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

Trinity Health

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 ...

Trinityhealth

Clinical Resource Manager

Boise, ID · 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 ...

Trinity Health

Clinical Resource Manager

Boise, ID · 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

Bankruptcy Supervisor

Meridian, ID · On-site

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 ...

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Showing results 21-40

All JobsUtilization Case JobsUtilization Case Manager JobsUtilization Case Manager Jobs in Middleton, ID

Utilization Case Manager information

See Middleton, ID salary details

$15

$34

$56

How much do utilization case manager jobs pay per hour?

As of Aug 7, 2026, the average hourly pay for utilization case manager in Middleton, ID is $34.46, according to ZipRecruiter salary data. Most workers in this role earn between $27.93 and $36.35 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 Middleton, ID look for? The top searched job categories for Utilization Case Manager jobs in Middleton, ID are:
What cities near Middleton, ID are hiring for Utilization Case Manager jobs? Cities near Middleton, ID with the most Utilization Case Manager job openings:
Utilization Case Manager jobs near you
Infographic showing various Utilization Case Manager job openings in Middleton, ID as of August 2026, with employment types broken down into 86% Full Time, and 14% Contract. Highlights an 86% In-person, and 14% Remote job distribution, with an average salary of $71,681 per year, or $34.5 per hour.

Remote Case Management RN - California License

Vivo HealthStaff

Boise, ID • Remote

$43 - $48/hr

Contractor

Re-posted 20 days ago

Job description

Vivo HealthStaff is actively recruiting for a fully remote Case Manager position. This temporary 3-month contract role, with an option to extend, and focuses on health care management and coordination for members with complex and chronic care needs. Utilizing the nursing process, the Case Manager will interact effectively with members, caregivers, and interdisciplinary team participants, all while working remotely.Job Description:- Care Coordination: Serve as a remote resource for the member, their family, and their physician, ensuring access to appropriate care and facilitating referrals/authorizations.- Comprehensive Assessments: Conduct thorough remote assessments, evaluating the member's health status, resource utilization, and treatment plans.- Care Plan Implementation: Collaborate remotely with the member, PCP, and care team to implement a care plan, interfacing with various healthcare professionals.- Education and Support: Provide remote education and self-management support tailored to the member's unique learning style.- Problem Solving: Assist in resolving issues with providers, claims, or services from a remote setting.- Care Coordination Efficiency: Work closely with delegated or contracted providers to ensure effective care coordination, remotely.- Compliance: Maintain confidentiality of all PHI in compliance with state and federal law and company policy, while working remotely.Supervisory Responsibilities:- None.Minimum Requirements:Experience:- 1-3 years of clinical experience, with 2 or more years in case management.- Health Plan experience preferred.Education/Licensure:- Active, valid, and unrestricted California RN license.Other Skills:- Understanding of community resources, treatment options, home health, funding options, and special programs.- Extensive knowledge of chronic condition management.- Bilingual in Spanish preferred.- Excellent verbal and written communication skills.- Team player with effective relationship-building skills.- Ability to work independently in a remote setting.- Experience using standardized clinical guidelines.- Strong organizational skills.- Proficiency in PC-based software programs, including Word, Excel, and PowerPoint.Vivo HealthStaff is a healthcare staffing and recruitment firm based in the San Francisco Bay Area, providing permanent and temporary opportunities to organizations across the United States.
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About Vivo HealthStaff

Sourced by ZipRecruiter

Vivo HealthStaff provides permanent recruitment services for both clinical and administrative positions in the healthcare sector. Over the past 2 years, our clients have seen a 98% retention rate with Vivo HealthStaff placements.

Industry

Health care and social assistance

Company size

11 - 50 Employees

Headquarters location

Dublin, CA, US

Year founded

2016

Social media

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