Case Manager - Care Management
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
Ridgefield, WA · On-site
$54.37/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
Ridgefield, WA · On-site
$54.37/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
Ridgefield, WA · On-site
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
Ridgefield, WA · On-site
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
Portland, OR · On-site
$54.37/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
Portland, OR · On-site
$54.37/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
Gresham, OR · On-site
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
Gresham, OR · On-site
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
Portland, OR · On-site
$54.37/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
Portland, OR · On-site
$54.37/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
Gresham, OR · On-site
$54.37/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
Gresham, OR · On-site
$54.37/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
RN Case Manager
$71K - $89K/yr
Medical
Dental
Vision
Life
Retirement
PTO
... performing Utilization Review and Service Authorizations for members of all books of business ... Certification in case management (CCMC) required or ability to obtain within 24 months of hire.
RN Case Manager
$71K - $89K/yr
Medical
Dental
Vision
Life
Retirement
PTO
... performing Utilization Review and Service Authorizations for members of all books of business ... Certification in case management (CCMC) required or ability to obtain within 24 months of hire.
Case Manager - Care Management
Portland, OR · On-site
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
Portland, OR · On-site
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
Portland, OR · On-site
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
Portland, OR · On-site
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
Portland, OR · On-site
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
Portland, OR · On-site
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
RN, Care Management
Portland, OR · On-site
Medical
Life
Retirement
PTO
Intensity of service is dependent on individual patient needs as assessed by the case manager. RN case managers practice robust utilization and resource management. RN case managers also frequently ...
RN, Care Management
Portland, OR · On-site
Medical
Life
Retirement
PTO
Intensity of service is dependent on individual patient needs as assessed by the case manager. RN case managers practice robust utilization and resource management. RN case managers also frequently ...
Case Manager - Care Management
Gresham, OR · On-site
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
Gresham, OR · On-site
$54.37 - $81.21/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
Gresham, OR · On-site
$54.37/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
Case Manager - Care Management
Gresham, OR · On-site
$54.37/hr
... utilization management and resource management. * Working knowledge of Care Management models across the continuum. Knowledge/Skills: * Knowledge of six core components of case management:
RN Case Manager - Oncology - On-Call
Portland, OR · On-site
Medical
Vision
Communicate data on population case managed, utilization and outcomes. Education of staff/clinicians. Development and distribution of education, tools and materials for member coordination.
RN Case Manager - Oncology - On-Call
Portland, OR · On-site
Medical
Vision
Communicate data on population case managed, utilization and outcomes. Education of staff/clinicians. Development and distribution of education, tools and materials for member coordination.
Utilization Case Manager information
See Portland, OR salary details
$17.59 - $21.78
3% of jobs
$21.78 - $25.98
1% of jobs
$25.98 - $30.17
6% of jobs
$32.20 is the 25th percentile. Wages below this are outliers.
$30.17 - $34.37
30% of jobs
The median wage is $35.88 / hr.
$34.37 - $38.56
26% of jobs
$40.16 is the 75th percentile. Wages above this are outliers.
$38.56 - $42.76
22% of jobs
$42.76 - $46.95
3% of jobs
$46.95 - $51.15
0% of jobs
$51.15 - $55.34
5% of jobs
$55.34 - $59.54
2% of jobs
$59.54 - $63.73
1% of jobs
$17
$38
$63
How much do utilization case manager jobs pay per hour?
As of Aug 17, 2026, the average hourly pay for utilization case manager in Portland, OR is $38.69, according to ZipRecruiter salary data. Most workers in this role earn between $31.35 and $40.77 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?
| Aspect | Utilization Case Manager | Utilization Review Nurse |
|---|---|---|
| Credentials | RN license, case management certification | RN license, certification in utilization review |
| Work Environment | Case management teams, hospitals, insurance companies | Utilization review departments, hospitals, insurance providers |
| Primary Focus | Coordinating patient care, discharge planning, resource allocation | Assessing medical necessity, reviewing patient records for appropriateness |
| Common Usage | Broader case management roles, patient advocacy | Specific 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 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 popular job titles related to Utilization Case Manager jobs in Portland, OR?
For Utilization Case Manager jobs in Portland, OR, the most frequently searched job titles are:
What job categories do people searching Utilization Case Manager jobs in Portland, OR look for?
The top searched job categories for Utilization Case Manager jobs in Portland, OR are:
What cities near Portland, OR are hiring for Utilization Case Manager jobs?
Cities near Portland, OR with the most Utilization Case Manager job openings:
$54.37 - $81.21/hr
Full-time
Re-posted 11 days ago
Job description
Overview
You are the voice, the coordinator and the empathetic advocate of patients facing difficult situations. Your compassion for patients and families with acute and chronic health conditions knows no limits. You are committed to working with healthcare teams to ensure every patient receives the care, comfort and dignity they deserve. If this is how you define your role as a Case Manager, we invite you to consider this opportunity.
Responsibilities- Coordinates and facilitates interdisciplinary provision of comprehensive, patient-centered, quality health care throughout the continuum for patients with acute and chronic health conditions.Â
- Fosters achievement of optimal health care outcomes within accepted standards of care. Â
- Serves as an expert resource to the healthcare team regarding the continuum of care, efficient use of resources, Best Practice protocols, team-based care, quality indicators and improvements, and regulatory requirements.Â
- Ensures a smooth transition of care between multiple health care environments with planned handoffs.Â
- Partners with patients and families in identifying health care issues and barriers to self-care in order to set priorities and engage in appropriate interventions.Â
- Demonstrates cultural agility and employs health literacy guidelines to provide education regarding self-management strategies. Â
- Utilizes rapid quality improvement cycles to continuously monitor, evaluate, measure, and report progress of interventions and outcomes.Â
- Paces the case to assure appropriate and fiscally sound care coordination across the continuum.
Education:
- Academic degree in nursing (BSN or higher) preferred.
Experience:
- This position requires extensive knowledge of disease management to include diagnostics, treatment and prognosis, community resources and healthcare reimbursement. Minimum 2 years clinical nursing experience required. Relevant experience in one or more of the following healthcare areas preferred:
- Coordination of community resources
- Care management of diverse patient populations
- Ambulatory Care
- Knowledge of levels of care throughout the health care continuum to include; inpatient, emergency care, rehab, home health, hospice, long term acute care, SNF, ICF, ALF with an overall understanding of utilization management and resource management.
- Working knowledge of Care Management models across the continuum.
Knowledge/Skills:
- Knowledge of six core components of case management:
- Psychosocial aspects
- Healthcare reimbursement
- Rehabilitation
- Healthcare management and delivery
- Principles of practice i.e. CMS guidelines, Interqual criteria
- Case Management concepts
- Excellent organizational skills
- Health literate oral and written communication skills for effective interaction with all members of the patient's health care team
- Knowledge of transitional planning to and from all venues
- Ability to determine and access appropriate community resources
- Ability to engage patient/family in discussion of health care goals and decisions with attention to cultural and health literacy implications
- Ability to adhere to and implement regulations in an effective manner. Must serve as a resource to all team members regarding regulatory issues.
- Keyboard skills and ability to navigate electronic systems applicable to job functions.
- Current applicable state RN licensure.Â
- Case management certification preferred.Â
- BLS for Healthcare Providers from the American Heart Association required for all employees who perform this job in the state of Oregon.
Our Legacy is good for health for Our People, Our Patients, Our Communities, Our World. Above all, we will do the right thing.
If you are passionate about our mission and believe you can contribute to our team, we encourage you to apply-even if you don't meet every qualification listed. We are committed to fostering an inclusive environment where everyone can grow and succeed.
Legacy Health is an equal opportunity employer and prohibits unlawful discrimination and harassment of any type and affords equal employment opportunities to employees and applicants without regard to race, color, religion or creed, citizenship status, sex, sexual orientation, gender identity, pregnancy, age, national origin, disability status, genetic information, veteran status, or any other characteristic protected by law.
To learn more about our employee benefits click here: www.legacyhealth.org/For-Health-Professionals/careers/benefiting-you
Employment Type: FULL_TIME
About Legacy Healing Center
Sourced by ZipRecruiter
Industry
Offices of mental health practitioners
Company size
1 - 10 Employees
Headquarters location
Margate, FL, US
Year founded
2017