The Nurse Case Manager- Inpatient is also responsible for ensuring that the patient is placed in the appropriate level of care while monitoring the utilization of healthcare resources and discharge ...
The Nurse Case Manager- Inpatient is also responsible for ensuring that the patient is placed in the appropriate level of care while monitoring the utilization of healthcare resources and discharge ...
Case Manager II PRN Days
Arlington, 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.
Case Manager II PRN Days
Arlington, 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.
Social Worker, PATH
Dallas, TX · Remote
Knowledge of utilization/case management processes and/or health insurance related information
Social Worker, PATH
Dallas, TX · Remote
Knowledge of utilization/case management processes and/or health insurance related information
Case Manager
Fort Worth, TX · On-site
$19.25 - $24.75/hr
The Case Manager is a qualified registered nurse with the ability to provide and oversee the care ... Participates in clinical record/utilization review of medical records and quality assurance and ...
Case Manager
Fort Worth, TX · On-site
$19.25 - $24.75/hr
The Case Manager is a qualified registered nurse with the ability to provide and oversee the care ... Participates in clinical record/utilization review of medical records and quality assurance and ...
Case Manager
Fort Worth, TX · On-site
$19.25 - $24.75/hr
The Case Manager is a qualified registered nurse with the ability to provide and oversee the care ... Participates in clinical record/utilization review of medical records and quality assurance and ...
Case Manager
Fort Worth, TX · On-site
$19.25 - $24.75/hr
The Case Manager is a qualified registered nurse with the ability to provide and oversee the care ... Participates in clinical record/utilization review of medical records and quality assurance and ...
Certified Case Manager or Accredited Case Manager. Experience with Milliman Care Guidelines (MCG). Minimum of 2 years of bedside nursing experience in an acute care setting. #J-18808-Ljbffr
Certified Case Manager or Accredited Case Manager. Experience with Milliman Care Guidelines (MCG). Minimum of 2 years of bedside nursing experience in an acute care setting. #J-18808-Ljbffr
Certified Case Manager or Accredited Case Manager. Experience with Milliman Care Guidelines (MCG). Minimum of 2 years of bedside nursing experience in an acute care setting. #J-18808-Ljbffr
Certified Case Manager or Accredited Case Manager. Experience with Milliman Care Guidelines (MCG). Minimum of 2 years of bedside nursing experience in an acute care setting. #J-18808-Ljbffr
How you'll contribute A Case Manager who excels in this role: * Completes departmental orientation ... proper utilization. Why join us We believe that investing in our employees is the first step to ...
How you'll contribute A Case Manager who excels in this role: * Completes departmental orientation ... proper utilization. Why join us We believe that investing in our employees is the first step to ...
RN Case Manager - Dallas
Plano, TX · On-site
$76K - $85K/yr
... optimal utilization of our provider network. Furthermore, you will coordinate closely with ... To excel as a Full-Time RN Case Manager at Injury Management Organization, Inc., candidates must ...
RN Case Manager - Dallas
Plano, TX · On-site
$76K - $85K/yr
... optimal utilization of our provider network. Furthermore, you will coordinate closely with ... To excel as a Full-Time RN Case Manager at Injury Management Organization, Inc., candidates must ...
Case Manager (CM)
Plano, TX · On-site
How you'll contribute A Case Manager who excels in this role: * Completes departmental orientation ... proper utilization. Why join us We believe that investing in our employees is the first step to ...
Case Manager (CM)
Plano, TX · On-site
How you'll contribute A Case Manager who excels in this role: * Completes departmental orientation ... proper utilization. Why join us We believe that investing in our employees is the first step to ...
Medical Case Manager
Richardson, TX · 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 ...
New
Medical Case Manager
Richardson, TX · 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 ...
New
RN Case Manager
Plano, TX · On-site
The RN Case Manager will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization. What You Will Do ...
RN Case Manager
Plano, TX · On-site
The RN Case Manager will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization. What You Will Do ...
Registered Nurse Case Manager
Dallas, TX · On-site
The RN Case Manager will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization. What You Will Do ...
Registered Nurse Case Manager
Dallas, TX · On-site
The RN Case Manager will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization. What You Will Do ...
The RN Case Manager will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization. What You Will Do ...
The RN Case Manager will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization. What You Will Do ...
Registered Nurse Case Manager
Dallas, TX · On-site
The RN Case Manager will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization. What You Will Do ...
Registered Nurse Case Manager
Dallas, TX · On-site
The RN Case Manager will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization. What You Will Do ...
The RN Case Manager will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization. What You Will Do ...
The RN Case Manager will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization. What You Will Do ...
The RN Case Manager will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization. What You Will Do ...
The RN Case Manager will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization. What You Will Do ...
The RN Case Manager will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization. What You Will Do ...
The RN Case Manager will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization. What You Will Do ...
The RN Case Manager will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization. What You Will Do ...
The RN Case Manager will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization. What You Will Do ...
Case Manager
Mansfield, TX · On-site
$18 - $23/hr
The Case Manager works with physicians and multidisciplinary team members to develop a plan of care ... Conducts utilization reviews. * Communicates appropriate information for timely updates and ...
Case Manager
Mansfield, TX · On-site
$18 - $23/hr
The Case Manager works with physicians and multidisciplinary team members to develop a plan of care ... Conducts utilization reviews. * Communicates appropriate information for timely updates and ...
Utilization Case Manager information
See Dallas, TX salary details
$16.41 - $20.32
3% of jobs
$20.32 - $24.23
1% of jobs
$24.23 - $28.15
6% of jobs
$30.04 is the 25th percentile. Wages below this are outliers.
$28.15 - $32.06
30% of jobs
The median wage is $33.47 / hr.
$32.06 - $35.97
26% of jobs
$37.46 is the 75th percentile. Wages above this are outliers.
$35.97 - $39.89
22% of jobs
$39.89 - $43.80
3% of jobs
$43.80 - $47.71
0% of jobs
$47.71 - $51.62
5% of jobs
$51.62 - $55.54
2% of jobs
$55.54 - $59.45
1% of jobs
$16
$36
$59
How much do utilization case manager jobs pay per hour?
As of Aug 11, 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.
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?
| 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 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:
Full-time
Re-posted 7 days ago
JPS Health Network rating
7.5
Based on 44 frontline employees who took The Breakroom Quiz
234th of 887 rated healthcare providers
Job description
Who We AreJPS Health Network is a $950 million, tax-supported healthcare system in North Texas. Licensed for 582 beds, the network features over 25 locations across Tarrant County, with John Peter Smith Hospital a Level I Trauma Center, Tarrant County's only psychiatric emergency center, and the largest hospital-based family medical residency program in the nation. The health network employs more than 7,200 people.
Acclaim Multispecialty Group is the medical practice group featuring over 300 providers serving JPS Health Network. Specialties range from primary care to general surgery and trauma. The Acclaim Multispecialty Group formed around a common set of incentives and expectations supporting the operational, financial, and clinical performance
outcomes of the network. Our goal is to provide high quality, compassionate clinical care for every patient, every time.
Why JPS?We're more than a hospital. We're 7,200 of the most dedicated people you could ever meet. Our goal is to make sure the people of our community get the care they need and deserve. As community stewards, we abide by three Rules of the Road:
1. Own it. Everyone who wears the JPS badge contributes to our journey to excellence.
2. Seek joy. Every day, every shift, we celebrate our patients, smile, and emphasize positivity.
3. Don't be a jerk. Everyone is treated with courtesy and respect. Smiling, laughter, compassion - key components of our everyday experience at JPS.
When working here, you're surrounded by passion, diversity, and dedication. We look forward to meeting you!
For more information, visit www.jpshealthnet.org.
To view all job vacancies, visit www.jpshealthnet.org, www.jpshealthnet.org/careers, or www.teamacclaim.org.
Job Title:
Nurse Case Manager - Inpatient
Requisition Number:
44398
Employment Type:
Full Time
Division:
CLINICAL INTEGRATION
Compensation Type:
Hourly
Job Category:
Nursing / LVN
Hours Worked:
7:30a-4:00p (M-F)
Location:
John Peter Smith Hospital
Shift Worked:
Day
Job Description:
Description: The Nurse Case Manager - Inpatient is responsible for coordinating the care and service of assigned patients with physicians, nurses, social workers and other members of the healthcare team to facilitate the progression of care from hospital admission through discharge. The Nurse Case Manager- Inpatient is also responsible for ensuring that the patient is placed in the appropriate level of care while monitoring the utilization of healthcare resources and discharge planning to achieve the desired clinical, financial, and resource utilization outcomes.
Typical Duties:
Qualifications:
Location Address:
1500 S. Main Street
Fort Worth, Texas, 76104
United States
Acclaim Multispecialty Group is the medical practice group featuring over 300 providers serving JPS Health Network. Specialties range from primary care to general surgery and trauma. The Acclaim Multispecialty Group formed around a common set of incentives and expectations supporting the operational, financial, and clinical performance
outcomes of the network. Our goal is to provide high quality, compassionate clinical care for every patient, every time.
Why JPS?We're more than a hospital. We're 7,200 of the most dedicated people you could ever meet. Our goal is to make sure the people of our community get the care they need and deserve. As community stewards, we abide by three Rules of the Road:
1. Own it. Everyone who wears the JPS badge contributes to our journey to excellence.
2. Seek joy. Every day, every shift, we celebrate our patients, smile, and emphasize positivity.
3. Don't be a jerk. Everyone is treated with courtesy and respect. Smiling, laughter, compassion - key components of our everyday experience at JPS.
When working here, you're surrounded by passion, diversity, and dedication. We look forward to meeting you!
For more information, visit www.jpshealthnet.org.
To view all job vacancies, visit www.jpshealthnet.org, www.jpshealthnet.org/careers, or www.teamacclaim.org.
Job Title:
Nurse Case Manager - Inpatient
Requisition Number:
44398
Employment Type:
Full Time
Division:
CLINICAL INTEGRATION
Compensation Type:
Hourly
Job Category:
Nursing / LVN
Hours Worked:
7:30a-4:00p (M-F)
Location:
John Peter Smith Hospital
Shift Worked:
Day
Job Description:
Description: The Nurse Case Manager - Inpatient is responsible for coordinating the care and service of assigned patients with physicians, nurses, social workers and other members of the healthcare team to facilitate the progression of care from hospital admission through discharge. The Nurse Case Manager- Inpatient is also responsible for ensuring that the patient is placed in the appropriate level of care while monitoring the utilization of healthcare resources and discharge planning to achieve the desired clinical, financial, and resource utilization outcomes.
Typical Duties:
- Provides an assessment for all observation status patients prior to observation placement. The patient is to be assessed throughout the shift to determine discharge readiness or the need to convert to an inpatient status by using the approved medical appropriateness criteria and all third-party payer regulatory requirement.
- Performs initial status review and level of care placement on all patients in an inpatient status using approved medical appropriate criteria in addition to third-party payer regulatory requirements.
- Conducts an initial clinical assessment on assigned patients as well as discharge planning assessment prior to admission, at the time of admission, or at discharge.
- Meets directly with the patient, family, and/or representative to assess needs and develop an individualized discharge plan based on the patient's medical diagnosis, treatment plan, financial resources, and psychosocial issues, etc.
- Reassesses the discharge plan throughout the patient's hospitalization with input from the healthcare team and patient, family, and/or representative and modifying as needed.
- Collaborates with the multi-disciplinary care team to ensure all needed clinical information is provided to the appropriate entities for the assigned level of care and supports the concurrent appeal process for any reduction in level of care or denial as requested.
- Maintains active communication with the patient, family, and/or representative, physicians, nursing and other members of the multi-disciplinary care team to effect timely, appropriate patient management; documents each component of the case management process and related activities.
- Identifies appropriate services not related to admission and assists in arrangement of services on an outpatient basis.
- Leads the Unit's daily interdisciplinary rounds to ensure a comprehensive plan of care is developed, including identification of patient needs, assignment of tasks to resolve clinical issues, review of discharge barriers, and identification of discharge planning options.
- Generates referrals to the Case Management Physician Advisor according to departmental policies.
- Serves as an educational resource for physician, nursing staff and others concerning case management strategies essential in meeting the organization's quality, utilization, financial and customer satisfaction objectives.
- Performs other related job duties as assigned.
Qualifications:
-
Required Education and Experience:
- Bachelor's Degree in Nursing from an accredited college or university.
- 3-5 years of clinical experience and/or case management, utilization review, and/or discharge planning experience in an acute care setting.
- RN licensure through the Texas State Board of Nurse Examiners.
- Master's Degree in Nursing from an accredited college or university.
- ACM Certification.
Required Licensure/Certification/Specialized Training:
Preferred Education and Experience:
Preferred Licensure/Certification:
Location Address:
1500 S. Main Street
Fort Worth, Texas, 76104
United States
What JPS Health Network employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About JPS Health Network
Sourced by ZipRecruiter
Who We AreJPS Health Network is a $950 million, tax-supported healthcare system in North Texas. Licensed for 582 beds, the network features over 25 locations across Tarrant County, with John Peter Smith Hospital a Level I Trauma Center, Tarrant County's only psychiatric emergency center, and the largest hospital-based family medical residency program in the nation. The health network employs more than 7,200 people. We're more than a hospital. We're 7,200 of the most dedicated people you could ever meet. Our goal is to make sure the people of our community get the care they need and deserve. Also, to provide high quality, compassionate clinical care for every patient, every time.
Industry
Health care and social assistance
Company size
5,001 - 10,000 Employees
Headquarters location
Fort Worth, TX, US
Year founded
1877