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Utilization Case Manager Jobs in Fort Wayne, IN (NOW HIRING)

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Utilization Case Manager information

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How much do utilization case manager jobs pay per hour?

As of Sep 2, 2026, the average hourly pay for utilization case manager in Fort Wayne, IN is $36.00, according to ZipRecruiter salary data. Most workers in this role earn between $29.18 and $37.93 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.

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 Fort Wayne, IN?

For Utilization Case Manager jobs in Fort Wayne, IN, the most frequently searched job titles are:

What job categories do people searching Utilization Case Manager jobs in Fort Wayne, IN look for?

The top searched job categories for Utilization Case Manager jobs in Fort Wayne, IN are:

What cities near Fort Wayne, IN are hiring for Utilization Case Manager jobs?

Cities near Fort Wayne, IN with the most Utilization Case Manager job openings:

Utilization Case Manager jobs near you

Utilization Assistant

Maple Heights Behavioral Health

Fort Wayne, IN • On-site

Per diem

Posted 15 days ago

Job description

Overview

This is a PRN position.

PURPOSE STATEMENT: 

Provide administrative support to the Utilization department. 

Responsibilities

ESSENTIAL FUNCTIONS: 

  • Perform pre-certification and negotiate continued stay with third party payers.  
  • Gather data to support case management activities, including presentation of gathered data and case notes. 
  • Coordinate discharge planning with clinical team, maintain CRM database with discharge information and follow up. 
  • Present case information and the needs of third-party payers to (?).   
  • Assist in admissions review, concurrent reviews and discharge planning. 
  • Assist physician in peer review by serving as information resource, gather data to support review and schedule peer review.  
  • Informs management about the status of current patients; documents utilization activities as instructed. Participates in performance improvement activities.  

OTHER FUNCTIONS:  

  • Perform other functions and tasks as assigned. 
Qualifications

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS: 

  • High school diploma or equivalent required.  

LICENSES/DESIGNATIONS/CERTIFICATIONS:  

  • Current certification as Registered Addiction Specialist, certified Substance Use Counselor or similar certification preferred.  

While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances  (e.g. emergencies, changes in workload, rush jobs or technological developments) dictate. 

We are committed to providing equal  employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.

Employment Type: OTHER

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