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Utilization Review Case Manager Jobs in Delaware

Holcomb Behavioral Health

Case Manager

Seaford, DE · 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.

Chimes

Case Manager

Newark, DE · 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.

Apis Services Inc

CASE MANAGER-HOURLY

Frankford, DE · On-site

The Case Manager works collaboratively with residents, family members, team members, community ... Participate in team meetings, case reviews, and treatment planning activities. * Communicate ...

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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.

Case Manager

Holcomb Behavioral Health

Seaford, DE • On-site

$21/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 15 days ago

Job description

Join Chimes - and go further to help others go far! Chimes is a not-for-profit organization that assists people with intellectual and behavioral challenges to achieve their fullest potential.
Our vast array of services - educational, employment, vocational, residential, habilitative and behavioral health - are delivered through a network of national and international affiliates. This allows us to take a comprehensive, holistic approach to improving the lives of every person we serve - those who receive and those who reap the benefits of our innovative, responsive solutions.
Job Description: The Case Manager will provide community-based services to individuals identified as eligible for behavioral health services, including assessing and monitoring resources that help the client live in the community in a stable and safe manner
Schedule Details: Monday - Friday, 9:00 am - 5:00 pm
Location: Sussex County
Program: Behavioral Health Services
Pay Rate: $21.00/hour
Job Functions:
  • Carry a caseload of up to 30 clients
  • Perform case management duties for consumers involved in Behavioral Health Services
  • Provide services based on Recovery Model principles
  • Develop individualized, strength-based service plans that are measurable and lead toward targeted outcomes
  • Assists consumer service needs and assists consumers in assessing appropriate mental health services
  • Assist consumers in obtaining and maintaining basic needs such as housing, food, healthcare, employment, and socialization
  • Assist consumers through assertive and creative efforts to gain needed resources and services identified in the service plan
  • Monitor the consumer's participation in the recovery plan and support services
  • Provide effective crisis assessment and crisis intervention to consumers when necessary
  • Maintain professional relations with the consumer, their families, payers, community support service representatives, coworkers, and other agencies
  • Ensure appropriate communication and coordination of effort between all the consumer's service providers and support systems
  • Act as an effective "single point of contact" for multiple health and social services linkages
  • Provide all authorized client service and provide supporting documentation for re-authorizations, as necessary, in a timely manner
  • Submit accurate and timely payroll and billing documentation
  • Need to be available for an on-call rotation 24/7

Minimum Requirements:
Education/Experience/Licensure (Must Meet One of the Following Criteria):
  • A bachelor's degree with major coursework in sociology, social work, psychology, gerontology, anthropology, political science, history, criminal justice, theology, nursing, counseling, or education
  • Be a registered nurse
  • A high school diploma and 12 semester credit hours in sociology, social welfare, psychology, gerontology, or other social science, and 2 years experience in public or private human services with 2 years in direct client contact (1 year for Lehigh and Northampton counties)
  • A high school diploma and 5 years of mental health direct care experience in public or private human services with employment as a case management staff person prior to April 1, 1989.

Clearances: Pennsylvania Child Abuse, Criminal and fingerprint-based federal criminal history; Verification that employee is not on any Medicaid/Medicare Exclusion list
Note: At the discretion of the Personnel Officer, additional related experience and/or education may be substituted instead of the requirements specified under Education and Experience
What's in it for you?
Total Rewards (For Full-Time Employees = >30 hours/week):
  • Competitive Pay
  • Medical, Dental, and Vision Insurance
  • Tuition Reimbursement options
  • Flexible Spending Accounts (Health, Dependent, and Transportation)
  • Life Insurance
  • Disability Insurance
  • Paid Time Off
  • 403(b) with Employer Match
  • Employee Recognition Programs
  • Employee Referral Bonus opportunities
  • Discounts through "Tickets at Work"
  • And More!

Want to learn more?
To learn more about Chimes, and how you can achieve personal and professional growth within a purpose-driven organization, visit us at: https://chimes.org/Careers.
Holcomb Behavioral Health Systems is accredited by the Joint Commission and provides a comprehensive range of services and supports for people with mental health, substance abuse, intellectual and developmental disabilities, and co-occurring disorders throughout southern and central Pennsylvania, central New Jersey, Delaware, and Maryland. Additionally, we provide an array of prevention and educational programs for youth, parents, and adults to encourage healthy choices and lifestyles.
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Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

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