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Utilization Case Manager Jobs in Toronto, ON (NOW HIRING)

Tool utilization * Workflow orchestration * Multi-agent collaboration * Human-in-the-loop ... Risk management Physical AI, Robotics & Autonomous Systems Develop intelligent robotic systems ...

Senior Baan Platform Architect

Concord, ON ยท On-site

CA$110K - CA$140K/yr

Johnson Controls, a global leader in thermal management, mission-critical building systems, energy ... Monitor system health, performance, and resource utilization. * Perform routine maintenance tasks ...

You will oversee pre-sales support, including customer trial configuration, use-case guidance, and ... Establish capacity planning, utilization, workload management, resource allocation, and service ...

Senior Associate, Electrical (P.Eng)

Toronto, ON ยท On-site

CA$125K - CA$155K/yr

Job Summary The Senior Associate is responsible for managing their respective Project Design Team ... Accountable for ensuring appropriate utilization, workload planning and forecasting * Implements ...

You will oversee pre-sales support, including customer trial configuration, use-case guidance, and ... Establish capacity planning, utilization, workload management, resource allocation, and service ...

Assume incident management role (communicator, tracker, escalator, driver, etc.). * Monitor system ... Support business case development, RFI/RFP and SLAs with vendors. Job Requirements: What can you ...

New

... prevail in case of any inconsistency. Mandatory local laws shall also prevail. * Leads daily ... The company's continued success depends on the full and effective utilization of qualified ...

... prevail in case of any inconsistency. Mandatory local laws shall also prevail. * Leads daily ... The company's continued success depends on the full and effective utilization of qualified ...

Tool utilization * Workflow orchestration * Multi-agent collaboration * Human-in-the-loop ... Risk management Physical AI, Robotics & Autonomous Systems Develop intelligent robotic systems ...

Senior Clinical Analyst

Toronto, ON ยท On-site

CA$97K - CA$121K/yr

Attend program, review, utilization and/or budget meetings to identify opportunities to empower ... Document requirements in use case format and create process models, leveraging principles in human ...

Senior Clinical Analyst

Toronto, ON ยท On-site

CA$97K - CA$121K/yr

Attend program, review, utilization and/or budget meetings to identify opportunities to empower ... Document requirements in use case format and create process models, leveraging principles in human ...

Showing results 41-55

Utilization Case Manager information

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?

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 degree do I need for utilization case manager?

Utilization case managers typically need at least a bachelor's degree in healthcare, social work, nursing, or a related field. Some positions may prefer or require a master's degree or relevant certifications, such as Certified Case Manager (CCM) or Certified Professional in Healthcare Quality (CPHQ).

What are popular job titles related to Utilization Case Manager jobs in Toronto, ON?

For Utilization Case Manager jobs in Toronto, ON, the most frequently searched job titles are:

What job categories do people searching Utilization Case Manager jobs in Toronto, ON look for?

The top searched job categories for Utilization Case Manager jobs in Toronto, ON are:

Infographic showing various Utilization Case Manager job openings in Toronto, ON as of August 2026, with employment types broken down into 88% Full Time, 11% Part Time, and 1% Contract. Highlights an 80% Physical, 4% Hybrid, and 16% Remote job distribution.

Senior AI Builder and Analyst, Customer Support

Toronto, ON โ€ข On-site

CA$108K - CA$146K/yr

Full-time

Medical, Dental, Vision

Posted 9 days ago


Job description

Clio is the global leader in legal AI technology, empowering legal professionals and law firms of every size to work smarter, faster, and more securely.

We are transforming the legal experience for all by bettering the lives of legal professionals while increasing access to justice.

Summary:

We are currently seeking a Senior AI Builder & Analyst to support our Customer Support organization. This role is available to candidates in our Burnaby, Calgary, or Toronto hub locations.

What your team does:

Customer Support, spanning Core Support, Technical Escalations, and Workforce Management, makes sure our people, tools, and processes are lined up to meet our customers where they are. As Clio moves further into an AI-first operating model, this role is where that shift is built: the tools, workflows, and collaboration that let a lean team see further and move faster across every function in Support.

This is a builder's role first. You're not just analyzing how AI could help; you're the one building and honing the tools that make it real, then handing off something the team can run.

What you'll work on:
  • Designing, building, and continuously refining AI-assisted tools and workflows for Support, Technical Escalations, and Workforce Management, closing the gap between "AI could help here" and a tool the team actually uses.

  • Owning the technical build: prompt design, workflow logic, integration with our existing stack, and ongoing tuning as needs change.

  • Partnering directly with leaders across Support, TechEsc, CSOps and WFM to identify where a built tool beats a manual process, and prioritizing accordingly; identifying where AI tooling should go next.

  • Optimizing and maintaining the AI-assisted QA tooling that turns conversation and case data into clear signal on quality and DSAT drivers, working closely with the QA program owner.

  • Designing dashboards and reporting that make quality trends visible to frontline leaders, not just to Support leadership.

  • Building and automating reporting on core Support metrics (SLA, occupancy, utilization, shrinkage, repeat contact) wherever a built tool beats a manual process, translating the data into recommendations leadership can act on.

  • Partnering with People/TAcq, Finance, and Product to keep the tools you build aligned to business growth and workforce planning needs.

What you bring:
  • 4+ years of experience working in a contact center or SaaS support environment.

  • Hands-on experience building AI-assisted workflows or tools, not just using them: prompt engineering, agentic workflows, AI QA scoring, or similar.

  • Strong reporting and data visualization skills (Looker, Salesforce, or advanced Excel/Sheets); comfort with SQL or a willingness to get there fast.

  • Working knowledge of core WFM and QA metrics (SLA, AHT, shrinkage, occupancy, utilization, DSAT, repeat contact) and what actually moves them.

  • A track record of translating complex, technical work into something a non-technical stakeholder can act on.

  • A bias for action and comfort operating without a lot of structure, this role is being built as the team's scope evolves, not stepping into something fully mapped out.

Serious bonus points if you have:
  • Experience with Talkdesk, Service Cloud, or a comparable contact center platform.

  • Exposure to building or evaluating AI teammates or agentic tooling in a live operational environment.

This role is a backfill for an existing position.

What you will find here:

Compensation is one of the main components of Clio's Total Rewards Program. We have developed a series of programs and processes to ensure we are creating fair and competitive pay practices that form the foundation of our human and high-performing culture.

Some highlights of our Total Rewards program include:

  • Competitive, equitable salary with top-tier health benefits, dental, and vision insurance

  • Hybrid work environment, with expectation for local Clions (Vancouver, Calgary, Toronto, Dublin, London, New York City and Sydney) to be in office min. twice per week.

  • Flexible time off policy, with an encouraged 20 days off per year.

  • $2000 annual counseling benefit

  • RRSP matching and RESP contribution

  • Clioversary recognition program with special acknowledgement at 3, 5, 7, and 10 years

The expected salary range for this role is $108,000 to $146,200 CAD. Initial placement within the range is informed by geographic region, experience, and skillset, with room to progress as impact and tenure grow. Final offer amounts will vary based on candidate profile.

Diversity, Inclusion, Belonging and Equity (DIBE) & Accessibility

Our team shows up as their authentic selves, and are united by our mission. We are dedicated todiversity, equity and inclusion. We pride ourselves in building and fostering an environment where our teams feel included, valued, and enabled to do the best work of their careers, wherever they choose to log in from. We believe that different perspectives, skills, backgrounds, and experiences result in higher-performing teams and better innovation. We are committed to equal employment and we encourage candidates from all backgrounds to apply.

Clio provides accessibility accommodations during the recruitment process. Should you require any accommodation, please let us know and we will work with you to meet your needs.

Learn more about our culture atclio.com/careers

We're a Human and High Performing AI company, meaning we use artificial intelligence to improve all of our operations. In recruitment, AI helps us streamline the process for greater efficiency. However, we've built our systems to ensure that a human always reviews AI-generated output, and we never make automated hiring decisions.

Disclaimer: We only communicate with candidates through official @clio.com email addresses.