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

AgeSpan

Protective Services Case Worker

Lawrence, MA · On-site

$33 - $34/hr

Liaison and clinical consultation with case management staff when appropriate. * Assist with community education efforts as assigned by Protective Services Supervisor. * Utilization of court system ...

AgeSpan

Protective Services Case Worker

Lawrence, MA · Hybrid

$33 - $34/hr

Liaison and clinical consultation with case management staff when appropriate. * Assist with community education efforts as assigned by Protective Services Supervisor. * Utilization of court system ...

GLC On-The-Go

Travel RN UM

Derry, NH · On-site

$2.2K - $2.3K/wk

GLC On-The-Go is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Derry, New Hampshire. & Requirements * Specialty: Utilization Review * Discipline: RN * Start ...

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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.

Director Inpatient Care Management

Concord Hospital

Concord, NH • On-site

Full-time

Posted 27 days ago

Concord Hospital Health System rating

7.2

Company rating: 7.2 out of 10

Based on 70 frontline employees who took The Breakroom Quiz

347th of 887 rated healthcare providers

Job description

Summary
The Director Inpatient Care Management provides strategic and operational leadership for care management, utilization management, discharge planning, transitions of care for the acute care setting, and population health initiatives across a three-hospital health system. This leader is responsible for ensuring regulatory compliance, optimizing resource utilization, improving patient outcomes, reducing avoidable readmissions, and supporting financial performance through effective utilization review and care coordination practices.
The Director collaborates closely with executive leadership, physicians, nursing leaders, case managers, social workers, revenue cycle teams, and community partners to ensure patients receive the right care, in the right setting, at the right time.
Education
Bachelor's degree in nursing AND a master's degree in a health-related/science field.
Certification, Registration, and Licensure
New Hampshire Registered (RN) License
Certified Case Manager (CCM), Accredited Case Manager (ACM), or related certification strongly preferred.
Experience
  • Minimum of 7-10 years of progressive leadership experience in Care Management, Case Management, Utilization Review, or Population Health.
  • Minimum of 5 years of management experience within a hospital or integrated health system.
  • Experience overseeing multi-site or multi-hospital operations preferred.

Responsibilities
  • Demonstrated success and process improvement in utilization management, denial prevention, throughput improvement, and care transition initiatives
  • Develop and implement a system-wide vision, strategy, and operational plan for Care Management and Utilization Review.
  • Standardize care management and utilization review processes across all hospitals and care settings.
  • Lead initiatives that improve quality outcomes, patient experience, throughput, length of stay, and cost-effective care delivery.
  • Support organizational goals related to value-based care, population health, and regulatory compliance.
  • Direct inpatient and outpatient care management services, including case management, social work, discharge planning, and care coordination.
  • Ensure timely and effective patient assessments, care planning, and transition-of-care activities.
  • Promote interdisciplinary collaboration to address clinical, psychosocial, and financial barriers to care.
  • Develop programs that reduce readmissions and improve post-acute care transitions.
  • Oversee utilization review processes to ensure appropriate level of care determinations and compliance with payer requirements.
  • Monitor medical necessity reviews and authorization processes.
  • Collaborate with physicians and clinical documentation teams to support accurate patient status determinations.
  • Lead denial prevention and appeals strategies to minimize revenue loss and improve reimbursement.
  • Analyze utilization and length-of-stay data to identify opportunities for improvement.
  • Ensure compliance with CMS Conditions of Participation, Joint Commission standards, state regulations, and payer requirements.
  • Maintain readiness for regulatory surveys, audits, and accreditation reviews.
  • Leadership and staff development.

Concord Hospital is an Equal Employment Opportunity employer. It is our policy to provide equal opportunity to all employees and applicants and to prohibit any discrimination because of race, color, religion, sex, sexual orientation, gender, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status.
Know Your Rights: Workplace Discrimination is Illegal
Applicants to and employees of this company are protected under federal law from discrimination on several bases. Follow the link above to find out more.
If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, you may contact Human Resources at 603-230-7269.
Physical and Work Requirements
The physical demands and characteristics of the work environment described here are representative of those that will be encountered by an employee to successfully perform the essential functions of this job.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The Dictionary of Occupational Titles Material Handling Classification is MEDIUM. The employee must
regularly lift, carry or push/pull up to 10 pounds, frequently lift, carry or push/pull up to 10 - 25 pounds, and occasionally lift, carry or push/pull up to 20 - 50 pounds.
While performing the duties of this Job, the employee is regularly required to do fine motor, hear, speak,
and walk. The employee is frequently required to bend, reach, sit, squat, and stand. The employee is
occasionally required to climb, do repetitive motion, kneel, and smell.
Specific vision abilities required by this job include color vision, depth perception, far vision, near vision,
and peripheral vision.
The employee is frequently exposed to airborne pathogens, blood borne pathogens, and bodily fluids. The employee is occasionally exposed to airborne contaminants, chemotherapeutic agents, electrical hazards - shock, moving mechanical parts, non-weather related heat or cold, slippery surfaces, and toxic or caustic chemicals.
The noise level in the work environment is usually moderate.

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