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Utilization Management Nurse Jobs in Iowa (NOW HIRING)

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Utilization Management Nurse

Dubuque, IA · On-site

Utilization Management Nurse Cottingham & Butler/ SISCO 1 Positions ID: 4627707008 Posted On 07/01/2025 Refreshed On 08/15/2026 Job Overview Utilization Management Nurse Location : Onsite in Dubuque ...

Actalent

Utilization Management Nurse

Des Moines, IA · On-site

$40/hr

Utilization Management Nurse We are seeking a dedicated Utilization Management Nurse to provide timely and appropriate prior approval services to members and healthcare providers. The role involves ...

HealthCheck360

Utilization Management Nurse

Asbury, IA · On-site

Utilization Management Nurse Onsite in Dubuque, IA. Also accepting remote applicants. We are looking for a nurse just like you - a nurse that thrives in a fast-paced environment, enjoys making a ...

Access Dubuque

Utilization Management CNA

Dubuque, IA · On-site

Utilization Management CNA Cottingham & Butler/ SISCO 1 Positions ID: 4965537008 Posted On 10/24/2025 Refreshed On 07/30/2026 Job Overview Utilization Management Assistant Location : Onsite in ...

HealthCheck360

Utilization Management Assistant

Dubuque, IA · On-site

$39K - $45K/yr

Utilization Management Assistant Location : Onsite in Dubuque, IA. Also accepting remote applicants ... CNA, Medical Assistants, or individuals with a background in customer service who are looking to ...

HealthCheck360

Utilization Management Assistant

Dubuque, IA · On-site

$39K - $45K/yr

Utilization Management Assistant Location : Onsite in Dubuque, IA. Also accepting remote applicants ... CNA, Medical Assistants, or individuals with a background in customer service who are looking to ...

HealthCheck360

Utilization Management Assistant

Dubuque, IA

$39K - $45K/yr

Utilization Management Assistant Location : Onsite in Dubuque, IA. Also accepting remote applicants ... CNA, Medical Assistants, or individuals with a background in customer service who are looking to ...

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Utilization Management Nurse information

See Iowa salary details

$36.6K

$84K

$153.1K

How much do utilization management nurse jobs pay per year?

As of Aug 21, 2026, the average yearly pay for utilization management nurse in Iowa is $84,048.00, according to ZipRecruiter salary data. Most workers in this role earn between $60,600.00 and $98,200.00 per year, depending on experience, location, and employer.

What is a utilization management nurse?

A Utilization Management Nurse is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients. They review medical records and treatment plans to ensure that care meets established guidelines and is cost-effective. Utilization Management Nurses work with healthcare providers, insurance companies, and patients to coordinate care and prevent unnecessary procedures or hospitalizations. Their goal is to support high-quality patient care while managing healthcare costs.

What does a utilization management nurse do?

A utilization management nurse ensures that healthcare services are administered appropriately. Their job responsibilities include working in a hospital, health practice, or other clinical setting reviewing patient clinical records, drafting clinical appeals, and overseeing staff members. The qualifications for a utilization management nurse include a nursing degree and a registered nursing license. Most people in this job also have career experience in case management and utilization review.

What are the key skills and qualifications needed to thrive as a utilization management nurse?

To thrive as a Utilization Management Nurse, you need a registered nursing license, strong clinical judgment, and experience in case management or utilization review. Familiarity with medical management software, InterQual or Milliman guidelines, and insurance authorization processes is typically required. Excellent analytical thinking, communication, and negotiation skills help you coordinate with providers and advocate for patients. These competencies ensure appropriate resource use, compliance with regulations, and optimal patient outcomes.

What are some common challenges a utilization management nurse faces when coordinating care between providers and insurance companies?

A Utilization Management Nurse often navigates the challenge of balancing patient advocacy with insurance guidelines, ensuring that care recommendations meet both clinical standards and payer requirements. Communicating complex medical information to both providers and insurance representatives can be demanding, especially when there are disagreements about coverage or medical necessity. Additionally, staying updated on changing policies and maintaining thorough documentation under tight deadlines are frequent aspects of the role. Strong collaboration skills and attention to detail are essential for success in this position.

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

AspectUtilization Management NurseCase Manager
CredentialsRN license, certifications in utilization reviewRN license, case management certification often preferred
Work EnvironmentInsurance companies, healthcare organizations, utilization review departmentsHospitals, community health agencies, insurance companies
Primary FocusReviewing medical necessity and appropriateness of servicesCoordinating patient care and discharge planning

Utilization Management Nurses primarily focus on reviewing medical necessity and approving healthcare services, while Case Managers coordinate patient care and facilitate discharge planning. Both roles require RN licensure and work within healthcare or insurance settings, but their core responsibilities differ in scope and focus.

More about Utilization Management Nurse jobs

What are the most commonly searched types of Utilization Management Nurse jobs in Iowa?

The most popular types of Utilization Management Nurse jobs in Iowa are:

What are popular job titles related to Utilization Management Nurse jobs in Iowa?

For Utilization Management Nurse jobs in Iowa, the most frequently searched job titles are:

What job categories do people searching Utilization Management Nurse jobs in Iowa look for?

The top searched job categories for Utilization Management Nurse jobs in Iowa are:

What cities in Iowa are hiring for Utilization Management Nurse jobs?

Cities in Iowa with the most Utilization Management Nurse job openings:

What are popular job titles related to Utilization Management Nurse jobs in IA?

For Utilization Management Nurse jobs in IA, the most frequently searched job titles are:

Utilization Management Nurse jobs near you
Infographic showing various Utilization Management Nurse job openings in Iowa as of August 2026, with employment types broken down into 83% Full Time, and 17% Part Time. Highlights an 94% In-person, and 6% Remote job distribution, with an average salary of $84,048 per year, or $40.4 per hour.

Utilization Management Nurse

Cottingham & Butler

Asbury, IA • On-site

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 18 days ago

Cottingham & Butler rating

8.6

Company rating: 8.6 out of 10

Based on 15 frontline employees who took The Breakroom Quiz

90th of 311 rated insurance

Job description

Utilization Management Nurse

Des Moines, Iowa, United States

Utilization Management Nurse

Location: Onsite in Dubuque, IA. Also accepting remote applicants.

We are looking for a nurse just like you - a nurse that thrives in a fast-paced environment, enjoys making a difference for patients, and prefers working in a professional office setting with daytime office hours and weekends/holidays off.

This position is responsible for working telephonically with providers to evaluate and pre-certify requests such as hospital stays, outpatient surgeries, outpatient tests, care, etc. Review requests and match up to an evidence-based guideline to ensure proper care and ensure the right service is happening at the right time and is medically necessary. In this position you will be handling multiple provider phone calls at any given time and need to be able to handle a very fast paced environment. You will also work closely with participants for referrals to case management and condition management services according to referral criteria and health plan guidelines.

Qualified candidates will have strong multitasking skills, RN and clinical experience, preferably in ER, ICU, mental health, orthopedics, and/or pain management. Bilingual is also preferred.

Full-Time Benefits - Most benefits start day 1

  • Medical, Dental, Vision Insurance
  • Flex Spending or HSA
  • 401(k) with company match
  • Profit-Sharing/Defined Contribution (1-year waiting period)
  • PTO/Paid Holidays
  • Company-paid ST and LT Disability
  • Maternity Leave/Parental Leave
  • Subsidized Parking
  • Company-paid Term Life/Accidental Death Insurance

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