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

Premera Blue Cross

Case Manager, RN

Spokane, WA · On-site

Our Case Managers are a compassionate team of clinicians who support members through a whole-person ... Engage members who are facing medical utilization disorders and build a relationship that will ...

MultiCare Health System

Dir Case Management II

Spokane, WA · On-site

$177K - $246K/yr

... utilization/resources management along the continuum of care; and facilitating the multidisciplinary case management process by coordinating the development and implementation of tools and systems ...

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Utilization Case Manager information

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$16

$36

$60

How much do utilization case manager jobs pay per hour?

As of Aug 6, 2026, the average hourly pay for utilization case manager in Spokane, WA is $36.89, according to ZipRecruiter salary data. Most workers in this role earn between $29.90 and $38.89 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 Spokane, WA? For Utilization Case Manager jobs in Spokane, WA, the most frequently searched job titles are:
What job categories do people searching Utilization Case Manager jobs in Spokane, WA look for? The top searched job categories for Utilization Case Manager jobs in Spokane, WA are:
What cities near Spokane, WA are hiring for Utilization Case Manager jobs? Cities near Spokane, WA with the most Utilization Case Manager job openings:
Utilization Case Manager jobs near you

Registered Nurse - Rehab Case Manager

Colorwave Inc

Spokane, WA • On-site

$66K - $128K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 10 days ago

Job description

Registered Nurse - Rehab Case Manager

Hospitals on Incredible Health are actively hiring and accepting applications in the Spokane, WA area for the following position: Registered Nurse - Rehab Case Manager. Nurses with experience in any of the following areas are strongly encouraged to apply: Cardiac, Clinical pathway, Navigator, Neurological patients, Orthopedic patients, Pediatric, Spine, Utilization Review, or VAD patients.

Shift(s) available: day shift

Job types available: full time, part time, and per diem

Employer features: 401(K), 403(B), Cross training, FSA, Healthgrades Specialty Excellence Award recipient, Level 2 trauma center, Life Insurance, Medical, Retirement Plan, U.S. News best hospital

Qualifications
  • RN Diploma degree or higher from an accredited school of nursing
  • Active and unencumbered Registered Nurse license in the state of Washington
Benefits
  • Healthcare coverage: Medical, Dental, Vision
  • 401K
  • Paid Time Off
  • Tuition Assistance

Salary: $66,520 to $128,750 /year

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