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Utilization Review Case Manager Jobs in Delaware

CASE MANAGER-HOURLY

Dover, DE ยท On-site

$18.25/hr

Participate in team meetings, treatment planning discussions, and case reviews. * Communicate ... One (1) year of case management experience. * Experience working with individuals experiencing ...

CASE MANAGER-HOURLY

DE ยท On-site

$18.25/hr

Participate in team meetings, treatment planning discussions, and case reviews. * Communicate ... One (1) year of case management experience. * Experience working with individuals experiencing ...

CASE MANAGER-HOURLY

New Castle, DE ยท On-site

$18.25/hr

Participate in team meetings, treatment planning discussions, and case reviews. * Communicate ... One (1) year of case management experience. * Experience working with individuals experiencing ...

CASE MANAGER-HOURLY

Dover, DE ยท On-site

$18.25/hr

Participate in team meetings, treatment planning discussions, and case reviews. * Communicate ... One (1) year of case management experience. * Experience working with individuals experiencing ...

CASE MANAGER-HOURLY

Dover, DE ยท On-site

$18.25/hr

Participate in team meetings, treatment planning discussions, and case reviews. * Communicate ... One (1) year of case management experience. * Experience working with individuals experiencing ...

RN Case Manager in Newark, DE

Newark, DE ยท On-site

$41.28 - $66.05/hr

RN Case Manager - Day Shift - Sign-on Bonus RN Case Manager - Day Shift M-F (Hours: 8a-4:30p with ... Utilization Management - Reviews patient status for appropriateness and anticipated payer coverage.

Case Manager

Wilmington, DE ยท Hybrid

$70.43 - $112/hr

This individual prepares drafts of legal and other documents and correspondence for attorney review ... Manages and trains case assistants, paralegals, and attorneys, delegates and supervises projects ...

RN Case Manager - Day Shift

Newark, DE ยท On-site

$41.28 - $66.05/hr

Utilization Management - Reviews patient status for appropriateness and anticipated payer coverage ... Case Management Certification (CMC) is required within 18 months of eligibility. Hourly Pay Range ...

RN Case Manager - Day Shift

Newark, DE ยท On-site

$41.28 - $66.05/hr

Utilization Management - Reviews patient status for appropriateness and anticipated payer coverage ... Case Management Certification (CMC) is required within 18 months of eligibility. Hourly Pay Range ...

Case Manager

Seaford, DE ยท On-site

$21/hr

The Case Manager will provide community-based services to individuals identified as eligible for ... For further information, please review the Know Your Rights notice from the Department of Labor.

Case Manager

Newark, DE ยท On-site

$21/hr

The Case Manager will provide community-based services to individuals identified as eligible for ... For further information, please review the Know Your Rights notice from the Department of Labor.

Showing results 21-40

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 cities in Delaware are hiring for Utilization Review Case Manager jobs? Cities in Delaware with the most Utilization Review Case Manager job openings:
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.

CASE MANAGER-HOURLY

Apis Services Inc

Dover, DE โ€ข On-site

$18.25/hr

Part-time

Posted 15 days ago


Job description

Case ManagerEmpower Recovery. Build Connections. Change Lives.

Are you passionate about helping individuals overcome barriers, access resources, and achieve meaningful recovery goals? Do you believe in the power of person-centered support and community-based services to transform lives?

We are seeking a compassionate and dedicated Case Manager to join our team. In this role, you will work directly with individuals to identify their strengths and needs, coordinate services, advocate for access to resources, and support them on their path to recovery, stability, and independence.

If you're looking for a rewarding career where you can make a lasting impact in the lives of others, we'd love to hear from you.


Position Summary

The Case Manager is responsible for assessing participant needs, identifying appropriate resources, and coordinating individualized services to support successful recovery outcomes. This position plays a critical role in implementing service and treatment plans, advocating for participants, connecting them with community resources, and ensuring they receive the support necessary to achieve their goals.

Working collaboratively with consumers, natural supports, community providers, and multidisciplinary team members, the Case Manager promotes recovery, community integration, wellness, and self-sufficiency through a person-centered and strengths-based approach.


Essential ResponsibilitiesParticipant Assessment & Service Planning
  • Assess participant strengths, needs, goals, and barriers to determine appropriate services and resources.
  • Assist in the development, implementation, and review of individualized recovery plans.
  • Collaborate with participants, natural supports, and approved stakeholders to establish meaningful and achievable recovery goals.
  • Monitor participant progress and make recommendations to support ongoing success.
Community-Based Support & Care Coordination
  • Provide community-based case management services focused on recovery, education, and skill development.
  • Connect participants to healthcare, behavioral health, housing, employment, transportation, financial assistance, and other community resources.
  • Support participants in navigating service systems and overcoming barriers to care.
  • Foster community engagement and encourage participation in meaningful activities and relationships.
Advocacy & Resource Development
  • Advocate for participants to ensure access to needed services and supports.
  • Develop and maintain relationships with community agencies and service providers.
  • Identify service gaps and help develop strategies to address unmet needs.
  • Promote participant empowerment, self-advocacy, and independence.
Documentation & Compliance
  • Complete assessments, case notes, treatment documentation, and progress reports in a timely and accurate manner.
  • Utilize collaborative documentation practices that encourage participant engagement.
  • Maintain compliance with organizational policies, funding requirements, licensing standards, and accreditation expectations.
  • Protect participant privacy and confidentiality in accordance with HIPAA regulations.
Crisis Intervention & On-Call Support
  • Participate in a rotating on-call schedule to provide crisis intervention and support services.
  • Respond effectively to participant crises and coordinate appropriate interventions and services.
  • Assist participants in accessing emergency resources and support when necessary.
Team Collaboration
  • Function as an active member of a multidisciplinary team providing holistic, recovery-oriented services.
  • Participate in team meetings, treatment planning discussions, and case reviews.
  • Communicate regularly with internal and external providers to ensure continuity of care.
  • Perform additional duties as assigned to support program goals and participant success.

QualificationsRequired Qualifications
  • Bachelor's Degree in Human Services or a related field.
  • Valid driver's license and reliable transportation.
  • Intermediate computer skills and proficiency with electronic documentation systems.
  • Ability to pass federal and state criminal background checks.
  • Minimum of two (2) years of experience working in human services, behavioral health, or a related field.
Preferred Qualifications
  • One (1) year of case management experience.
  • Experience working with individuals experiencing mental health, substance use, or co-occurring challenges.
  • Knowledge of community resources, recovery-oriented services, and person-centered practices.

Core CompetenciesCommunication Skills

Ability to communicate effectively with participants, families, providers, and community partners.

Assessment & Critical Thinking

Ability to evaluate participant needs, identify barriers, and determine appropriate services and interventions.

Care Coordination & Case Management

Skilled in organizing, implementing, and monitoring individualized service plans.

Advocacy

Strong commitment to helping participants access services, resources, and opportunities that support recovery and independence.

Collaboration & Teamwork

Ability to work effectively within multidisciplinary teams and community partnerships.

Problem Solving

Proactive approach to identifying challenges, addressing service gaps, and developing solutions.

Cultural Competence

Commitment to providing respectful, inclusive, and individualized services that reflect the unique backgrounds, experiences, and identities of participants.

Documentation & Compliance

Ability to maintain accurate records and meet all regulatory, funding, and organizational requirements.


Working Conditions

This position combines office-based and community-based work and may require:

  • Extensive community travel (approximately 75% of participant contacts occur in the community)
  • Home visits, community meetings, and provider appointments
  • Exposure to varying weather and environmental conditions
  • Participation in an on-call rotation for crisis intervention services
  • Flexible scheduling to meet participant and program needs

The work environment may include exposure to:

  • Dust, fumes, and airborne particles
  • Extreme temperatures
  • Wet or humid conditions
  • Loud noise levels
  • Mechanical, chemical, electrical, and other environmental hazards

Physical RequirementsPhysical Demand Level: Medium Work

This position requires the ability to:

  • Exert up to 50 pounds of force occasionally
  • Exert up to 20 pounds of force frequently
  • Exert up to 10 pounds of force regularly
Physical Activities

The employee must be able to:

  • Sit, stand, and walk for extended periods
  • Walk on uneven surfaces and climb stairs
  • Bend, stoop, crouch, kneel, and reach
  • Lift and carry materials or equipment as needed
  • Drive a motor vehicle regularly for community-based services
  • Perform repetitive motions associated with documentation and computer work
  • Communicate effectively and observe environmental and participant needs

Why Join Our Team?

At RHD, we believe recovery is possible for everyone. Our team is committed to empowering individuals, strengthening communities, and providing person-centered services that foster hope, healing, and independence.

As a Case Manager, you'll have the opportunity to build meaningful relationships, advocate for those in need, and make a lasting difference in the lives of the people we serve.

Join us and help individuals achieve recovery, wellness, and a brighter future.