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Utilization Manager Jobs in Iowa (NOW HIRING)

Trinity Health

Case Manager RN

Des Moines, IA · On-site

Perform admission, concurrent, and post-discharge utilization reviews in accordance with the Utilization Management Plan and regulatory requirements. * Apply Milliman Care Guidelines and payer ...

Trinity Health

Case Manager RN

Des Moines, IA · On-site

Perform admission, concurrent, and post-discharge utilization reviews in accordance with the Utilization Management Plan and regulatory requirements. * Apply Milliman Care Guidelines and payer ...

Trinity Health

Case Manager RN

Des Moines, IA · On-site

Perform admission, concurrent, and post-discharge utilization reviews in accordance with the Utilization Management Plan and regulatory requirements. * Apply Milliman Care Guidelines and payer ...

Trinityhealth

Case Manager RN

Des Moines, IA · On-site

Perform admission, concurrent, and post-discharge utilization reviews in accordance with the Utilization Management Plan and regulatory requirements. * Apply Milliman Care Guidelines and payer ...

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All JobsUtilization JobsUtilization Manager JobsUtilization Manager Jobs in Iowa

Utilization Manager information

See Iowa salary details

$36.6K

$85.5K

$157.3K

How much do utilization manager jobs pay per year?

As of Sep 4, 2026, the average yearly pay for utilization manager in Iowa is $85,484.00, according to ZipRecruiter salary data. Most workers in this role earn between $55,900.00 and $102,800.00 per year, depending on experience, location, and employer.

What is a utilization manager?

A utilization manager works in the insurance industry to analyze health care needs in medical cases and determine further patient care. In this career, your job duties include conducting interviews to determine what services you register for and cutting down on unnecessary costs. You may review medical records and compile documentation to improve care and report your findings. Skills in management, customer service, and health care services are vital in this career. Job experience in nursing is a benefit when applying for utilization manager positions. Additional qualifications include a bachelor’s degree and medical case management certificate.

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

To thrive as a Utilization Manager, you need a solid background in healthcare management, case review, and knowledge of insurance regulations, often supported by a degree in nursing, healthcare administration, or a related field. Familiarity with utilization management software, electronic health records (EHRs), and certification such as Certified Case Manager (CCM) are typically required. Strong analytical thinking, communication, and negotiation skills help Utilization Managers effectively coordinate care and collaborate with providers. These skills ensure appropriate resource use, regulatory compliance, and optimal patient outcomes within healthcare organizations.

What are some common challenges faced by utilization managers, and how can they be addressed?

Utilization Managers often face challenges such as balancing cost containment with patient care quality, navigating complex insurance policies, and managing high caseloads. To address these, effective communication with healthcare providers and payers is essential, as is staying current with regulatory requirements and best practices. Building strong relationships within interdisciplinary teams and leveraging data analytics tools can also help Utilization Managers make informed decisions and improve workflow efficiency.

What is the difference between Utilization Manager vs Utilization Coordinator?

AspectUtilization ManagerUtilization Coordinator
CertificationsOften requires healthcare or case management certificationsMay have similar certifications but less emphasis on management
Work EnvironmentTypically in healthcare organizations, overseeing utilization review processesSupports daily operations, assisting with case documentation and scheduling
Employer & Industry UsageCommon in healthcare, insurance, and managed care companiesFound in similar settings, often working under Utilization Managers

In summary, a Utilization Manager generally has broader responsibilities, overseeing utilization review and resource allocation, while a Utilization Coordinator focuses on supporting daily tasks and documentation. Both roles are integral in healthcare settings but differ in scope and level of responsibility.

More about Utilization Manager jobs

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

The most popular types of Utilization jobs in Iowa are:

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

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

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

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

What cities in Iowa are hiring for Utilization Manager jobs?

Cities in Iowa with the most Utilization Manager job openings:

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

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

Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in Iowa as of August 2026, with employment types broken down into 1% As Needed, 85% Full Time, 13% Part Time, and 1% Contract. Highlights an 81% Physical, 2% Hybrid, and 17% Remote job distribution, with an average salary of $85,484 per year, or $41.1 per hour.

Case Manager RN

Trinity Health

Des Moines, IA • On-site

Full-time

Re-posted 27 days ago

Trinity Health rating

6.6

Company rating: 6.6 out of 10

Based on 354 frontline employees who took The Breakroom Quiz

572nd of 898 rated healthcare providers

Job description

Employment Type:Full timeShift:Weekend ShiftDescription:RN Case Manager (Onsite)

Shift:

Weekends

General Summary:

Responsible for the review of inpatient and outpatient admission records for appropriate admission status at Mercy Medical Center and Mercy West Lakes. Works in collaboration with the attending physician and the Case Management staff utilizing admission criteria guidelines-and second level physician review process when appropriate. Interacts with insurance providers to obtain authorization and continued stay approval for admission. Collaborates with the Verification department, Revenue cycle and Medical Eligibility to facilitate the establishment of the correct payer source for patient stay and the documentation of the interactions in the STAR admitting system

Key Responsibilities

  • Perform admission, concurrent, and post-discharge utilization reviews in accordance with the Utilization Management Plan and regulatory requirements.

  • Apply Milliman Care Guidelines and payer-specific criteria to determine appropriate patient status.

  • Collaborate with attending physicians to clarify admission status and initiate second-level physician reviews as needed.

  • Communicate status changes promptly to Case Management, Admitting, and other relevant departments.

  • Provide patient/family education and issue Notices of Status Change when required.

  • Accurately document utilization review activities, status determinations, authorizations, denials, and communications in the medical record and STAR system.

  • Submit timely clinical information to payers to prevent technical denials and support authorization and continued stay.

  • Review and route denial notifications for appeal consideration; collaborate with post-denials, RAC, and appeal teams.

  • Monitor insurance coverage and communicate updates to verification and financial teams.

  • Participate in peer-to-peer reviews and advocate for appropriate admission status and continued stay.

Qualifications

  • Current Iowa RN license.

  • Minimum of five (5) years of clinical nursing experience.

  • BSN or healthcare-related degree preferred.

  • Knowledge of insurance eligibility, CMS rules, and utilization review processes across the continuum of care.

  • Strong clinical judgment, communication, and independent decision-making skills.

  • Utilization Review certification within 12 months of hire preferred.

  • Completion of Mandatory Reporter abuse training within three (3) months of hire.

Work Environment & Physical Requirements

  • Primarily office-based with computer, phone, and documentation tasks.

  • Light physical activity with occasional lifting; use of assistive devices and additional personnel as required.

  • Visual acuity sufficient to review medical records and electronic systems.

  • Ability to work collaboratively in a fast-paced, high-stress healthcare environment while maintaining professionalism and courtesy.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

What Trinity Health employees say

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About Trinity Health

Sourced by ZipRecruiter

Trinity Health Ann Arbor is a 537 -bed teaching hospital located on 340 acre campus. Recognized by IBM Watson as a Top 100 Hospital and #1 Teaching Hospital, Trinity Health Ann Arbor has been a leading health care provider for more than 100 years. Trinity Health has received numerous local and national awards in recognition of our leadership, quality outcomes, and clinical excellence.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Livonia, MI, US

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