ZipRecruiter

Log In

1

Utilization Review Case Manager Jobs in Nebraska

Bryan Health

Utilization Management Manager

Lincoln, NE · On-site

Reviews and reports out on Utilization Management (UM) trends. 12. Ensures quality of services through UM, review of medical records and provider education, while identifying training opportunities ...

Bryan Health

Utilization Management Manager

Lincoln, NE · On-site

Reviews and reports out on Utilization Management (UM) trends. 12. Ensures quality of services through UM, review of medical records and provider education, while identifying training opportunities ...

Bryan Health

Utilization Management Manager

Lincoln, NE · On-site

Reviews and reports out on Utilization Management (UM) trends. 12. Ensures quality of services through UM, review of medical records and provider education, while identifying training opportunities ...

Corvel

Telephonic Case Manager I

Omaha, NE · Remote

$63K - $95K/yr

The Case Manager communicates directly with treating physicians to evaluate and recommend ... Strong cost containment background, such as utilization review or managed care helpful

Corvel

Telephonic Case Manager I

Omaha, NE · Remote

$63K - $95K/yr

The Case Manager communicates directly with treating physicians to evaluate and recommend ... Strong cost containment background, such as utilization review or managed care helpful

University of Nebraska-Lincoln

Case Manager

Lincoln, NE · On-site

$48K/yr

Position Information Position Information Working Title Case Manager Department Student Advocacy & Support-10975 Requisition Number S_260540 Posting Open Date 07/15/2026 Application Review Date: (To ...

The Salvation Army

Case Manager

Lincoln, NE · On-site

$16 - $19/hr

Providing case management for the emergency assistance department. Works with clients and other ... Administrative skills to include utilization of standard office equipment, data entry, 10-key ...

Gphealth

Case Manager - BSW/Bachelors

North Platte, NE

$21 - $27.50/hr

... and documents the utilization of resources and progress of the patient through their care ... review, personal interview, and consultation with members of treatment teams as necessary. This ...

next page

Showing results 1-20

All JobsUtilization Review Case JobsUtilization Review Case Manager JobsUtilization Review Case Manager Jobs in Nebraska

Utilization Review Case Manager information

See Nebraska salary details

$15

$34

$57

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

As of Jul 27, 2026, the average hourly pay for utilization review case manager in Nebraska is $34.79, according to ZipRecruiter salary data. Most workers in this role earn between $28.17 and $36.68 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 Nebraska? For Utilization Review Case Manager jobs in Nebraska, the most frequently searched job titles are:
What job categories do people searching Utilization Review Case Manager jobs in Nebraska look for? The top searched job categories for Utilization Review Case Manager jobs in Nebraska are:
What cities in Nebraska are hiring for Utilization Review Case Manager jobs? Cities in Nebraska 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 Nebraska as of July 2026, with employment types broken down into 1% As Needed, 77% Full Time, 19% Part Time, 1% Temporary, and 2% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $72,358 per year, or $34.8 per hour.
Utilization Review Nurse

Utilization Review Nurse

Berkshire Hathaway Homestate Companies

Omaha, NE • Hybrid

Other

Medical, Dental, Vision, Life, PTO

Posted 18 days ago

Job description

WHAT WE'RE LOOKING FOR
We have openings in our Omaha, Nebraska office for Utilization Review Nurses. The Utilization Review Nurse ensures all aspects of an injured worker's treatment are effective, efficient, and in accordance with applicable legal requirements.
This is a full-time, permanent position within our Medical Management team and that will allow experienced nurses to put their years of clinical knowledge to use in an office environment and learn new skills in this growing industry. No UR experience required!
ESSENTIAL RESPONSIBILITIES
  • Review complex workers compensation medical treatment requests to ensure accordance with evidence-based medical treatment guidelines, which are generally recognized by the national medical community and are scientifically based.
  • Research claim file in relation to the requested medical treatment while interpreting medical reports/claims summaries and applies appropriate established guidelines to requested treatment. Refers treatment requests, which do not meet guidelines, for peer review and determination.
  • Advocate for the injured worker and claims department, ensuring proposed treatment requests are appropriate for the diagnosis.
  • Performs daily tasks within the appropriate established workflow processes, utilizes accepted guidelines and meets legislative and departmental timeframes.
  • Maintain patient confidentiality in discussions of treatment, disease process and conditions.
  • Routinely contacts providers to clarify treatment requests, examination findings, as well as obtain additional medical information as needed.
  • Maintains clear, concise, and accurate documentation of requested medical treatments to include clinical findings, treatment guidelines, and determination.
  • Provide appropriate notices to providers, injured workers, claims staff, and attorneys.
  • Act as a medical resource in regards to utilization review to Claims Support Nurse, Bill Review, and Claims department.
  • Foster a positive and close working relationship with other Company staff, including the claims staff, medical bill review, claims support nurse, special investigations, legal, liens, the call center, and client services.
  • Communicate effectively with individuals outside the company, including clients, medical providers, and vendors.
WHAT WILL SET YOU APART
  • EDUCATION: Bachelor of Science Nursing degree (BSN), or Registered Nursing degree (RN) from four-year college or university, or an accredited college.
  • LICENSES/EXPERIENCE: A current RN license as well as 5+ years of recent, hands-on clinical experience in a Critical care unit such as Medical Surgery, Emergency Room, ICU, Oncology, Orthopedics, Neuro or other similar settings. Must have an active state license and eligible to obtain additional state licenses.
  • TECHNICAL SKILLS: Knowledge of current recognized evidence-based medicine guidelines required. Proficient in Microsoft Office suite of applications. Able to perform independent internet medical research. Able to quickly master proprietary and vendor software applications.
  • LANGUAGE ABILITY: Able to read, analyze, and interpret common scientific and technical journals, statutes, regulations, medical reports, medical coding, medical bills, financial reports, and legal documents. Able to respond to technical inquiries or complaints from Company employees, external sources, and regulatory or auditing entities.
  • REASONING ABILITY: Able to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Able to deal with problems involving several concrete variables in standardized situations.
 
WHAT WE OFFER
  • Work From Home (Up to 2 days per week upon eligibility)
  • Onsite Gym
  • Garage Parking
  • Within walking distance of the Old Market District
  • Paid Time Off
  • Paid Holidays
  • Retirements Savings Match
  • Group Health Insurance (Medical, Dental, and Vision)
  • Life and AD&D Insurance
  • Long Term Disability Insurance
  • Paid Community Volunteer Day
  • Employee Assistance Program
  • Tuition Reimbursement Program
  • Employee Referral Program
  • Diversity, Equity and Inclusion Program
ABOUT US
With more than 50 years in business, Berkshire Hathaway Homestate Companies (BHHC) has grown from a regional organization to a national insurance group, offering insurance products from coast to coast. Relationships are the cornerstone of our culture, and we believe in doing the right thing. That means we invest in our business in every way possible to deliver on our mission and demonstrate that people are what powers our success. Our commitment to financial strength and integrity means our customers can rest assured that we will be there when it counts.
 
At BHHC we embrace diversity and foster an environment where our people can be their authentic selves. Our differences make us stronger and better together, which fosters a harmonious workplace-something we truly value. We've created an approachable and collaborative atmosphere. Here you'll find a welcoming workplace where everyone can feel valued, supported, and inspired to do great work. Together, we raise the bar by being curious, remaining customer-focused, and operating with integrity.
apply for this job

Apply