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Utilization Review Case Manager Jobs in Kentucky

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Utilization Review Case Manager information

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

As of Aug 8, 2026, the average hourly pay for utilization review case manager in Kentucky is $31.69, according to ZipRecruiter salary data. Most workers in this role earn between $25.67 and $33.41 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 Kentucky? For Utilization Review Case Manager jobs in Kentucky, the most frequently searched job titles are:
What job categories do people searching Utilization Review Case Manager jobs in Kentucky look for? The top searched job categories for Utilization Review Case Manager jobs in Kentucky are:
What cities in Kentucky are hiring for Utilization Review Case Manager jobs? Cities in Kentucky 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 Kentucky 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 $65,913 per year, or $31.7 per hour.

RN Case Manager - HOME VISITS

Interim HealthCare

Dry Ridge, KY • On-site

Other

Re-posted 9 days ago

Job description

Description

Our Registered Nurse Case Managers (RNCM) have been called to care when they’re needed most. At Interim HealthCare, you’ll support a full range of patient services to bring comfort and dignity to our clients. 

What we offer our Registered Nurse Case Managers (RNCM):    

·           Competitive pay, benefits, and incentives.  

·           Truly flexible scheduling – a dedication to work/life balance – Full-time/ Part-time / PRN / Weekends  

·           Daily Pay option available    

·           No Overtime Required    

·           1:1 patient care   

Excited to hear more? 

Working at Interim HealthCare means a career unlike any other. With integrity at the center of all we do, we know that when we support you and your community, you’ll change lives every day.    

As a Registered Nurse Case Manager (RNCM), you will:   

·           Conduct In Person patient interviews and comprehensive physical assessments.

·           Oversee the implementation and ongoing assessment of the patient’s plan of care through the management of home health aides, LPNs, RNs, and other caregivers.

·           Communicate patient conditions and collaborate with appropriate providers to deliver care when patient needs evolve.

·           Provide education to patients and families on proper home health care procedures. Ie. Wound care, IV administration, medication management.

·           Work to decrease readmissions by promoting preventative care and ensuring continuity of care.

To qualify as a Registered Nurse Case Manager (RNCM) with us, you will need:    

·           Licensure: Current unrestricted license to practice as a Registered Nurse (RN) in the state associated with this position    

·           Current CPR/AED/BLS/First Aid certification    

·           Reliable transportation to/from care sites and/or work locations.

·           One (1) year of professional experience practicing as a Registered Nurse (RN) in home health or similar setting; previous case management/utilization review experience preferred.

·           OASIS experience preferred.

·           Practical trach and/or ventilator experience preferred, not required.

At Interim HealthCare, we know that being our best is non-negotiable – that’s why we treat your family like our own. We take a patient-centric approach to address each individual’s mind, body, and spirit, our caregivers work tirelessly to help their patients and families find peace. From our unmatched referral response times to our focus on quality improvement, the most beautifully complicated time of your life is our life’s work.  

We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.

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