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Utilization Case Manager Jobs in Manchester, NH (NOW HIRING)

Business Integra LLC

RN Case Manager

Concord, NH · On-site

Strong knowledge of case management principles, discharge planning, and utilization review. * Excellent communication, organizational, and problem-solving skills. * BLS certification (required); ACLS ...

Team Select Home Care

Case Manager

Salem, NH · On-site

$20 - $25.75/hr

The Case Manager is a qualified registered nurse with the ability to provide and oversee the care ... Participates in clinical record/utilization review of medical records and quality assurance and ...

Team Select Home Care

Case Manager

Salem, NH · On-site

$20 - $25.75/hr

The Case Manager is a qualified registered nurse with the ability to provide and oversee the care ... Participates in clinical record/utilization review of medical records and quality assurance and ...

Wellspring Nurse Source

Travel RN UM

Derry, NH · On-site

Wellspring Nurse Source is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Derry, New Hampshire. & Requirements * Specialty: Utilization Review * Discipline ...

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All JobsUtilization Case JobsUtilization Case Manager JobsUtilization Case Manager Jobs in Manchester, NH

Utilization Case Manager information

See Manchester, NH salary details

$16

$36

$59

How much do utilization case manager jobs pay per hour?

As of Aug 7, 2026, the average hourly pay for utilization case manager in Manchester, NH is $36.33, according to ZipRecruiter salary data. Most workers in this role earn between $29.42 and $38.32 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 Manchester, NH? For Utilization Case Manager jobs in Manchester, NH, the most frequently searched job titles are:
What job categories do people searching Utilization Case Manager jobs in Manchester, NH look for? The top searched job categories for Utilization Case Manager jobs in Manchester, NH are:
Utilization Case Manager jobs near you
Infographic showing various Utilization Case Manager job openings in Manchester, NH as of August 2026, with employment types broken down into 82% Full Time, and 18% Contract. Highlights an 82% In-person, and 18% Remote job distribution, with an average salary of $75,563 per year, or $36.3 per hour.

RN - Case Manager - CMC - AS Utilization Management - Part Time - 8 Hour - Days

John Muir Health

Concord, NH

$89.23 - $121.58/hr

Part-time

Posted 23 days ago

John Muir Health rating

8.8

Company rating: 8.8 out of 10

Based on 25 frontline employees who took The Breakroom Quiz

26th of 1,055 rated hospitals

Job description

Job Description:The role of the inpatient case manager is one of patient advocate of appropriate utilization of resources. The inpatient case manager applies the process of assessment, planning, implementation, monitoring, evaluation and coordination of care to meet the patient's health care needs through hospitalization and transition back to the community and does this in coordination with the interdisciplinary health team.
The RN Case Manager is expected to function within the full scope of the nursing practice with specialized focus on care coordination, compliance, transition management, education, and utilization management.

Education:

  • Bachelor's Degree Accredited School of Nursing Required

Experience:

  • 3 years Nursing - Medical/Surgical Preferred or

  • 3 years Nursing - Critical Care Preferred

  • 2 years Care Coordination - Case Management Preferred or Equivalent Work Experience

Certifications/Licensures:

  • RN Registered Nursing - California Board of NursingRequired

  • BLS Basic Life Support - American Heart AssociationRequired

  • ACM Accredited Case Manager - ACMA American Case Management Association or

  • CCM Certified Case Manager - CCMC Commission for Case Manager Certification Strongly Preferred

Skills:

  • Strong written and verbal communication skills.

  • Effectively motivates teams.

  • Strong knowledge of Medicare and Medi-Cal guidelines and benefit resources as applicable to hospitalization and transition planning.

  • Working know ledge of common diagnoses and procedures and the impact this w ill have to patients/families and their ability to manage their care outside of the hospital. Specialized know ledge may be required for certain areas of practice.

  • Knowledge of individual and family development over the life span, and the influences of cultural and spiritual values in health care.

  • General knowledge of commercial coverage plans and usually covered benefits. Strong understanding of various reimbursement models and impact to care delivery, patient management and reimbursements such as ACOs, DRGs, Full Risk, etc.

  • Strong understanding of the criteria, rules and regulations around Inpatient, Observation and Outpatient levels of patient management.

  • Strong know ledge of geriatrics and the impact to health and function in the aged as w ell as a working know ledge of chronic/progressive disease states such as CHF, COPD, Diabetes and End Stage Renal Disease, etc.

  • Clear understanding of the role of the inpatient Social Worker and Palliative Care Resources.

  • Ability to plan, organize, manage time and prioritize work in collaboration with others.

  • Ability to work independently and as a part of a multidisciplinary team.

  • Effective problem solving and conflict resolution skills.

  • Ability to work respectfully and creatively with clients of diverse functional abilities, social, economic, and cultural backgrounds to support both client autonomy and client safety.

  • Leadership skills to delegate and provide direction/guidance to staff and hold others accountable.

  • Able to learn and work in a variety of computer programs, including EPIC, Allscripts, InterQual, and Microsoft Outlook.

Set Schedule: Wed-Sat

Work Shift:08.0 - 08:00 - 16:30 No Waive (United States of America)

Pay Range:

$89.23 - $121.58Hourly
Offer amounts are based on demonstrated/relevant experience and/or licensure.
Pay will be adjusted to the local market if hired outside of the Bay Area.

Note: Positions at JMH which are exempt (not eligible for overtime) under the level of Manager are listed as hourly for compensation purposes on this posting. The work shift will contain the word 'exempt' on it.
Scheduled Weekly Hours:32

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