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Utilization Case Manager Jobs in Seattle, WA (NOW HIRING)

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Utilization Case Manager information

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$18

$41

$68

How much do utilization case manager jobs pay per hour?

As of Aug 11, 2026, the average hourly pay for utilization case manager in Seattle, WA is $41.52, according to ZipRecruiter salary data. Most workers in this role earn between $33.65 and $43.75 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 Seattle, WA? For Utilization Case Manager jobs in Seattle, WA, the most frequently searched job titles are:
What job categories do people searching Utilization Case Manager jobs in Seattle, WA look for? The top searched job categories for Utilization Case Manager jobs in Seattle, WA are:
What cities near Seattle, WA are hiring for Utilization Case Manager jobs? Cities near Seattle, WA with the most Utilization Case Manager job openings:
Infographic showing various Utilization Case Manager job openings in Seattle, WA as of August 2026, with employment types broken down into 67% Full Time, and 33% Part Time. Highlights an 100% In-person job distribution, with an average salary of $86,366 per year, or $41.5 per hour.

Manager Care Management Social Work

Ambition 24Hours Inc

Everett, WA โ€ข On-site

$113K - $178K/yr

Full-time

Re-posted 20 days ago


Job description

Manager Care Management – Social Work

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Location: Everett, Washington
Setting: Acute Care Hospital
Schedule: Full Time
Estimated Salary Range: $113,000 – $178,630 annually
Relocation Assistance: Available
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Job Overview
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We are seeking an experienced Manager Care Management – Social Work to lead care management operations within a large acute care hospital setting in Everett, Washington. This leadership role is responsible for overseeing daily operations related to care coordination, case management, discharge planning, utilization management, and social work services.

The Manager will collaborate closely with physicians, hospital leadership, interdisciplinary healthcare teams, patients, families, and community agencies to ensure high-quality patient care, effective discharge planning, and operational efficiency. This role requires strong leadership, clinical expertise, and experience managing complex case management programs within a hospital environment.

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Key Responsibilities
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Oversee daily operations of the Care Management Department
Lead teams responsible for case management, discharge planning, and social work services
Develop and implement clinical standards, workflows, and quality improvement initiatives
Collaborate with physicians, nursing leadership, and interdisciplinary teams
Ensure effective utilization management and care coordination practices
Support patient transitions of care and discharge planning processes
Maintain compliance with regulatory, accreditation, and organizational standards
Supervise staff performance, development, scheduling, and operational goals
Serve as liaison between patients, families, healthcare teams, and community resources

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Requirements
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Master’s Degree in Social Work from an accredited program required
Active Washington Clinical Independent Social Worker License required
Minimum 6 years of case management experience in an acute care setting required
Minimum 2 years of managerial or director-level leadership experience required
Large hospital experience strongly preferred
Strong knowledge of care coordination, utilization management, and discharge planning
Excellent leadership, communication, and organizational skills
Ability to manage complex operations within a fast-paced healthcare environment