1

Utilization Review Case Manager Jobs in Iowa (NOW HIRING)

Description: RN Case Manager (Onsite) Shift: Monday-Friday (8 hours) No Weekends General Summary ... Perform admission, concurrent, and post-discharge utilization reviews in accordance with the ...

Description: RN Case Manager (Onsite) Shift: Monday-Friday (8 hours) No Weekends General Summary ... Perform admission, concurrent, and post-discharge utilization reviews in accordance with the ...

Description: RN Case Manager (Onsite) Shift: Monday-Friday (8 hours) No Weekends General Summary ... Perform admission, concurrent, and post-discharge utilization reviews in accordance with the ...

Weekend Shift Description: RN Case Manager (Onsite) Shift: Weekends General Summary: Responsible ... Perform admission, concurrent, and post-discharge utilization reviews in accordance with the ...

Description: RN Case Manager (Onsite) Shift: Monday-Friday (8 hours) No Weekends General Summary ... Perform admission, concurrent, and post-discharge utilization reviews in accordance with the ...

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Weekend Shift Description: RN Case Manager (Onsite) Shift: Weekends General Summary: Responsible ... Perform admission, concurrent, and post-discharge utilization reviews in accordance with the ...

Weekend Shift Description: RN Case Manager (Onsite) Shift: Weekends General Summary: Responsible ... Perform admission, concurrent, and post-discharge utilization reviews in accordance with the ...

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Day Shift Description: RN Case Manager (Onsite) Shift: Monday-Friday (8 hours) No Weekends General ... Perform admission, concurrent, and post-discharge utilization reviews in accordance with the ...

Bilingual RN Case Manager

Dubuque, IA · On-site

$20.25 - $25.75/hr

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Bilingual RN Case Manager

Dubuque, IA · On-site

$20.25 - $25.75/hr

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Bilingual RN Case Manager

Dubuque, IA · On-site

$20.25 - $25.75/hr

Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.

Showing results 21-40

Utilization Review Case Manager information

See Iowa salary details

$15

$34

$56

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

As of Aug 19, 2026, the average hourly pay for utilization review case manager in Iowa is $34.27, according to ZipRecruiter salary data. Most workers in this role earn between $27.79 and $36.11 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 cities in Iowa are hiring for Utilization Review Case Manager jobs?

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

Infographic showing various Utilization Review Case Manager job openings in Iowa as of August 2026, with employment types broken down into 58% Full Time, and 42% Contract. Highlights an 100% In-person job distribution, with an average salary of $71,282 per year, or $34.3 per hour.

Case Manager RN

Trinity Health

Des Moines, IA • On-site

Full-time

Re-posted 11 days ago


Trinity Health rating

6.6

Company rating: 6.6 out of 10

Based on 354 frontline employees who took The Breakroom Quiz

568th of 888 rated healthcare providers


Job description

Employment Type:Full timeShift:Description:RN Case Manager (Onsite)

Shift:

Monday-Friday (8 hours) No Weekends

General Summary:

Responsible for the review of inpatient and outpatient admission records for appropriate admission status at Mercy Medical Center and Mercy West Lakes. Works in collaboration with the attending physician and the Case Management staff utilizing admission criteria guidelines-and second level physician review process when appropriate. Interacts with insurance providers to obtain authorization and continued stay approval for admission. Collaborates with the Verification department, Revenue cycle and Medical Eligibility to facilitate the establishment of the correct payer source for patient stay and the documentation of the interactions in the STAR admitting system

Key Responsibilities
  • Perform admission, concurrent, and post-discharge utilization reviews in accordance with the Utilization Management Plan and regulatory requirements.

  • Apply Milliman Care Guidelines and payer-specific criteria to determine appropriate patient status.

  • Collaborate with attending physicians to clarify admission status and initiate second-level physician reviews as needed.

  • Communicate status changes promptly to Case Management, Admitting, and other relevant departments.

  • Provide patient/family education and issue Notices of Status Change when required.

  • Accurately document utilization review activities, status determinations, authorizations, denials, and communications in the medical record and STAR system.

  • Submit timely clinical information to payers to prevent technical denials and support authorization and continued stay.

  • Review and route denial notifications for appeal consideration; collaborate with post-denials, RAC, and appeal teams.

  • Monitor insurance coverage and communicate updates to verification and financial teams.

  • Participate in peer-to-peer reviews and advocate for appropriate admission status and continued stay.

Qualifications
  • Current Iowa RN license.

  • Minimum of five (5) years of clinical nursing experience.

  • BSN or healthcare-related degree preferred.

  • Knowledge of insurance eligibility, CMS rules, and utilization review processes across the continuum of care.

  • Strong clinical judgment, communication, and independent decision-making skills.

  • Utilization Review certification within 12 months of hire preferred.

  • Completion of Mandatory Reporter abuse training within three (3) months of hire.

Work Environment & Physical Requirements
  • Primarily office-based with computer, phone, and documentation tasks.

  • Light physical activity with occasional lifting; use of assistive devices and additional personnel as required.

  • Visual acuity sufficient to review medical records and electronic systems.

  • Ability to work collaboratively in a fast-paced, high-stress healthcare environment while maintaining professionalism and courtesy.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.


What Trinity Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom


Trinity Health logo

About Trinity Health

Sourced by ZipRecruiter

Trinity Health Ann Arbor is a 537 -bed teaching hospital located on 340 acre campus. Recognized by IBM Watson as a Top 100 Hospital and #1 Teaching Hospital, Trinity Health Ann Arbor has been a leading health care provider for more than 100 years. Trinity Health has received numerous local and national awards in recognition of our leadership, quality outcomes, and clinical excellence.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Livonia, MI, US