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Utilization Management Case Manager Rn Jobs in Memphis, TN

Baptist

RN-Case Manager

Southaven, MS · On-site

* Department Case Management Administration Job Summary Manages the care for a specific population ... Utilization Review * Discharge planning * Readmission Reduction Participation * Payer Communication ...

Genex

Onsite Telephonic Case Manager (RN)

Memphis, TN · On-site

Provision of comprehensive Utilization Management, incorporating the strategies of cost containment ... Must be a RN. OTHER QUALIFICATIONS: Prior Utilization Review/Case Management experience preferred.

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Utilization Management Case Manager Rn information

See Memphis, TN salary details

$18

$46

$77

How much do utilization management case manager rn jobs pay per hour?

As of Sep 15, 2026, the average hourly pay for utilization management case manager rn in Memphis, TN is $46.18, according to ZipRecruiter salary data. Most workers in this role earn between $34.33 and $55.82 per hour, depending on experience, location, and employer.

What is the difference between Utilization Management Case Manager Rn vs Utilization Review Nurse?

AspectUtilization Management Case Manager RnUtilization Review Nurse
CredentialsRN license, certification in case management (e.g., CCM)RN license, often with certification in utilization review
Work EnvironmentInsurance companies, healthcare facilities, case management teamsHospitals, insurance companies, outpatient clinics
Primary FocusCoordinating patient care, managing cases, ensuring appropriate utilizationReviewing medical necessity, approving or denying services
Common TasksAssessing patient needs, developing care plans, liaising with providersEvaluating medical records, making utilization decisions, ensuring compliance

The main difference is that the Utilization Management Case Manager Rn focuses on coordinating patient care and managing cases, while the Utilization Review Nurse primarily reviews medical records to approve or deny services. Both roles require RN licensure and related certifications, but their daily responsibilities and work environments differ slightly.

Are utilization management case managers in demand?

Utilization management case managers are in demand due to the growing need for healthcare cost control and efficient patient care coordination. Employers in healthcare organizations, insurance companies, and managed care plans seek professionals with strong clinical knowledge, certification, and experience in utilization review processes. The role offers stable employment opportunities as healthcare systems focus on cost-effective treatment management.
Infographic showing various Utilization Management Case Manager Rn job openings in Memphis, TN as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 14% Part Time, and 2% Contract. Highlights an 85% Physical, 2% Hybrid, and 13% Remote job distribution, with an average salary of $96,047 per year, or $46.2 per hour.

Director Case Management [Full Time/ Permanent]

Memphis, TN • On-site

Central Business Solutions, Inc
See more jobs at Central Business Solutions, Incexternal

Other

Re-posted 10 days ago

Job description

Director Case Management [Full Time/ Permanent]

The individual in this position has overall responsibility for hospital utilization management, transition management, and operational management of the Case Management Department in order to promote effective utilization of hospital resources, timely and accurate revenue cycle processes, denial prevention, safe and timely patient throughput, and compliance with all state and federal regulations related to case management services. This position integrates national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention; Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction; Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care; Compliance with state and federal regulatory requirements, TJC accreditation standards, and Tenet policy; and Education provided to physicians, patients, families, and caregivers.

Responsibilities

  • Manage department operations to assure effective throughput and reimbursement for services provided
  • Lead the implementation and oversight of the hospital Utilization Management Plan using data to drive hospital utilization performance improvement
  • Ensure medical necessity and revenue cycle processes are completed accurately and in compliance with CMS regulations and Tenet policy
  • Ensure timely and effective patient transition and planning to support efficient patient throughput
  • develop and provide physician education and feedback on hospital utilization
  • other duties as assigned.

Qualifications

  • Required:
    • Education: Bachelor's degree in Business, Nursing or Health Care Administration for RN or Master's in Social Work for MSW
    • Experience: 3 years of acute hospital case management or healthcare leadership experience
  • Licensure/Certification:
    • Registered Nurse or LCSW/LMSW license.
    • Must be currently licensed, certified or registered to practice profession as required by law or regulation in state of practice or policy.
    • Active RN or LCSW/LMSW license for state(s) covered.
  • Preferred:
    • Experience: 5 years of acute hospital case management leadership multi-site experience
    • Education: MSN, MBA, MSW, or MHA
    • Licensure/Certification: Accredited Case Manager (ACM)
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