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Utilization Review Case Manager Jobs in Idaho (NOW HIRING)

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Utilization Review Case Manager information

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$15

$34

$56

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

As of Aug 30, 2026, the average hourly pay for utilization review case manager in Idaho is $34.33, according to ZipRecruiter salary data. Most workers in this role earn between $27.84 and $36.20 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 Idaho?

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

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

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

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

Cities in Idaho 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 Idaho as of August 2026, with employment types broken down into 59% Full Time, and 41% Contract. Highlights an 100% In-person job distribution, with an average salary of $71,406 per year, or $34.3 per hour.

UTILIZATION REVIEW COORDINATOR

Idaho Falls, ID • On-site

MOUNTAIN VIEW HOSPITAL LLC
Health Care and Social Assistance • 1 - 5K employees

5.5

Company rating: 5.5 out of 10

Based on 60 frontline employees who took The Breakroom Quiz

945th of 1,064 rated hospitals

People enjoy working here

Recommended by students

Learn more about MOUNTAIN VIEW HOSPITAL LLCexternal

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 3 days ago

Job description

Mountain View Hospital is looking for a Utilization Review Coordinator to join our team!
JOB SUMMARY: As a member of the Utilization Management Team, the UR
Coordinator helps establish and maintain efficient methods of ensuring the medical necessity and appropriateness of hospital admissions and extended stays. The Utilization Management Team directs the program in accordance with Mountain View Hospital's mission and strategic goals. The Utilization Management Team directs those activities within the facility which monitor adherence to the hospital's utilization review plan. The goal of Utilization Management is to continuously improve effective use of hospital services through monitoring patient admissions and stays.
About Mountain View:
Mountain View Hospital and our 29 affiliate clinics are committed to providing compassionate, cutting edge care to our patients. We serve the entire Snake River Valley - all the way from Pocatello to Rexburg. Our medical capabilities span everything from wound care to urgent care, oncology to neurology, physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a continuously expanding rural health practice.
Our work environment is mission driven, people-centric and supportive. It is what sets apart and makes people excited to come to work each day. If you are looking for a career where you can make a difference in your community, we invite you to apply.
BENEFITS:
Taking care for our community starts with taking care of our own team. Mountain View Hospital is proud to offer its employees competitive and comprehensive benefit packages. Benefits include:
  • Medical, Dental and Vision Insurance
  • Paid Time Off (vacation, holidays and sick days) and Medical Paid Time Off
  • Retirement Plans (401K with up to 6% match)
  • Earned Quarterly Bonus Program
  • Education Reimbursement Program
  • Discount for medically necessary procedures performed at Mountain View Hospital and Idaho Falls Community Hospital

Please note benefits are based on eligibility according to full-time, part-time or PRN status classification.
Education/Certification: High School Diploma or equivalent. Coding certificate completion is required within 1 year of employment
Experience: Background in medical terminology is helpful. Medical coding and/or insurance experience preferred, however coding certification will be required with in one calendar year of employment

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