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Utilization Case Manager Jobs in Dallas, TX (NOW HIRING)

Encompass Health

Case Manager

Dallas, TX

$19.75 - $25.50/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 Certification:

Encompass Health Corporation

Case Manager

Dallas, TX · On-site

$18.50 - $23.75/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 ...

Encompass Health

Case Manager

Dallas, TX

$19.75 - $25.50/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 Certification:

Select Medical

Case Manager - PRN

Denton, TX

... utilization management criteria, and implementation of safe and appropriate discharge plans. The Case Manager assesses the psychosocial needs of the patient and provides intervention as part of the ...

Valor Healthcare, Inc.

RN Case Manager

Dallas, TX · On-site

Non-Clinical case Managers coordinate all aspects of the care of individual patients ... They ensure proper utilization of services and resources and provide assistance within, between ...

ScionHealth

Case Manager II PRN

Dallas, TX · On-site

Follows patients throughout the continuum of care and ensures optimum utilization of resources ... of functions of case management, utilization review and management, and discharge planning.

AMERICAN GI FORUM NATIONA

Case Manager-SSVF

Dallas, TX · On-site

$17.75 - $23/hr

The Case Manager will be responsible for providing a case management plan that will include the ... Utilization of general office equipment (e.g., fax, scan, etc.) * Computer literacy including ...

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Utilization Case Manager information

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$36

$59

How much do utilization case manager jobs pay per hour?

As of Sep 1, 2026, the average hourly pay for utilization case manager in Dallas, TX is $36.09, according to ZipRecruiter salary data. Most workers in this role earn between $29.23 and $38.03 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 are popular job titles related to Utilization Case Manager jobs in Dallas, TX?

For Utilization Case Manager jobs in Dallas, TX, the most frequently searched job titles are:

What job categories do people searching Utilization Case Manager jobs in Dallas, TX look for?

The top searched job categories for Utilization Case Manager jobs in Dallas, TX are:

What cities near Dallas, TX are hiring for Utilization Case Manager jobs?

Cities near Dallas, TX with the most Utilization Case Manager job openings:

Utilization Case Manager jobs near you
Infographic showing various Utilization Case Manager job openings in Dallas, TX as of August 2026, with employment types broken down into 87% Full Time, 11% Part Time, and 2% Contract. Highlights an 82% Physical, 2% Hybrid, and 16% Remote job distribution, with an average salary of $75,074 per year, or $36.1 per hour.

Medical Case Manager

Dallas, TX • On-site

AmTrust Financial Services, Inc.
Insurance Services • 5 - 10K employees
Learn more about AmTrust Financial Services, Inc.external

Full-time

Medical, Dental, Life, Retirement, PTO

Re-posted 4 days ago

Job description

Overview
AmTrust Financial Services, a fast growing commercial insurance company, has a need for a Telephonic Medical Case Manager, RN.
PRIMARY PURPOSE: To provide comprehensive quality telephonic case management to proactively drive a medically appropriate return to work through engagement with the injured employee, provider and employer. Our nurses will be empathetic informative medical resources for our injured employees and they will partner with our adjusters to develop a personalized holistic approach for each claim. These responsibilities may include utilization review, pharmacy oversight and care coordination.
This position is remote in Texas.
Responsibilities
  • Uses clinical/nursing skills to determine whether all aspects of a patient's care, at every level, are medically necessary and appropriately delivered.
  • Perform Utilization Review activities prospectively, concurrently or retrospectively in accordance with the appropriate jurisdictional guidelines.
  • Sends letters as needed to prescribing physician(s) and refers to physician advisor as necessary
  • Responsible for accurate comprehensive documentation of case management activities in case management system.
  • Uses clinical/nursing skills to help coordinate the individual's treatment program while maximizing quality and cost-effectiveness of care including direction of care to preferred provider networks where applicable.
  • Addresses need for job description and appropriately discusses with employer, injured employee and/or provider. Works with employers on modifications to job duties based on medical limitations and the employee's functional assessment.
  • Responsible for helping to ensure injured employees receive appropriate level and intensity of care through use of medical and disability duration guidelines, directly related to the compensable injury and/or assist adjusters in managing medical treatment to drive resolution.
  • Communicates effectively with claims adjuster, client, vendor, supervisor and other parties as needed to coordinate appropriate medical care and return to work.
  • Performs clinical assessment via information in medical/pharmacy reports and case files; assesses client's situation to include psychosocial needs, cultural implications and support systems in place
  • Objectively and critically assesses all information related to the current treatment plan to identify barriers, clarify or determine realistic goals and objectives, and seek potential alternatives.
  • Partners with the adjuster to develop medical resolution strategies to achieve maximal medical improvement or the appropriate outcome
  • Evaluate and update treatment and return to work plans within established protocols throughout the life of the claim.
  • Engage specialty resources as needed to achieve optimal resolution (behavioral health program, physician advisor, peer reviews, medical director).
  • Partner with adjuster to provide input on medical treatment and recovery time to assist in evaluating appropriate claim reserves
  • Maintains client's privacy and confidentiality; promotes client safety and advocacy; and adheres to ethical, legal, accreditation and regulatory standards.
  • Other duties as may be assigned.
  • Supports the organization's quality program(s).

Qualifications
Education & Licensing
  • Active unrestricted compact RN license in a state or territory of the United States required.
  • Bachelor's degree in nursing (BSN) from accredited college or university or equivalent work experience preferred.
  • Certification in case management, pharmacy, rehabilitation nursing or a related specialty is highly preferred.
  • Ability to acquire, and maintain, appropriate Professional Certifications and Licenses to comply with respective state laws may be required
  • Preferred for license(s) to be obtained within three - six months of starting the job.
  • Written and verbal fluency in Spanish and English preferred

Experience
3+ years of related experience or equivalent combination of education and experience required to include 2+ years of direct clinical care OR 2+ years of case management/utilization management required.
Skills & Knowledge:
  • Knowledge of workers' compensation laws and regulations
  • Knowledge of case management practice
  • Knowledge of the nature and extent of injuries, periods of disability, and treatment needed
  • Knowledge of URAC standards, ODG, Utilization review, state workers compensation guidelines
  • Knowledge of pharmaceuticals to treat pain, pain management process, drug rehabilitation
  • Knowledge of behavioral health
  • Excellent oral and written communication, including presentation skills
  • PC literate, including Microsoft Office products
  • Leadership/management/motivational skills
  • Analytic and interpretive skills
  • Strong organizational skills
  • Excellent interpersonal and negotiation skills
  • Ability to work in a team environment
  • Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding
Auditory/Visual: Hearing, vision and talking
The expected salary range for this role is $80,000.00-$88,000.00.
Please note that the salary information shown above is a general guideline only. Salaries are based upon a wide range of factors considered in making the compensation decision, including, but not limited to, candidate skills, experience, education and training, the scope and responsibilities of the role, as well as market and business considerations.
What We Offer
AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off.
AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities.
AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain and develop the best talent available. We see diversity as more than just policies and practices. It is an integral part of who we are as a company, how we operate and how we see our future.

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