RN Case Coordinator
Hartford, CT · On-site
... utilization management functions; develop and implement transition planning activities; utilize and document aspects of care in our case management specific computer applications; and collaborate ...
RN Case Coordinator
Hartford, CT · On-site
... utilization management functions; develop and implement transition planning activities; utilize and document aspects of care in our case management specific computer applications; and collaborate ...
RN Case Coordinator
Hartford, CT · On-site
... utilization management functions; develop and implement transition planning activities; utilize and document aspects of care in our case management specific computer applications; and collaborate ...
RN Case Coordinator
Hartford, CT · On-site
... utilization management functions; develop and implement transition planning activities; utilize and document aspects of care in our case management specific computer applications; and collaborate ...
RN Discharge Planner
Glastonbury, CT · On-site
Experience in skilled nursing facilities, clinical reimbursement, concurrent review and/or utilization management is desirable * Experience/knowledge of Medicare guidelines, InterQual and/or McKesson
RN Discharge Planner
Glastonbury, CT · On-site
Experience in skilled nursing facilities, clinical reimbursement, concurrent review and/or utilization management is desirable * Experience/knowledge of Medicare guidelines, InterQual and/or McKesson
RN Discharge Planner
Glastonbury, CT · On-site
Experience in skilled nursing facilities, clinical reimbursement, concurrent review and/or utilization management is desirable * Experience/knowledge of Medicare guidelines, InterQual and/or McKesson
RN Discharge Planner
Glastonbury, CT · On-site
Experience in skilled nursing facilities, clinical reimbursement, concurrent review and/or utilization management is desirable * Experience/knowledge of Medicare guidelines, InterQual and/or McKesson
RN Discharge Planner
Glastonbury, CT · On-site
$75 - $100/hr
Experience in skilled nursing facilities, clinical reimbursement, concurrent review and/or utilization management is desirable * Experience/knowledge of Medicare guidelines, InterQual and/or McKesson
RN Discharge Planner
Glastonbury, CT · On-site
$75 - $100/hr
Experience in skilled nursing facilities, clinical reimbursement, concurrent review and/or utilization management is desirable * Experience/knowledge of Medicare guidelines, InterQual and/or McKesson
RN Discharge Planner
Glastonbury, CT · On-site
Experience in skilled nursing facilities, clinical reimbursement, concurrent review and/or utilization management is desirable * Experience/knowledge of Medicare guidelines, InterQual and/or McKesson
RN Discharge Planner
Glastonbury, CT · On-site
Experience in skilled nursing facilities, clinical reimbursement, concurrent review and/or utilization management is desirable * Experience/knowledge of Medicare guidelines, InterQual and/or McKesson
... utilization management functions; develop and implement transition planning activities; utilize and document aspects of care in our case management specific computer applications; and collaborate ...
... utilization management functions; develop and implement transition planning activities; utilize and document aspects of care in our case management specific computer applications; and collaborate ...
... utilization management functions; develop and implement transition planning activities; utilize and document aspects of care in our case management specific computer applications; and collaborate ...
... utilization management functions; develop and implement transition planning activities; utilize and document aspects of care in our case management specific computer applications; and collaborate ...
... utilization management functions; develop and implement transition planning activities; utilize and document aspects of care in our case management specific computer applications; and collaborate ...
... utilization management functions; develop and implement transition planning activities; utilize and document aspects of care in our case management specific computer applications; and collaborate ...
... utilization management functions; develop and implement transition planning activities; utilize and document aspects of care in our case management specific computer applications; and collaborate ...
... utilization management functions; develop and implement transition planning activities; utilize and document aspects of care in our case management specific computer applications; and collaborate ...
Registered Nurse
Holyoke, MA · On-site
$45.71 - $68.56/hr
Registered Nurse In Home Health Explore opportunities with Caretenders, a part of LHC Group, a ... Adheres to and participates in the agency's utilization management model * Ability to function in ...
Registered Nurse
Holyoke, MA · On-site
$45.71 - $68.56/hr
Registered Nurse In Home Health Explore opportunities with Caretenders, a part of LHC Group, a ... Adheres to and participates in the agency's utilization management model * Ability to function in ...
Registered Nurse
Holyoke, MA · On-site
$45.71 - $68.56/hr
As the Registered Nurse in Home Health you will provide and direct provisions of nursing care to ... Adheres to and participates in the agency's utilization management model * Ability to function in ...
Registered Nurse
Holyoke, MA · On-site
$45.71 - $68.56/hr
As the Registered Nurse in Home Health you will provide and direct provisions of nursing care to ... Adheres to and participates in the agency's utilization management model * Ability to function in ...
Registered Nurse
$45.71 - $68.56/hr
As the Registered Nurse in Home Health you will provide and direct provisions of nursing care to ... Adheres to and participates in the agency's utilization management model * Ability to function in ...
Registered Nurse
$45.71 - $68.56/hr
As the Registered Nurse in Home Health you will provide and direct provisions of nursing care to ... Adheres to and participates in the agency's utilization management model * Ability to function in ...
Registered Nurse
Belchertown, MA · On-site
$45.71 - $68.56/hr
As the Registered Nurse in Home Health you will provide and direct provisions of nursing care to ... Adheres to and participates in the agency's utilization management model You'll be rewarded and ...
Registered Nurse
Belchertown, MA · On-site
$45.71 - $68.56/hr
As the Registered Nurse in Home Health you will provide and direct provisions of nursing care to ... Adheres to and participates in the agency's utilization management model You'll be rewarded and ...
Registered Nurse
Belchertown, MA · On-site
$45.71 - $68.56/hr
As the Registered Nurse in Home Health you will provide and direct provisions of nursing care to ... Adheres to and participates in the agency's utilization management model You'll be rewarded and ...
Registered Nurse
Belchertown, MA · On-site
$45.71 - $68.56/hr
As the Registered Nurse in Home Health you will provide and direct provisions of nursing care to ... Adheres to and participates in the agency's utilization management model You'll be rewarded and ...
Registered Nurse
Belchertown, MA · On-site
$45.71 - $68.56/hr
As the Registered Nurse in Home Health you will provide and direct provisions of nursing care to ... Adheres to and participates in the agency's utilization management model You'll be rewarded and ...
Registered Nurse
Belchertown, MA · On-site
$45.71 - $68.56/hr
As the Registered Nurse in Home Health you will provide and direct provisions of nursing care to ... Adheres to and participates in the agency's utilization management model You'll be rewarded and ...
Registered Nurse
Ware, MA · On-site
$45.71 - $68.56/hr
As the Registered Nurse in Home Health you will provide and direct provisions of nursing care to ... Adheres to and participates in the agency's utilization management model You'll be rewarded and ...
Registered Nurse
Ware, MA · On-site
$45.71 - $68.56/hr
As the Registered Nurse in Home Health you will provide and direct provisions of nursing care to ... Adheres to and participates in the agency's utilization management model You'll be rewarded and ...
Registered Nurse Home Health
Charlton, MA · On-site
$47.88 - $71.82/hr
Registered Nurse In Home Health Enjoy a flexible full-time weekday schedule along with ... Adheres to and participates in the agency's utilization management model You'll be rewarded and ...
New
Registered Nurse Home Health
Charlton, MA · On-site
$47.88 - $71.82/hr
Registered Nurse In Home Health Enjoy a flexible full-time weekday schedule along with ... Adheres to and participates in the agency's utilization management model You'll be rewarded and ...
New
Registered Nurse Home Health
Charlton, MA · On-site
$47.88 - $71.82/hr
Registered Nurse In Home Health Enjoy a flexible full-time weekday schedule along with ... Adheres to and participates in the agency's utilization management model You'll be rewarded and ...
New
Registered Nurse Home Health
Charlton, MA · On-site
$47.88 - $71.82/hr
Registered Nurse In Home Health Enjoy a flexible full-time weekday schedule along with ... Adheres to and participates in the agency's utilization management model You'll be rewarded and ...
New
Registered Nurse Home | , | Group
Charlton, MA · On-site
$47.88 - $71.82/hr
Registered Nurse In Home Health Enjoy a flexible full-time weekday schedule along with ... Adheres to and participates in the agency's utilization management model You'll be rewarded and ...
Registered Nurse Home | , | Group
Charlton, MA · On-site
$47.88 - $71.82/hr
Registered Nurse In Home Health Enjoy a flexible full-time weekday schedule along with ... Adheres to and participates in the agency's utilization management model You'll be rewarded and ...
Utilization Management Nurse information
See Springfield, MA salary details
$38.9K - $50.1K
15% of jobs
$50.1K - $61.3K
8% of jobs
$62.9K is the 25th percentile. Wages below this are outliers.
$61.3K - $72.6K
15% of jobs
The median wage is $79.7K / yr.
$72.6K - $83.8K
20% of jobs
$83.8K - $95K
11% of jobs
$100.6K is the 75th percentile. Wages above this are outliers.
$95K - $106.3K
13% of jobs
$106.3K - $117.5K
5% of jobs
$117.5K - $128.7K
3% of jobs
$128.7K - $140K
4% of jobs
$140K - $151.2K
3% of jobs
$151.2K - $162.4K
3% of jobs
$38.9K
$89.2K
$162.4K
How much do utilization management nurse jobs pay per year?
As of Aug 20, 2026, the average yearly pay for utilization management nurse in Springfield, MA is $89,170.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,300.00 and $104,100.00 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?
| Aspect | Utilization Management Nurse | Case Manager |
|---|---|---|
| Credentials | RN license, certifications in utilization review | RN license, case management certification often preferred |
| Work Environment | Insurance companies, healthcare organizations, utilization review departments | Hospitals, community health agencies, insurance companies |
| Primary Focus | Reviewing medical necessity and appropriateness of services | Coordinating 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 popular job titles related to Utilization Management Nurse jobs in Springfield, MA?
For Utilization Management Nurse jobs in Springfield, MA, the most frequently searched job titles are:
What job categories do people searching Utilization Management Nurse jobs in Springfield, MA look for?
The top searched job categories for Utilization Management Nurse jobs in Springfield, MA are:
What cities near Springfield, MA are hiring for Utilization Management Nurse jobs?
Cities near Springfield, MA with the most Utilization Management Nurse job openings:
Job description
Work where every moment matters.
Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network.
Hartford Hospital is one of the largest and most respected teaching hospitals New England. We are a Level 1 Trauma Center that provides cutting edge treatment to its patients. This is made possible by being home to the largest robotic surgery center in the Northeast and the Center for Education, Simulation and Innovation (CESI), one of the most-advanced medical simulation training centers in the world. When hospitals cannot provide the advanced care, expertise and new treatment options their patients require, they turn to us.
We invite you to explore the opportunities in a hospital that has the highest degree of respect for its nurses and takes great pride in the quality of care we provide and in the integrity of our institution!
The Case Coordination Department at Hartford Hospital is responsible for the assessment of patient needs for the most appropriate level of care across the continuum. Our staff consist of Registered Nurses experienced in discharge planning and case management and embrace a universal concept of patient advocacy. They are well supported by a team of administrative assistants of various roles and functions enabling a smooth and timely transition for all patients to the next level of care.
Position Summary:
The primary focus of this position is on facilitating patient throughput. As a Case Coordinator at Hartford Hospital, assigned to a select inpatient population, you will assess patients for appropriate level of care; coordinate their care and services across the care continuum; identify risk factors; facilitate involvement of support services; perform utilization management functions; develop and implement transition planning activities; utilize and document aspects of care in our case management specific computer applications; and collaborate with other health care team members on process and quality improvement initiatives. You will gain the opportunity to become a key member of a collaborative nursing team, in which patients and their care will be your first priority.
Qualifications:
• The successful candidate will possess a CT RN license
• ASN required, BSN preferred.
• Three years acute-care, and diversified clinical nursing experience, including medical/surgical nursing is required; case management, home care, and/or managed care experience strongly considered
• Excellent communication, negotiation and conflict resolution skills required.
• Knowledge of computer applications and reimbursement systems preferred.
• Certification in case management desired.
We take great care of careers.
With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge - helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.
As an Equal Opportunity Employer/Affirmative Action employer, the organization will not discriminate in its employment practices due to an applicant's race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status.
Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network.
Hartford Hospital is one of the largest and most respected teaching hospitals New England. We are a Level 1 Trauma Center that provides cutting edge treatment to its patients. This is made possible by being home to the largest robotic surgery center in the Northeast and the Center for Education, Simulation and Innovation (CESI), one of the most-advanced medical simulation training centers in the world. When hospitals cannot provide the advanced care, expertise and new treatment options their patients require, they turn to us.
We invite you to explore the opportunities in a hospital that has the highest degree of respect for its nurses and takes great pride in the quality of care we provide and in the integrity of our institution!
The Case Coordination Department at Hartford Hospital is responsible for the assessment of patient needs for the most appropriate level of care across the continuum. Our staff consist of Registered Nurses experienced in discharge planning and case management and embrace a universal concept of patient advocacy. They are well supported by a team of administrative assistants of various roles and functions enabling a smooth and timely transition for all patients to the next level of care.
Position Summary:
The primary focus of this position is on facilitating patient throughput. As a Case Coordinator at Hartford Hospital, assigned to a select inpatient population, you will assess patients for appropriate level of care; coordinate their care and services across the care continuum; identify risk factors; facilitate involvement of support services; perform utilization management functions; develop and implement transition planning activities; utilize and document aspects of care in our case management specific computer applications; and collaborate with other health care team members on process and quality improvement initiatives. You will gain the opportunity to become a key member of a collaborative nursing team, in which patients and their care will be your first priority.
Qualifications:
• The successful candidate will possess a CT RN license
• ASN required, BSN preferred.
• Three years acute-care, and diversified clinical nursing experience, including medical/surgical nursing is required; case management, home care, and/or managed care experience strongly considered
• Excellent communication, negotiation and conflict resolution skills required.
• Knowledge of computer applications and reimbursement systems preferred.
• Certification in case management desired.
We take great care of careers.
With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge - helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.
As an Equal Opportunity Employer/Affirmative Action employer, the organization will not discriminate in its employment practices due to an applicant's race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status.
About Hartford HealthCare at Home
Sourced by ZipRecruiter
Hartford HealthCare at Home, based in Wethersfield, Connecticut, US, is a premier provider in the healthcare industry, specifically in home-based care services. Their official website can be accessed at hartfordhealthcareathome.org. They offer a wide range of services including nursing, physical therapy, occupational therapy, speech therapy, social work, and home health aid. The company was established with the mission to enhance the capability of people to achieve optimal health and wellbeing through its home care services. They maintain a patient-centric approach and belief in making a real difference in people's lives. As an integral part of Hartford HealthCare, they share the vision to be “most trusted for personalized coordinated care”.
Industry
Health care and social assistance
Company size
201 - 500 Employees
Headquarters location
Wethersfield, CT, US