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

Elara Caring

Care Team Supervisor

Fort Wayne, IN

$22 - $26/hr

Monitor systems to confirm authorizations align with scheduled services and Review utilization reports * Communicate professionally and effectively withcaregivers, clients, case managers, and ...

Elara Caring

Care Team Supervisor

Fort Wayne, IN

$22 - $26/hr

Monitor systems to confirm authorizations align with scheduled services and Review utilization reports * Communicate professionally and effectively withcaregivers, clients, case managers, and ...

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Utilization Case Manager information

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$59

How much do utilization case manager jobs pay per hour?

As of Aug 6, 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.

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 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

Registered Nurse Care Manager PRN

Lutheran Hospital of Indiana

Fort Wayne, IN • On-site

Part-time

Retirement

Re-posted 18 days ago

Lutheran Hospital (Fort Wayne) rating

6.5

Company rating: 6.5 out of 10

Based on 40 frontline employees who took The Breakroom Quiz

714th of 1,054 rated hospitals

Job description

Job Description

Job Summary

Job Summary

Lutheran Hospital Registered Nurse Care Manager
PRN Flat Rate
Hours: .2 FTE
Shift:  day shift 8-430p
Benefits:

  • 401(k) with matching

This position is not eligible for immigration sponsorship now or in the future. Applicants must be authorized to work in the U.S. for any employer.
 The Care Manager - RN is responsible for coordinating and overseeing discharge planning, transitions of care, and case management activities to ensure optimal patient outcomes. This role involves collaborating with interdisciplinary teams, reviewing medical records for appropriateness and medical necessity, and maintaining compliance with federal, state, and accreditation standards. To be successful in this role, at least 1-2 years experience is required, with preferred 3-5 years, to include bedside nursing and Care Management experience.
Essential Functions

  • Conducts daily reviews of medical records to assess the appropriateness of admission, continued hospital stay, and utilization of diagnostic services.
  • Collaborates with interdisciplinary teams (IDT) to ensure effective communication and coordination of patient care, including identifying avoidable days and resolving care transition issues.
  • Develops and implements discharge plans, coordinating post-hospital placement and social services to meet patient needs.
  • Refers cases to physicians or managers when patients do not meet established criteria, ensuring timely and appropriate interventions.
  • Serves as a liaison with community agencies, maintaining relationships and facilitating seamless transitions for discharged patients.
  • Facilitates interdisciplinary meetings to address patient care needs, resolve challenges, and support collaborative care planning.
  • Maintains accurate and timely documentation of case management activities, including records of referrals, patient interactions, and compliance with reporting requirements.
  • Identifies and appropriately refers cases to Child/Adult Protective Services, ensuring compliance with legal and ethical standards.
  • Provides professional assistance to patients, families, and physicians regarding discharge planning and post-hospital care options.
  • Performs other duties as assigned.
  • Maintains regular and reliable attendance.
  • Complies with all policies and standards.

Qualifications

  • Bachelor's Degree in Nursing preferred
  • 2-4 years of clinical nursing experience in a hospital, home health, or nursing home setting required
  • 2-4 years of care management experience preferred

Knowledge, Skills and Abilities

  • Strong understanding of case management principles, discharge planning, and transitions of care.
  • Knowledge of federal, state, and Joint Commission standards related to case management.
  • Excellent communication and interpersonal skills to collaborate effectively with patients, families, and interdisciplinary teams.
  • Ability to assess complex situations, identify solutions, and implement care plans efficiently.
  • Proficiency in electronic medical records (EMR) and documentation systems.
  • Strong organizational and time management skills to prioritize tasks in a dynamic environment.

Licenses and Certifications

  • RN - Registered Nurse - State Licensure and/or Compact State Licensure required
  • BCLS - Basic Life Support preferred

State Specific Requirements

  • Alabama: Accredited Case Manager (ACM) or Certified Case Manager (CCM) certification preferred.
  • New Mexico: Advanced Cardiovascular Life Support (ACLS) and Pediatric Advanced Life Support (PALS) certifications preferred.

Equal opportunity employer

What Lutheran Hospital (Fort Wayne) employees say

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About Lutheran Hospital

Sourced by ZipRecruiter

Lutheran Hospital, based in Fort Wayne, Indiana, US, operates in the healthcare industry providing wide-ranging medical services to the community. Its official website can be found at lutheranhospital.com. Lutheran Hospital has a rich legacy of addressing the region's healthcare needs since its founding. The hospital is committed to delivering quality care and services across various departments such as emergency medicine, surgical services, cardiology, oncology, orthopedics, neurosciences, and women's health. An important aspect of their mission is to enhance the health status of the people they serve, delivered in a way which upholds their values of compassion, quality, justice, stewardship, and respect.

Industry

Hospitals

Company size

5,001 - 10,000 Employees

Headquarters location

Fort Wayne, IN, US

Year founded

1903

Social media

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