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Utilization Case Manager Jobs in Goodyear, AZ (NOW HIRING)

The Case Manager - Early Childhood will receive specific training as it pertains to the birth to five demographic, including the utilization of developmental screeners, parent-child observational ...

SMI Case Manager EMPACT

Maricopa, AZ · On-site

$19.50 - $25.25/hr

We are looking for candidates to join our team as Case Manager at our City of Maricopa location ... Utilization Review. * Perform additional related duties as assigned by Director. What you'll ...

Showing results 21-40

Utilization Case Manager information

See Goodyear, AZ salary details

$16

$35

$58

How much do utilization case manager jobs pay per hour?

As of Aug 23, 2026, the average hourly pay for utilization case manager in Goodyear, AZ is $35.65, according to ZipRecruiter salary data. Most workers in this role earn between $28.89 and $37.60 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 job categories do people searching Utilization Case Manager jobs in Goodyear, AZ look for?

The top searched job categories for Utilization Case Manager jobs in Goodyear, AZ are:

What cities near Goodyear, AZ are hiring for Utilization Case Manager jobs?

Cities near Goodyear, AZ with the most Utilization Case Manager job openings:

$27/hr

Full-time

Re-posted 25 days ago


Job description

Now Hiring: Behavioral Health Case Manager

Are you a dedicated professional who thrives on connecting patients with resources, supporting treatment goals, and empowering individuals through recovery? Join our growing behavioral health team and make a lasting impact on the lives of our patients and their families.

Position Summary:

This position directly supports the Social Worker (SW) team members. The Case Manager is an active member of a patient’s treatment team and is responsible for assisting Social Workers with discharge planning, treatment team meetings, coordination of care with outpatient care providers, and EMR documentation.

ESSENTIAL FUNCTIONS:
  • Orients patients and families to the facility, services, service limitations, and rights of patients (Patient Rights).
  • Involves patients (and families) in treatment planning by identifying measurable goals.
  • Monitoring of treatment plan with the patient(s) throughout their residency.
  • Attends scheduled treatment team meetings and identifies and interprets psychosocial needs of residents for inclusion in the treatment plan.
  • Completes mandatory documentation within timelines established by applicable regulations. Mediates issues that arise among patients, families, and staff.
  • Provides linkage with appropriate community resources by maintaining knowledge of other systems, making referrals, and identifying unmet needs (e.g., transportation, outpatient treatment referrals, etc.)
  • Provides patients with crisis management services.
  • Develops a comprehensive discharge plan beginning upon admission in collaboration with patients, patient’s families, multidisciplinary staff, referral agencies, and outpatient services.
  • Visibility and accessibility on assigned units while maintaining appropriate boundaries.
  • Conform with and abide by all regulations, policies, work procedures and instructions.

COMPETENCIES:

  • Effective oral and written communication.
  • Ability to problem solve, utilizing good judgement.
  • Ability to adhere to safety policies and procedures.
  • Ability to recognize the importance of adapting to the carious patient age groups (adolescents and adults).
  • Utilize theoretical concepts to guide the effective practice within specific standards of care for adolescent and adult age groups.
  • Ability to understand and comply with government regulations, regulatory standards, and hospital policies.
  • Ability to initiate action, take personal responsibility, suggest improvements, and solve problems within the scope of job.
  • Customer/client focused.
  • Effective Human Relations skills.
  • Knowledge of all code procedures.

WORK ENVIRONMENT:

This job operates in a clinical setting. This role routinely requires interaction with patients, documentation, and utilization of standard office equipment. This role routinely utilizes de-escalation techniques to address patients that are engaged in aggressive behavior or acting out. Ability to exercise self-control in potentially volatile situations such as being verbally or physically confronted in a threatening or aggressive manner; must be able to work and concentrate amidst distractions such as noise, conversation, and foot traffic; ability to handle interruptions often and be able to move from one task to another; must be flexible and not easily frustrated in dealing with differences of opinions.

PHYSICAL DEMANDS:

Ability to stoop, kneel, crouch, crawl, reach, stand, walk, push, pull, lift, grasp, and be able to perceive the attributes of objects such as size, shape, temperature, and/or texture by touching with skin, particularly that of the fingertips. Ability to express and exchange ideas via spoken work during activities in which they must convey detail or important spoken instructions to others accurately, sometimes quickly and loudly. Ability to express and exchange ideas via written assignments effectively and accurately. Hearing to perceive the nature of sound with no less than 40 db loss @ Hz, 1000 Hz, and 2000 Hz with or without correction; ability to perceive detailed information through oral communication and to make fine discriminations in sound. Performs repetitive motions with wrists, hands, and fingers.

REQUIRED EDUCATION / EXPERIENCE:

  • Bachelor’s degree in Social Work or related field.
  • CPR/BLS certification
  • CPI required prior to patient interaction.
  • Two years of behavioral health experience preferred.