ZipRecruiter

Log In

1

Utilization Review Case Manager Jobs in Delaware

Christiana Care Health Services

$85K - $137K/yr

Reviews the admission assessment and collaborates with primary nurse and other health care ... Completes a minimum of 8 continuing education credits (CEU'S) per year in Utilization and/or Case ...

Christiana Care Health Services

$85K - $137K/yr

Reviews the admission assessment and collaborates with primary nurse and other health care ... Completes a minimum of 8 continuing education credits (CEU'S) per year in Utilization and/or Case ...

Apis Services Inc

CASE MANAGER-HOURLY

Dover, DE · On-site

$18.25/hr

Community navigation and resource utilization * Support residents in building skills necessary for ... Participate in team meetings, case reviews, and treatment planning activities. * Maintain accurate ...

Nemours

Case Management RN

Wilmington, DE · On-site

The Nurse Case Manager (NCM)/Case Management RN is responsible for the coordination of care of ... peer reviews. * Identifies patients at risk for unsafe transitions, high ED utilization, or ...

Apis Services Inc

CASE MANAGER

New Castle, DE · On-site

$18.25/hr

Case ManagerPosition Summary The Case Manager is responsible for assessing participant needs ... reviewing recovery plans in collaboration with participants, natural supports, and approved ...

next page

Showing results 1-20

All JobsUtilization Review Case JobsUtilization Review Case Manager JobsUtilization Review Case Manager Jobs in Delaware

Utilization Review Case Manager information

See Delaware salary details

$16

$36

$60

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

As of Aug 7, 2026, the average hourly pay for utilization review case manager in Delaware is $36.52, according to ZipRecruiter salary data. Most workers in this role earn between $29.62 and $38.51 per hour, depending on experience, location, and employer.

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 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 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 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 are popular job titles related to Utilization Review Case Manager jobs in Delaware? For Utilization Review Case Manager jobs in Delaware, the most frequently searched job titles are:
What job categories do people searching Utilization Review Case Manager jobs in Delaware look for? The top searched job categories for Utilization Review Case Manager jobs in Delaware are:
What cities in Delaware are hiring for Utilization Review Case Manager jobs? Cities in Delaware 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 Delaware as of August 2026, with employment types broken down into 88% Full Time, 11% Part Time, and 1% Contract. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution, with an average salary of $75,956 per year, or $36.5 per hour.

Certified Case Manager

Encompass Health

Middletown, DE

Full-time

Re-posted 28 days ago

Encompass Health rating

7.0

Company rating: 7.0 out of 10

Based on 421 frontline employees who took The Breakroom Quiz

416th of 887 rated healthcare providers

Job description

The Certified Case Manager (CCM) serves as a key member of the interdisciplinary team and actively manages and directs resource utilization to achieve the highest quality outcomes during a patient's rehabilitation experience. The CCM coordinates and advocates for the patient during their hospitalization and from admission to post discharge. As an effective communicator, the CCM manages information to effectively oversee health care delivery and facilitate interdisciplinary plan of care decisions. The CCM facilitates timely communication regarding the patient's care, establishes and monitors the discharge plan implementation while identifying and addressing patient's psychosocial and support systems issues. The CCM oversees the effective coordination of services and manages issues in the following main areas: admission and discharge, team conference and interdisciplinary plan of care communication, patient and family education, payor relations and total fiscal management. The CCM performs ongoing utilization review and acts as a liaison to the payor while assuring that cost effective treatment is provided by the team. The CCM assures that regulations regarding patient's rights are fulfilled.

The Encompass Health Way 

We proudly set the standard in care by leading with empathy, doing what's right, focusing on the positive, and standing stronger together. Encompass Health is a trusted leader in post-acute care with over 150 nationwide locations and a team of 36,000 exceptional individuals and growing! 
 
At Encompass Health, we celebrate and welcome diversity in our inclusive culture. We provide equal employment opportunities regardless of race, ethnicity, gender, sexual orientation, gender identity or expression, religion, national origin, color, creed, age, mental or physical disability, or any other protected classification. 

What Encompass Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Encompass Health logo

About Encompass Health

Sourced by ZipRecruiter

Helping patients regain hope and independence, Encompass Health is a national leader in post-acute care. We operate rehabilitation hospitals in 36 states as well as Puerto Rico. Following the Encompass Way, we are driven by our core values: We proudly set the standard, lead with empathy, do what's right, focus on the positive, and remain stronger together.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Birmingham, AL, US

View All Encompass Health Jobs

Apply