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Utilization Case Manager Jobs in Independence, KY

Pinnacle Treatment Centers

Case Manager

Cincinnati, OH · On-site

$19.25 - $24.75/hr

Case Manager M-F 6a-2:30p and possible Saturdays 6a-10a We offer competitive salary, full benefits ... utilization of resources, service delivery, and compliance with external agencies and referral ...

Interim HealthCare

RN Case Manager

Cincinnati, OH

One (1) year of professional experience practicing as a Registered Nurse (RN) in home health or similar setting; previous case management/utilization review experience preferred. OASIS experience ...

Salo, Inc Career Site

RN Case Manager

Cincinnati, OH · On-site

... case management/utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that ...

Salo, Inc Career Site

RN Case Manager

Cincinnati, OH · On-site

... case management/utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that ...

Interim HealthCare

RN Case Manager

Cincinnati, OH · On-site

... case management/utilization review experience preferred. · OASIS experience preferred. · Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that ...

Interim HealthCare

RN Case Manager

Cincinnati, OH · On-site

... case management/utilization review experience preferred. · OASIS experience preferred. · Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that ...

UnitedHealth Group

Waiver Case Manager

Fort Wright, KY · On-site

$53K - $79K/yr

As the Wavier Case Manager, you are the key player in integrating Case Management and Social ... You are their advocate, championing their well-being while educating staff on resource utilization ...

UnitedHealth Group

Waiver Case Manager

Fort Wright, KY · On-site

$53K - $79K/yr

As the Wavier Case Manager, you are the key player in integrating Case Management and Social ... You are their advocate, championing their well-being while educating staff on resource utilization ...

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All JobsUtilization Case JobsUtilization Case Manager JobsUtilization Case Manager Jobs in Independence, KY

Utilization Case Manager information

See Independence, KY salary details

$16

$35

$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 Independence, KY is $35.92, according to ZipRecruiter salary data. Most workers in this role earn between $29.09 and $37.88 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 Independence, KY look for? The top searched job categories for Utilization Case Manager jobs in Independence, KY are:
What cities near Independence, KY are hiring for Utilization Case Manager jobs? Cities near Independence, KY with the most Utilization Case Manager job openings:
Utilization Case Manager jobs near you
Infographic showing various Utilization Case Manager job openings in Independence, KY as of June 2026, with employment types broken down into 93% Full Time, 6% Part Time, and 1% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $74,712 per year, or $35.9 per hour.

Case Manager

Pinnacle Treatment Centers OH - VI LLC

Cincinnati, OH

$19.25 - $24.75/hr

Full-time

Re-posted 4 days ago

Job description

Case Manager

M-F 6a-2:30p and possible Saturdays 6a-10a

We offer competitive salary, full benefits package, Paid Time Off, and opportunities for professional growth.

Pinnacle Treatment Centers is a growing leader in addiction treatment services. We provide care across the nation touching the lives of more than 30,000 patients daily.

Our mission is to remove all barriers to recovery and transform individuals, families, and communities with treatment that works.

Our employees believe we are creating a better world where lives and communities are made whole again, through comprehensive treatment.

As a Case Manager, you will provide quality care through developing, implementing, managing, and evaluating patient care plans. You may convey clinical information between the insurance provider and treatment team as warranted.

Benefits:

  • 18 days PTO (Paid Time Off)
  • 401k with company match
  • Company sponsored ongoing training and certification opportunities.
  • Full comprehensive benefits package including medical, dental, vision, short term disability, long term disability and accident insurance.
  • Substance Use Disorder Treatment and Recovery Loan Repayment Program (STAR LRP)
  • Discounted tuition and scholarships through Capella University.

Requirements:

  • High school diploma or equivalent.
  • Be an individual who has received training for or education in mental health or substance use disorder competencies; and who has demonstrated, prior to or within ninety days of hire the minimum competencies in basic mental health or substance use disorder and recovery skills listed in this rule. Basic competencies shall include, at a minimum, an understanding of;
    • Substance use disorder treatment and recovery including how to therapeutically engage a person in treatment and recovery;
    • Health care systems, social service systems, and the criminal justice system;
    • Psychiatric and substance use disorder symptoms and their impact on functioning and behavior;
    • Crisis response procedures and de-escalation techniques; and
    • How the individual's own behavior can impact the behavior of others.

Required supervision (OH Administrative Code – Rule 5122-29-30):

  • All case managers must be under the supervision of one of the following:
    • Psychologist
    • Board Licensed School Psychologist
    • LISW
    • LPCC
    • LIMFT
    • LICDC
    • LMFT
    • LCDC II
    • LCDC III
    • LPC
    • LSW
  • Valid/Current Driver's License
  • Ability to travel up to 15% may be required

Responsibilities:

  • Providing case management and care coordination services for patients enrolled in treatment. Responsible for coordinating continuum of care activities for assigned patients and ensuring optimum utilization of resources, service delivery, and compliance with external agencies and referral sources requirements.
  • May include activities such as coordinating patient assessments, treatment planning and crisis intervention services; providing training and facilitating linkages for the use of community resources; monitoring service delivery; obtaining or assisting patients in obtaining necessary services (e.g. financial assistance, housing assistance, food, clothing, medical services, educational services, vocational services, recreational services, etc.); assisting patients in becoming involved with self-help support groups; assisting patients in increasing social support networks with family members, friends, and/or organizations; assisting patients in performing daily living activities; and coordinating criminal justice services.
  • Conducting individual and family educational sessions and engaging in various duties related to coordinating treatment and discharge activities, as needed.
  • Coordinating, in a timely manner, issues or activities relevant to the team, and/or to the team’s relationship within the facility or treatment milieu
  • Adhering to organizational policies, procedures, performance improvement initiatives and maintains organizational and industry policies regarding confidentiality.
  • Attend team meetings and complete all training courses timely as required.
  • Other duties as assigned.


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