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Utilization Management Jobs in Delaware (NOW HIRING)

Christiana Care Health Services

$30.34 - $48.55/hr

Utilization Management - review patient status for appropriateness and anticipated payer coverage. * THE CARE MANAGEMENT MODEL: Our Care Management Triad Team Model is a collaboration between the ...

Christiana Care Health Services

$30.34 - $48.55/hr

Utilization Management - review patient status for appropriateness and anticipated payer coverage. * THE CARE MANAGEMENT MODEL: Our Care Management Triad Team Model is a collaboration between the ...

Bayhealth

Care Manager

Dover, DE · On-site

Responsibilities: 1. Applies utilization management criteria for the review process, distinguishing levels of care and interacting with Physicians, other healthcare team member, and outside agencies ...

ChristianaCare

RN Case Manager - Outpatient

Wilmington, DE · On-site

$41.28 - $66.05/hr

Registered Nurse with BSN required or relevant experience in Utilization Management or Case Management * DE RN License or Compact Licensure. * Ability to obtain a non-compact state RN Licensure as ...

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Utilization Management information

See Delaware salary details

$39K

$89.6K

$163.1K

How much do utilization management jobs pay per year?

As of May 29, 2026, the average yearly pay for utilization management in Delaware is $89,560.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,600.00 and $104,600.00 per year, depending on experience, location, and employer.

What is a Utilization Management job?

A Utilization Management (UM) job involves evaluating medical services to ensure they are necessary, cost-effective, and compliant with healthcare guidelines. Professionals in this field review patient care plans, authorize treatments, and collaborate with healthcare providers to optimize resource use. They work for insurance companies, hospitals, or healthcare organizations to balance quality care with cost control. Strong analytical skills and knowledge of medical policies are essential in this role.

What are the key skills and qualifications needed to thrive in the Utilization Management position, and why are they important?

To thrive in Utilization Management, you need a strong understanding of healthcare procedures, insurance guidelines, and case review processes, usually backed by a clinical background such as RN, LPN, or allied health certification. Familiarity with medical management software, electronic health records (EHR), and utilization review tools like InterQual or MCG is often required. Excellent analytical thinking, attention to detail, and effective communication skills greatly enhance performance in this role. These competencies enable accurate assessment of medical necessity, ensure regulatory compliance, and support efficient, collaborative workflows between providers, insurers, and patients.

What are the typical daily responsibilities of a Utilization Management professional?

As a Utilization Management professional, your day-to-day duties typically include reviewing patient admissions, authorizing ongoing treatment or procedures, assessing medical necessity, and ensuring services comply with insurance policies and industry guidelines. You will frequently collaborate with physicians, nurses, and insurance representatives to facilitate timely and appropriate care decisions while managing cost and quality. Documentation and communication play key roles as you help bridge the gap between clinical teams and payers. This role is often fast-paced, requires decisive action, and provides opportunities to have a direct impact on patient outcomes and organizational efficiency.
More about Utilization Management jobs
What are the most commonly searched types of Utilization Management jobs in Delaware? The most popular types of Utilization Management jobs in Delaware are:
What are popular job titles related to Utilization Management jobs in Delaware? For Utilization Management jobs in Delaware, the most frequently searched job titles are:
What job categories do people searching Utilization Management jobs in Delaware look for? The top searched job categories for Utilization Management jobs in Delaware are:
What cities in Delaware are hiring for Utilization Management jobs? Cities in Delaware with the most Utilization Management job openings:
Utilization Management jobs near you
Social Worker II - MSW - ED - Newark - 11p - 7:30a - $15K Sign-On Bonus

Social Worker II - MSW - ED - Newark - 11p - 7:30a - $15K Sign-On Bonus

Christiana Care Health Services

$30.34 - $48.55/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 18 days ago

ChristianaCare rating

7.8

Company rating: 7.8 out of 10

Based on 123 frontline employees who took The Breakroom Quiz

131st of 864 rated healthcare providers

Job description

Job Details

  • The successful candidate may be eligible for a $15,000 sign on bonus to be paid within first year of a two-year commitment.

    If you are an energetic, motivated, compassionate Social Worker that understands the importance of care coordination and who is seeking a work environment filled with Love and Excellence, ChristianaCare is where you want to be.

    ChristianaCare includes an extensive network of outpatient services, home health care, urgent care centers, three hospitals (over 1200 beds), a free-standing emergency department, a Level I trauma center and a Level III neonatal intensive care unit, a comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care and women's health.


    ChristianaCare Offers

  • Medical, Dental, Vision, Life Insurance, etc.
  • Two retirement planning offerings, including 403(b) with company contributions
  • Generous paid time off with annual roll-over and opportunities to cash-out
  • 12 weeks paid parental leave
  • Tuition assistance
  • Incredible Work/Life benefits including annual membership to care.com, access to backup care services for dependents through Care@Work, retirement planning services, financial coaching, fitness and wellness reimbursement, and great discounts through several vendors for hotels, rental cars, theme parks, shows, sporting events, movie tickets and much more!
  • RN Case Manager - manage patient care and drive patient progression and establish a discharge plan.
  • Social Worker - resolve psycho-social barriers and supports discharge needs.
  • Utilization Management - review patient status for appropriateness and anticipated payer coverage.

  • THE CARE MANAGEMENT MODEL:

    Our Care Management Triad Team Model is a collaboration between the following:

  • RN Case Manager - manage patient care and drive patient progression and establish a discharge plan.
  • Social Worker - resolve psycho-social barriers and supports discharge needs.
  • Utilization Management - review patient status for appropriateness and anticipated payer coverage.

  • EDUCATION AND EXPERIENCE REQUIREMENTS:

  • Master's degree in Social Work (MSW) or Master of Social Services degree (MSS) from an accredited graduate school required prior to hire date.
  • Licensed CSW or MSW as required by the state of Delaware prior to hire date.
  • Acute Care Social Work experience preferred.

  • SPECIAL REQUIREMENTS:

    CCM preferred within 18 months of eligibility.

Hourly Pay Range: $30.34 - $48.55This pay rate/range represents ChristianaCare's good faith and reasonable estimate of compensation at the time of posting. The actual salary within this range offered to a successful candidate will depend on individual factors including without limitation skills, relevant experience, and qualifications as they relate to specific job requirements.

Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.

Post End Date

May 31, 2026

EEO Posting Statement

ChristianaCare offers a competitive suite of employee benefits to maximize the wellness of you and your family, including health insurance, paid time off, retirement, an employee assistance program. To learn more about our benefits for eligible positions visithttps://careers.christianacare.org/benefits-compensation/

What ChristianaCare employees say

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About ChristianaCare

Sourced by ZipRecruiter

ChristianaCare is one of the country's most dynamic health care organizations, centered on improving health outcomes, making high-quality care more accessible and lowering health care costs. ChristianaCare includes an extensive network of outpatient services, home health care, urgent care centers, three hospitals (1,299 beds), a free-standing emergency department, a Level I trauma center and a Level III neonatal intensive care unit, a comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care and women's health. It also includes the pioneering Gene Editing Institute and was rated by IDG Computerworld as one of the nation's Best Places to Work in IT. ChristianaCare is a nonprofit teaching health system with more than 260 residents and fellows. It is continually ranked by U.S. News & World Report as a Best Hospital. With the unique CareVio data-powered care coordination service and a focus on population health and value-based care, ChristianaCare is shaping the future of health care.

Industry

Outpatient health care

Company size

10,000+ Employees

Headquarters location

Wilmington, DE, US

Year founded

1888

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