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Utilization Case Manager Jobs in Meridian, ID (NOW HIRING)

Medical Case Manager I

Boise, ID ยท On-site

$62K - $93K/yr

As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful. * Strong ...

Clinical Resource Manager

Boise, ID

$61K - $85K/yr

Provides hospital case management/utilization review and discharge planningcollaboratively determining level of care needs beyond acute care, providing decision support to patients/families and ...

Clinical Resource Manager

Boise, ID ยท On-site

$61K - $85K/yr

Provides hospital case management/utilization review and discharge planningcollaboratively determining level of care needs beyond acute care, providing decision support to patients/families and ...

Clinical Resource Manager

Boise, ID ยท On-site

$61K - $85K/yr

Provides hospital case management/utilization review and discharge planning collaboratively determining level of care needs beyond acute care, providing decision support to patients/families and ...

Aldridge Pite, LLP is a multi-state law firm that focuses heavily on the utilization of technology ... bankruptcy case managers, clients, and mortgage servicers to resolve exceptions. * Develop ...

Occupational Therapist

Nampa, ID ยท On-site

$35.75 - $47.25/hr

Contribute to facility patient care, utilization review, case management, administrative staff/department head meetings, and family conference activities/communications. * Ensures punctuality and ...

Showing results 21-40

Utilization Case Manager information

See Meridian, ID salary details

$16

$35

$58

How much do utilization case manager jobs pay per hour?

As of Aug 6, 2026, the average hourly pay for utilization case manager in Meridian, ID is $35.37, according to ZipRecruiter salary data. Most workers in this role earn between $28.65 and $37.31 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 Meridian, ID look for? The top searched job categories for Utilization Case Manager jobs in Meridian, ID are:
What cities near Meridian, ID are hiring for Utilization Case Manager jobs? Cities near Meridian, ID with the most Utilization Case Manager job openings:

Medical Case Manager I

CorVel Healthcare Corporation

Boise, ID โ€ข On-site

$62K - $93K/yr

Full-time

Re-posted 22 days ago


Job description

CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in Boise, ID.

Work from home, and on the road. Monday – Friday, regular business hours.

As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and their families. Your responsibilities include working closely with injured workers to facilitate their recovery. You will work collaboratively with the patient, their family, medical providers, members of our team, and others. This is a heavy local travel role responsible for working with a caseload of workers compensation injured workers within a defined jurisdiction.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

  • Provides Medical Case Management to individuals through in person and telephonic communications with the patient, physician, other health care providers, employer and others.
  • Utilizes their medical and nursing knowledge to discuss the current treatment plan with the physician and discuss alternate treatment plans.
  • Evaluates patient’s treatment plan for appropriateness, medical necessity, and cost effectiveness.
  • Provides assessment, planning, implementation and evaluation of patient’s progress.
  • Attends doctors, other providers, home and in some cases, attorney’s visits.
  • Attends hospital and/or long-term facility discharge planning conferences, et cetera for the purpose of determining appropriateness of care and developing an effective long-term care strategy. Initial home visit for initial evaluation.
  • Implements care such as negotiation the delivery of durable medical equipment and nursing services.
  • This role requires regular travel, dependent on the injured worker’s injuries and needs. The employee must be available for local travel up to approximately 60% of the work week/month
  • This role may require overnight travel.

KNOWLEDGE & SKILLS:

  • Effective communication and multi-tasking skills in a high-volume, fast-paced, team-oriented environment.
  • Experience as a RN, Medical Case Manager is ideal, or a clinical background in orthopedics, neurology, or rehabilitation is preferred.
  • Ability to meet with the patient, their physicians, other healthcare providers, attorneys, and advisors/clients and coworkers.
  • A cost containment background, such as utilization review or managed care is helpful.
  • Strong interpersonal, time management and organizational skills.
  • Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets.
  • Ability to work both independently and within a team environment.

EDUCATION & EXPERIENCE:

  • Graduate of accredited school of nursing.
  • Current RN Licensure in state of operation.
  • Certification as a CCM, CIRS, or other Case Management certifications are preferred.
  • A valid driver’s license, reliable transportation, and ability to travel to assigned locations is required.

PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range: $62,306 – $93,123

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

About CorVel – Medical Case Managers

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. In addition, Medical Case Managers are eligible for bonus and will be provided state-of-the-art technological devices to ensure ready access to CorVel’s proprietary Case Management application, enabling staff to retrieve documents on the go and log activities as they occur.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

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