ZipRecruiter

Log In

1

Utilization Case Manager Jobs in Federal Way, WA

Santa Clara Post Acute

Case Manager RN

Tacoma, WA · On-site

$125K/yr

Are You Ready to Lead in Healthcare? We are currently seeking a Full-Time Case Manager (RN) to join ... coordination and utilization of services to ensure the highest quality care. Your key ...

Elevance Health

Nurse Case Mgr II (US)

Seattle, WA · On-site

$79K - $130K/yr

Assists with development of utilization/care management policies and procedures. Minimum ... Case Management experience is preferred. * Certification as a Case Manager is preferred. * Minimum ...

New

Elevance Health

Nurse Case Mgr II (US)

Seattle, WA

$79K - $130K/yr

Assists with development of utilization/care management policies and procedures. Minimum ... Case Management experience is preferred. * Certification as a Case Manager is preferred. * Minimum ...

New

next page

Showing results 1-20

All JobsUtilization Case JobsUtilization Case Manager JobsUtilization Case Manager Jobs in Federal Way, WA

Utilization Case Manager information

See Federal Way, WA salary details

$18

$40

$67

How much do utilization case manager jobs pay per hour?

As of Aug 7, 2026, the average hourly pay for utilization case manager in Federal Way, WA is $40.75, according to ZipRecruiter salary data. Most workers in this role earn between $33.03 and $42.93 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?

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 job categories do people searching Utilization Case Manager jobs in Federal Way, WA look for? The top searched job categories for Utilization Case Manager jobs in Federal Way, WA are:
What cities near Federal Way, WA are hiring for Utilization Case Manager jobs? Cities near Federal Way, WA with the most Utilization Case Manager job openings:
Utilization Case Manager jobs near you

Registered Nurse Case Manager

Healthcare Support Staffing

Tacoma, WA

Full-time

Re-posted 21 days ago

Job description

Company Description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

We are aggressively seeking a RN Case Manager for a Healthcare organization. As the Year 2016 is in full swing, this organization is very busy, and they need YOUR help.


Take advantage of flexible hours,a competitive salary, and be a RN Case Manager  with one of the fastest-growing healthcare companies in the U.S. Get in NOW, while there is still huge room for growth and career development!


This exciting opportunity will require a RN Case Manager who can provide a high level of service and attention to their members. If you are seasoned, and you meet the qualifications listed below, please send your updated resume to Alex Bennewitz for immediate consideration.


Daily Responsibilities: 


Perform onsite review of emergent/urgent and continued stay requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinations

Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings

Collaborate with various staff within provider networks and discharge planning team electronically, telephonically, or onsite to coordinate member care

Conduct discharge planning

Educate providers on utilization and medical management processes

Provide clinical knowledge and act as a clinical resource to non-clinical team staff

Enter and maintain pertinent clinical information in various medical management systems

Qualifications

Requirements:


2 years RN experience in acute care with some utilization management, prior authorization, concurrent review, and proficient with Excel

Experience using TruCare system

Strong Excel experience  background in diverse populations/environments (e.g. Critical care, ICU, cardiac, neonatal, pediatric, Case Management

Experience processing 10-15 authorizations a day

Additional Information

Interested in hearing more about this great opportunity? Please click Apply or call Alex Bennewitz  at 513-996-1192


Healthcare Support logo

About Healthcare Support

Sourced by ZipRecruiter

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Maitland, FL, US

Year founded

2003

Social media

FacebookTwitter

View All Healthcare Support Jobs

Apply