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 ...
Case Manager RN
Des Moines, IA · On-site
Weekend Shift Description: RN Case Manager (Onsite) Shift: Weekends General Summary: Responsible ... Perform admission, concurrent, and post-discharge utilization reviews in accordance with the ...
Case Manager RN
Des Moines, IA · On-site
Weekend Shift Description: RN Case Manager (Onsite) Shift: Weekends General Summary: Responsible ... Perform admission, concurrent, and post-discharge utilization reviews in accordance with the ...
RN Case Manager
Dubuque, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Dubuque, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Des Moines, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Des Moines, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Des Moines, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Des Moines, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Des Moines, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Des Moines, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
Case Manager RN
Des Moines, IA · On-site
Weekend Shift Description: RN Case Manager (Onsite) Shift: Weekends General Summary: Responsible ... Perform admission, concurrent, and post-discharge utilization reviews in accordance with the ...
Case Manager RN
Des Moines, IA · On-site
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 ...
Weekend Shift Description: RN Case Manager (Onsite) Shift: Weekends General Summary: Responsible ... Perform admission, concurrent, and post-discharge utilization reviews in accordance with the ...
RN Case Manager
Dubuque, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Dubuque, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Des Moines, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
Quick apply
RN Case Manager
Des Moines, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Dubuque, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Dubuque, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Dubuque, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Dubuque, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Dubuque, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Dubuque, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
RN Case Manager
Dubuque, IA · On-site
Provide telephonic case management and utilization review for assigned consumers. * Develop, implement, and monitor individualized care plans to ensure quality and cost-effective outcomes.
Quick apply
RN Case Manager
Dubuque, IA · On-site
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
Asbury, 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
Asbury, 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.
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.
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.
Quick apply
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.
Weekend Shift Description: RN Case Manager (Onsite) Shift: Weekends: Saturday and Sunday 7am - 7:30 ... Perform admission, concurrent, and post-discharge utilization reviews in accordance with the ...
Weekend Shift Description: RN Case Manager (Onsite) Shift: Weekends: Saturday and Sunday 7am - 7:30 ... Perform admission, concurrent, and post-discharge utilization reviews in accordance with the ...
Utilization Review Case Manager information
See Iowa salary details
$15.58 - $19.29
3% of jobs
$19.29 - $23.01
1% of jobs
$23.01 - $26.72
6% of jobs
$28.52 is the 25th percentile. Wages below this are outliers.
$26.72 - $30.44
30% of jobs
The median wage is $31.78 / hr.
$30.44 - $34.15
26% of jobs
$35.57 is the 75th percentile. Wages above this are outliers.
$34.15 - $37.87
22% of jobs
$37.87 - $41.59
3% of jobs
$41.59 - $45.30
0% of jobs
$45.30 - $49.02
5% of jobs
$49.02 - $52.73
2% of jobs
$52.73 - $56.45
1% of jobs
$15
$34
$56
How much do utilization review case manager jobs pay per hour?
As of Sep 12, 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?
| Aspect | Utilization Review Case Manager | Utilization Review Nurse |
|---|---|---|
| Credentials | Typically requires a nursing license or relevant healthcare certification | Registered Nurse (RN) license is required |
| Work Environment | Office-based, insurance companies, healthcare organizations | Hospital, clinic, insurance review departments |
| Primary Focus | Reviewing medical necessity, coordinating care, managing cases | Assessing 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 Iowa?
For Utilization Review Case Manager jobs in Iowa, the most frequently searched job titles are:
- Utilization Review Rn
- Remote Utilization Review Rn
- Evening Optum Health Utilization Review
- Home Based Utilization Review Nurse
- Part Time Utilization Review Nurse
- Freelance Utilization Review Nurse
- Flex Schedule Remote Utilization Review Nurse
- Telephonic Nurse Case Manager
- Remote Utilization Review Nurse
- Overnight Utilization Review Nurse
What job categories do people searching Utilization Review Case Manager jobs in Iowa look for?
The top searched job categories for Utilization Review Case Manager jobs in Iowa are:
- Nurse Practitioner Utilization Review
- From Home International Utilization Review Nurse
- Utilization Review Manager
- Weekend Utilization Review
- Lpn Utilization Review
- Utilization Review
- Contract Case Management
- Remote Dental Utilization Review
- Authorization Utilization Review Bcba
- Anthem Utilization Review Nurse
What cities in Iowa are hiring for Utilization Review Case Manager jobs?
Cities in Iowa with the most Utilization Review Case Manager job openings:
Case Manager RN
Des Moines, IA
Trinityhealth
• Health Care and Social Assistance • 10K+ employees10,000+ employees
Full-time
Re-posted 5 days ago
Trinity Health rating
6.6
Based on 354 frontline employees who took The Breakroom Quiz
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 ResponsibilitiesPerform 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.
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.
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
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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