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Utilization Case Manager Jobs in Kent, WA (NOW HIRING)

ScionHealth

Case Manager Part Time

Seattle, WA · On-site

$57.06 - $83.47/hr

Follows patients throughout the continuum of care and ensures optimum utilization of resources ... of functions of case management, utilization review and management, and discharge planning.

Vivian Health

RN Case Manager in Seattle, WA

Seattle, WA · On-site

RN Case Manager Liaison Nurse - Outpatient Complex Care - Seattle WA 5-8s ** CASE MANAGER LIAISON ... utilization of health care resources. Will be working closely with primary care teams and specialty ...

New

Elevance Health

Nurse Case Mgr II

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 ...

Elevance Health

Nurse Case Mgr II

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 ...

Elevance Health

Nurse Case Mgr II

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 ...

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 ...

Sound

PATH Outreach Case Manager

Tukwila, WA

$23 - $28.25/hr

The PATH Outreach Case Manager works with a variety of clients with behavioral health disorders and ... Monitors utilization of services and the success of outcome measures. * Participates in team member ...

Sound

PATH Outreach Case Manager

Tukwila, WA · On-site

$30.84 - $32.41/hr

The PATH Outreach Case Manager works with a variety of clients with behavioral health disorders and ... Monitors utilization of services and the success of outcome measures. * Participates in team member ...

Sound

PATH Outreach Case Manager

Tukwila, WA · On-site

$30.84 - $32.41/hr

The PATH Outreach Case Manager works with a variety of clients with behavioral health disorders and ... Monitors utilization of services and the success of outcome measures. * Participates in team member ...

Santaclarapostacute

Case Manager RN

Tacoma, WA · On-site

$112.50 - $137.50/hr

As a Full -Time Case Manager(RN) , you will oversee and manage the delivery of care for residents ... coordination and utilization of services to ensure the highest quality care. Your key ...

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All JobsUtilization Case JobsUtilization Case Manager JobsUtilization Case Manager Jobs in Kent, WA

Utilization Case Manager information

See Kent, WA salary details

$18

$41

$67

How much do utilization case manager jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for utilization case manager in Kent, WA is $41.19, according to ZipRecruiter salary data. Most workers in this role earn between $33.37 and $43.41 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 Kent, WA look for?

The top searched job categories for Utilization Case Manager jobs in Kent, WA are:

What cities near Kent, WA are hiring for Utilization Case Manager jobs?

Cities near Kent, WA with the most Utilization Case Manager job openings:

Utilization Case Manager jobs near you

Case Manager Part Time

ScionHealth

Seattle, WA • On-site

$57.06 - $83.47/hr

Part-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 5 days ago

Key responsibilities

  • Coordinates and facilitates the care of patients through collaboration and communication with the Interdisciplinary Care Transitions team.

  • Monitors patients' stay to ensure effective care coordination, resource utilization, and compliance with review agencies.

  • Participates in interdisciplinary rounds and conferences to review treatment goals, optimize resource use, and develop post-hospital care plans.

ScionHealth rating

5.6

Company rating: 5.6 out of 10

Based on 49 frontline employees who took The Breakroom Quiz

808th of 898 rated healthcare providers

Job description

Kindred Hospital Seattle - First Hill is an 80-bed long-term acute care hospital offering the same in depth care you would receive in a traditional hospital, but for an extended recovery period. We partner with your physician and offer 24-hour clinical care seven days a week so you can start your journey to wellness. We are located in the heart of downtown Seattle, surrounded by a number of shops and restaurants within walking distance.
Job Summary
Coordinates and facilitates the care of the patient population through effective collaboration and communication with the Interdisciplinary Care Transitions (ICT) team members. Follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies. Provides ongoing support and expertise through comprehensive assessment, care planning, plan implementation and overall evaluation of individual patient needs. Enhances the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integration of functions of case management, utilization review and management, and discharge planning.
Essential Functions
Care Coordination
  • Coordinates clinical and/or psycho-social activities with the Interdisciplinary Team and Physicians.
  • Monitors all areas of patients' stay for effective care coordination and efficient care facilitation.
  • Remains current from a knowledge base perspective regarding reimbursement modalities, community resources, case management, psychosocial and legal issues that affect patients and providers of care.
  • Appropriately refers high risk patients who would benefit from additional support.
  • Serves as a patient advocate. Enhances a collaborative relationship to maximize the patient's and family's ability to make informed decisions.
  • Demonstrates knowledge of the principles of growth and development over the life span and the skills necessary to provide age appropriate care to the patient population served.
  • Participates in interdisciplinary patient care rounds and/or conferences to review treatment goals, optimize resource utilization, provide family education and identified post hospital needs. Collaborates with clinical staff in the development and execution of the plan of care, and achievement of goals.
  • Coordinates with interdisciplinary care team, physicians, patients, families, post-acute providers, payors, and others in the planning of the patients' care throughout the care continuum.

Knowledge/Skills/Abilities/Expectations
  • Knowledge of government and non-government payor practices, regulations, standards and reimbursement.
  • Knowledge of Medicare benefits and insurance processes and contracts.
  • Knowledge of accreditation standards and compliance requirements.
  • Ability to demonstrate critical thinking, appropriate prioritization and time management skills.
  • Basic computer skills with working knowledge of Microsoft Office, word-processing and spreadsheet software.
  • Excellent interpersonal, verbal and written skills in order to communicate effectively and to obtain cooperation/collaboration from hospital leadership, as well as physicians, payors and other external customers
  • Demonstrates good interpersonal skills when working or interacting with patients, their families and other staff members.
  • Approximate percent of time required to travel, 0%
  • Must read, write and speak fluent English.
  • Must have good and regular attendance.
  • Performs other related duties as assigned.

Pay Range: $57.06-$83.47/hr.
ScionHealth has a comprehensive benefits package for benefit-eligible employees that includes Medical, Dental, Vision, 401(k), FSA/HSA, Life Insurance, Paid Time Off, and Wellness.
Qualifications
Education
  • Postsecondary (Cert/Diploma/Program Grad) from an accredited school of nursing (Required) And
  • Bachelor's Degree in nursing or social work: BSN, MSN, BSW or MSW (Preferred)

Licenses/Certifications
  • RN - Registered Nurse - State Licensure and/or Compact State Licensure in the state of practice Upon Hire (Required) Or
  • LCSW- License Clinical Social Worker LCSW or LSW Upon Hire (Required) Or
  • CSWCM - Social Work Case Manager Certification Upon Hire (Preferred)

Experience
  • 2+ years experience in healthcare setting (Required) And
  • Prior Experience in case management, utilization review, or discharge planning (Preferred)

What ScionHealth employees say

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