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Utilization Review Case Manager Jobs in Arizona (NOW HIRING)

Staffingine LLC

MSW Case Manager

Tuba City, AZ · On-site

$24.50 - $32/hr

The Social Worker/RN Case Manager is responsible for utilization review of patient cases in the inpatient and outpatient services departments, and review of medical necessity of referrals to ...

Azkrmc

Case Manager-ED

Kingman, AZ · On-site

$65 - $90/hr

Case Manager Position Code: CaseMgr-6027 Department: Case Management Safety Sensitive: Yes No ... Performs Utilization Review (UR) to determine medical necessity for admission, continued stay ...

Encompass Health

Case Manager

Avondale, AZ · On-site

$19.50 - $25.25/hr

Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...

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Utilization Review Case Manager information

See Arizona salary details

$15

$34

$56

How much do utilization review case manager jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for utilization review case manager in Arizona is $34.00, according to ZipRecruiter salary data. Most workers in this role earn between $27.55 and $35.87 per hour, depending on experience, location, and employer.

What is a utilization review case manager?

A Utilization Review Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical treatments and services provided to patients. They review clinical information, coordinate with providers and insurance companies, and ensure that patient care aligns with established guidelines and policies. Their goal is to optimize patient outcomes while managing healthcare costs and ensuring compliance with regulations.

What are some common challenges utilization review case managers face when coordinating care across multiple departments?

Utilization Review Case Managers often navigate complex communication between physicians, nursing staff, insurance providers, and patients to ensure appropriate care and resource use. Balancing timely authorizations with evolving patient needs and varying documentation standards can be challenging. Additionally, staying current with changing regulations and payer requirements requires ongoing learning and adaptability. Building strong collaborative relationships and maintaining clear, concise documentation are key strategies for overcoming these hurdles.

What are the key skills and qualifications needed to thrive as a utilization review case manager, and why are they important?

To thrive as a Utilization Review Case Manager, you need a clinical background such as an RN or LCSW license, strong knowledge of medical necessity criteria, and experience with case management. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of regulatory guidelines like Medicare and Medicaid are essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration between patients, providers, and payers. These skills ensure appropriate resource use, compliance with regulations, and high-quality patient care.

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

AspectUtilization Review Case ManagerUtilization Review Nurse
CredentialsTypically requires a nursing license or relevant healthcare certificationRegistered Nurse (RN) license is required
Work EnvironmentOffice-based, insurance companies, healthcare organizationsHospital, clinic, insurance review departments
Primary FocusReviewing medical necessity, coordinating care, managing casesAssessing medical records, clinical review, patient care evaluation

Both roles involve healthcare review and require nursing credentials, but the Utilization Review Case Manager often focuses on coordinating care and managing cases, while the Utilization Review Nurse emphasizes clinical assessment and review of medical records. Understanding these differences helps in choosing the right career path or job search focus.

What are popular job titles related to Utilization Review Case Manager jobs in Arizona?

For Utilization Review Case Manager jobs in Arizona, the most frequently searched job titles are:

What job categories do people searching Utilization Review Case Manager jobs in Arizona look for?

The top searched job categories for Utilization Review Case Manager jobs in Arizona are:

What cities in Arizona are hiring for Utilization Review Case Manager jobs?

Cities in Arizona with the most Utilization Review Case Manager job openings:

Utilization Review Case Manager jobs near you
Infographic showing various Utilization Review Case Manager job openings in Arizona as of August 2026, with employment types broken down into 88% Full Time, and 12% Part Time. Highlights an 94% In-person, and 6% Remote job distribution, with an average salary of $70,722 per year, or $34 per hour.

MSW Case Manager

Staffingine LLC

Tuba City, AZ • On-site

$24.50 - $32/hr

Contractor

Re-posted 19 days ago

Job description

Job Title: MSW Case Manager
Job Location: Tuba City, AZ
Job Type: Contract

Job Description:

  • The Social Worker/RN Case Manager is responsible for utilization review of patient cases in the inpatient and outpatient services departments, and review of medical necessity of referrals to specialty providers for services not normally provided within the TCRHCC facility.
  • The incumbent will work with a multidisciplinary team to promote the efficient and effective use of a variety of health care resources by focusing on the whole patient to provide a seamless continuum of care.
  • The goals are the provision of quality care, decrease the fragmentation of care, enhancement of patient self-care and quality of life, and cost containment.
  • The incumbent will work closely work with Providers, Nurses, Social Workers, Physicians, the PRC department, and all health care providers staff at TCRHCC to ensure implementation of appropriate resources in the fulfillment of utilization goals for the hospital and third-party payors.
  • The Social Worker/RN Case Manager will be responsible to the Director of Case Management/Care Coordination.