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Utilization Review Case Manager Jobs in Minnesota

HealthPartners

RN Case Manager

Bloomington, MN · On-site

$36.37 - $54.55/hr

Minimum of 3 years clinical practice experience in an acute care setting; minimum of 3 years relevant utilization review, discharge planning, or case management experience; and current clinical ...

HealthPartners

RN Case Manager

Bloomington, MN · On-site

Minimum of 3 years clinical practice experience in an acute care setting; minimum of 3 years relevant utilization review, discharge planning, or case management experience; and current clinical ...

UnitiMed

RN Case Manager

Minneapolis, MN · On-site

Referral bonus up to $700 Registered Nurse (RN),Case Management/Utilization Review, About the Company: Uniti Med is an award-winning healthcare staffing company with a mission to provide staffing ...

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All JobsUtilization Review Case JobsUtilization Review Case Manager JobsUtilization Review Case Manager Jobs in Minnesota

Utilization Review Case Manager information

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$16

$35

$58

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

As of Sep 2, 2026, the average hourly pay for utilization review case manager in Minnesota is $35.74, according to ZipRecruiter salary data. Most workers in this role earn between $28.94 and $37.69 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 Minnesota?

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

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

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

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

Cities in Minnesota 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 Minnesota as of August 2026, with employment types broken down into 57% Full Time, and 43% Contract. Highlights an 100% In-person job distribution, with an average salary of $74,329 per year, or $35.7 per hour.

RN Case Manager

HealthPartners

Bloomington, MN • On-site

$36.37 - $54.55/hr

Full-time

Medical, Retirement

Re-posted 28 days ago

HealthPartners rating

7.5

Company rating: 7.5 out of 10

Based on 138 frontline employees who took The Breakroom Quiz

233rd of 898 rated healthcare providers

Job description


HealthPartners is hiring an RN Case Manager. This position exists to provide support to patients, their families, and physicians in addressing medical and social concerns; educate and empower patients and families to make informed personal health care decisions; and facilitate communication between patient, physician, health plan and community.
This is a primarily remote position that includes several in-person member visits each week in homes, healthcare facilities, and other community settings throughout the Metro area.
ACCOUNTABILITIES:
  • Member Focus
    • Ensures all activities are member-focused and individualized, resulting in personalized attention to each patient's unique needs.
    • Identifies interventions and resources to assist member reaching personal health related goals.
    • Identifies patterns and episodes of care that are predictive of future needs and services.
  • Integration
    • Integrates clinical and psychosocial information for case identification and individual patient assessment to develop action-oriented and time-specific planning and implementation of appropriate interventions.
    • Facilitates integration of patient care by encouragement of effective communications between patients, families, providers, health plan and care system programs, and community-based services.
    • Adheres to department policy and procedure in daily activities.
    • Coordinates service coverage with appropriate funding sources when indicated.
    • Works with Supervisor, Case Management, Government Programs department and Member Services department to ensure compliance with Medicare requirements and regulations.
  • Communication
    • Effectively communicates with patients and their families to provide them with a better understanding of their health, health care benefits, and health care system.
    • Effectively and routinely communicates with patients, families, physicians and health care team members to facilitate successful collaboration resulting in high levels of member/patient/family/provider satisfaction.
    • Provides educational information and materials to members to support preference sensitive decisions.
    • Provides regular reporting of member outcomes to Case Management leadership according to defined process.
    • Identifies and promptly reports potentially adverse situations to leadership as outlined in department policy and procedure.
    • Identifies and promptly reports high cost cases for reinsurance.
    • Maintains current and accurate documentation and case management files in accordance with Case Management policy and procedure.
    • Maintains confidentiality of information in accordance with department and corporate policies.
  • Relationships and Team Building
    • Establishes and maintains good working relationships within the Case Management department, with other HealthPartners departments, and with other health team participants.
    • Supports other team members in achieving patient centered goals.
    • Assists supervisor in maintaining a cohesive Case Management team by contributing to a collaborative, respectful, and diverse environment.
    • Participates in and contributes to appropriate departmental and/or organizational meetings.
  • Technology
    • Maintains knowledge of and effectively uses automated applications and systems.
    • Identifies deficits in technological literacy and seeks appropriate training under guidance of supervisor.
    • Maintains maximum individual productivity through proficient use of automated systems.
  • Personal Development
    • Participates in ongoing independent study and education-related professional activities to maintain and increase knowledge in the areas of Case Management, patient care services, and benefit packages for development of effective case management skills.
    • Demonstrates responsiveness to and appreciation of constructive feedback and recommendations for personal growth and development.
    • Maintains current, active Minnesota nursing licensure.
    • May maintain current, active nursing licensure in other states as assigned.
  • Other Duties
    • Willingly participates in various committees, task forces, projects, and quality improvement teams, as needed and assigned.
    • Performs other duties as assigned.

CURRENT DIMENSION:
  • Directly reports to Supervisor, Case Management.
  • Directly manages caseload with anticipation of up to 85 members with complex needs.
  • Interacts with medical, administrative, and front line staff within and outside the organization in order to collaborate on members care.

REQUIRED QUALIFICATIONS:
  • Registered Nurse with current unrestricted license in the State of Minnesota, BSN preferred. License free of history of restrictions and/or sanctions in the past 10 years in all states with current or past licensure.
  • Minimum of 3 years clinical practice experience in an acute care setting; minimum of 3 years relevant utilization review, discharge planning, or case management experience; and current clinical knowledge.
  • Demonstrated effective, independent nursing judgment and skills.
  • Demonstrated skill and experience in effectively collaborating with care team members, using a high level of expertise in written, oral and interpersonal communication.
  • Demonstrated working knowledge of quality improvement, utilization management, benefit plans, fiscal management, and various payment methodologies preferred. Understanding of healthcare and/or HMO industry.
  • Demonstrated skill in effective use and management of automated medical management systems.
  • Demonstrated flexibility, organization, and appropriate decision-making under challenging situations.
  • Basic computer skills

CHALLENGES:
  • Maintaining member focus in a rapidly evolving environment.
  • Influencing team members and colleagues to work collaboratively in achieving the goals and objectives of the Case Management Program.
  • Contributing a positive team building approach as a member of the Case Management team, and a global member of the Case Management Department.

DECISION-MAKING:
  • Makes independent decisions within the scope of this position's accountabilities and determines the need for and the timing of consultation with Case Management leadership and/or Medical Director.
  • Uses professional clinical judgment, organizational knowledge, industry knowledge, and common sense in determining appropriate alternatives for members/patients/families, consulting with leadership and/or Medical Director, when indicated.
  • Makes recommendations to leadership regarding policy development needs and/or changes.

About Us
At HealthPartners we believe in the power of good - good deeds and good people working together. As part of our team, you'll find an inclusive environment that encourages new ways of thinking, celebrates differences, and recognizes hard work.
We're a nonprofit, integrated health care organization, providing health insurance in six states and high-quality care at more than 90 locations, including hospitals and clinics in Minnesota and Wisconsin. We bring together research and education through HealthPartners Institute, training medical professionals across the region and conducting innovative research that improve lives around the world.
At HealthPartners, everyone is welcome, included and valued. We're working together to increase diversity and inclusion in our workplace, advance health equity in care and coverage, and partner with the community as advocates for change.
Benefits Designed to Support Your Total HealthAs a HealthPartners colleague, we're committed to nurturing your diverse talents, valuing your dedication, and supporting your work-life balance. We offer a comprehensive range of benefits to support every aspect of your life, including health, time off, retirement planning, and continuous learning opportunities. Our goal is to help you thrive physically, mentally, emotionally, and financially, so you can continue delivering exceptional care.
Join us in our mission to improve the health and well-being of our patients, members, and communities.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant because of race, color, sex, age, national origin, religion, sexual orientation, gender identify, status as a veteran and basis of disability or any other federal, state or local protected class.

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