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Utilization Review Case Manager Jobs in Nebraska

GQR Global Markets

RN Case Manager

Omaha, NE · On-site

$2.3K - $2.4K/wk

  • Medical

  • Dental

  • Vision

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Omaha, Nebraska Start Date: August 31, 2026 Profession: Registered Nurse (RN) Facility: Hospital Estimated Pay ...

New

GLC On-The-Go

Travel RN MDS/IP

Nebraska City, NE · On-site

$75/hr

GLC On-The-Go is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Nebraska City, Nebraska. & Requirements * Specialty: Utilization Review * Discipline: RN * ...

UnitiMed

RN Case Manager

Omaha, NE · On-site

  • Medical

  • Dental

  • Vision

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 ...

New

The Bridge Behavioral Health

Case Manager (Full time)

Lincoln, NE · On-site

$20 - $22/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Case Manager Make Recovery Possible at The Bridge Behavioral Health Now offering a $500 Hiring ... Coordinate continued stay reviews, utilization reviews, and insurance authorizations to support ...

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

Omaha, NE · On-site

$22/hr

Provide case management utilizing a trauma informed, strength-based, person-centered approach ... Administrative skills to include utilization of standard office equipment, data entry, attention to ...

The Salvation Army

Case Manager

Omaha, NE · On-site

$20 - $20.70/hr

Case Managers assist residents with services, housing search and provide the support of residents ... Administrative skills to include utilization of standard office equipment, data entry, 10-key ...

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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 Aug 18, 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 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 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 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 $72,358 per year, or $34.8 per hour.

Utilization Review Specialist

Berkshire Hathaway Homestate Companies

Omaha, NE

Full-time

Posted 15 days ago

Job description

Berkshire Hathaway Homestate Companies, Workers Compensation Division, has an opening for a Utilization Review Specialist in Omaha to join its Medical Management team.  The individual ensures that medical treatment requests from providers are medically appropriate and reviewed in compliance with State laws and Company policies. 
ESSENTIAL RESPONSIBILITIES
  • Triages and manages intake coordination of requests for authorization and independent medical review requests. 
  • Reviews authorization requests for approval in accordance with evidence-based medical treatment guidelines. 
  • Researches claim files in relation to the requested medical treatment, interprets medical reports while utilizing critical thinking, and applies appropriate established guidelines to requested treatment. 
  • Advocates for the injured worker and Claims department, ensuring proposed treatment requests are appropriate for the diagnosis. 
  • Escalates treatment requests outside of authorization authority for review by a Utilization Review Specialist 2 or Utilization Review Nurse. 
  • Ensures that utilization review processes are performed in accordance with the time limits and other requirements set by State law and Company policy. 
  • Routinely contacts providers to clarify treatment requests and examination findings, as well as to obtain additional medical information as needed. 
  • Gains and Maintains a thorough understanding of Company policies regarding the review of authorization requests by Utilization Review Specialists. 
  • Establishes and maintains a close, positive communicative relationship and working partnership with Medical Bill Review staff to ensure effective and efficient integrated medical management of treatment provided to injured workers.
  • Fosters a positive and close working relationship with other Company staff, including adjusting staff, other Medical Management staff, Special Investigations Unit, Legal, Liens, Customer Care, and Client Services.
  • Maintains patient confidentiality and safeguards protected health information in accordance with State and Federal laws and Company policies. 
  • Enters clear, concise, and accurate documentation of requested medical treatments, to include clinical findings, treatment guidelines, and determinations. 
  • Ensures that appropriate notices are forwarded to medical providers, injured workers, Claims staff, and attorneys. 
  • Provides general office or administrative support throughout the department.  
QUALIFICATIONS
  • EDUCATION: Bachelor's or Associate's degree in a medical field from an accredited college or technical school required. 
  • EXPERIENCE: Minimum of 6 months of relevant experience and/or training in a medical field, or equivalent combination of education and experience, required. 
  • TECHNICAL SKILLS: Able to effectively use Microsoft Office/365 applications and able to become proficient in proprietary and vendor software applications. 
  • LANGUAGE ABILITY: Able to read and understand basic documents, including statutes, regulations, medical records, medical bills, medical resource materials, claim notes, and claim data fields. Able to write clear, concise reports accurately conveying complex and nuanced information, as well as correspondence on medical and legal points. Able to effectively present information and respond to questions with adjusting staff, Management, and others. 
  • MATH AND REASONING ABILITY: Able to solve practical problems and deal with a variety of variables in situations where only limited standardization exists. Able to interpret a variety of instructions furnished in written, oral, diagram, graph, or schedule form. Able to apply concepts such as addition, subtraction, multiplication, division, fractions, percentages, ratios, and proportions to practical situations. Ability to derive appropriate conclusions and apply on the job.
 
CORE COMPETENCIES
ATTENTION TO DETAIL 
   Double-checks the accuracy of information and work product to provide accurate and consistent work.
   Completes all work according to procedures and standards.
   Works in a conscientious, consistent, and thorough manner.
COMMUNICATION 
   Communicates and articulates clearly; is informative and appropriately concise.
   Asks questions freely to broaden knowledge and skills.
   Prepares clear and concise e-mails and other basic required written communications.
PROBLEM SOLVING & DECISION MAKING 
   Is objective; is able to evaluate facts apart from personal bias.
   Identifies key decisions within area of responsibility and escalates tasks to appropriate authority as needed.
   Effectively uses appropriate decision-making techniques.
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