Case Manager RN
Des Moines, IA · On-site
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 ...
Des Moines, IA · On-site
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 ...
Des Moines, IA · On-site
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 ...
Des Moines, IA · On-site
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 ...
Des Moines, IA · On-site
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 ...
Des Moines, IA · On-site
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 ...
Des Moines, IA · On-site
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 ...
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 ...
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 ...
Des Moines, IA · On-site
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 ...
Des Moines, IA · On-site
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 ...
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.
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.
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.
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.
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.
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.
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.
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 ...
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 ...
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 ...
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
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.
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.
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.
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
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.
Des Moines, IA · On-site
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 ...
Des Moines, IA · On-site
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 ...
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.
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.
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.
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.
$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
$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.
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.
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.
$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
| 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.
For Utilization Review Case Manager jobs in Iowa, the most frequently searched job titles are:
The top searched job categories for Utilization Review Case Manager jobs in Iowa are:
Cities in Iowa with the most Utilization Review Case Manager job openings:

6.6
Based on 354 frontline employees who took The Breakroom Quiz
568th of 888 rated healthcare providers
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.
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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.
Health care and social assistance
10,000+ Employees
Livonia, MI, US