of contact for residents and families regarding care plans, insurance coverage, and discharge options
• Monitor length of stay and levels of care to ensure appropriate resource utilization
• Maintain accurate and timely documentation in the electronic health record (EHR) in compliance with state and federal regulations
• Ensure compliance with CMS, state survey, and facility policies related to case management and discharge planning
• Collaborate with admissions to review referrals and support smooth transitions into the facility
What We Offer:
This is a Remote Position.
- Competitive Salary
- Medical, Dental, and Vision Insurance
- 401K Retirement Plan
- Paid Time Off (PTO) and Sick Time in accordance with VA Law
- Employee Wellness Program
- Flexible Spending Account
- Employee Assistance Program
- Daily Pay
Requirements
- LPN in the state of Virginia
- Experience in managed care/HMOS and skilled nursing admission and/or admissions coordination.
If you are a motivated and compassionate healthcare professional looking for a new challenge, we encourage you to apply for this exciting opportunity.
To learn more about this role and how you can make a difference at Prestige Healthcare Services, please apply today!
Prestige Healthcare Services is an equal opportunity employer.