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Utilization Review Case Manager Jobs in Utah (NOW HIRING)

University of Utah Health

Case Manager

Salt Lake City, UT · On-site

$19.25 - $25/hr

Case management services include monitoring patient care to ensure progress toward desired outcome ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

University of Utah Health

Case Manager

Park City, UT · On-site

$21 - $27/hr

Case management services include monitoring patient care to ensure progress toward desired outcome ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

University of Utah Health

Case Manager

Salt Lake City, UT · On-site

$19.25 - $25/hr

Case management services include monitoring patient care to ensure progress toward desired outcome ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

University of Utah Health

Case Manager

Salt Lake City, UT · On-site

$19.75 - $25.50/hr

Case management services include monitoring patient care to ensure progress toward desired outcome ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

University of Utah Health

Case Manager

Salt Lake City, UT · On-site

$19.25 - $25/hr

Case management services include monitoring patient care to ensure progress toward desired outcome ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

University of Utah Health

Case Manager

Salt Lake City, UT · On-site

$19.75 - $25.25/hr

Case management services include monitoring patient care to ensure progress toward desired outcome ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

University of Utah Health

Case Manager

Salt Lake City, UT · On-site

$19.25 - $25/hr

Case management services include monitoring patient care to ensure progress toward desired outcome ... Negotiates with third party payers relative to benefit levels, eligibility, utilization review, and ...

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Utilization Review Case Manager information

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$15

$33

$54

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

As of Aug 13, 2026, the average hourly pay for utilization review case manager in Utah is $33.22, according to ZipRecruiter salary data. Most workers in this role earn between $26.92 and $35.00 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 Utah?

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

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

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

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

Cities in Utah 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 Utah as of August 2026, with employment types broken down into 1% As Needed, 85% Full Time, 13% Part Time, and 1% Contract. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution, with an average salary of $69,089 per year, or $33.2 per hour.

Utilization Review Nurse

University of Utah

Salt Lake City, UT • On-site

Other

Re-posted 21 days ago

University Of Utah rating

7.2

Company rating: 7.2 out of 10

Based on 159 frontline employees who took The Breakroom Quiz

384th of 618 rated colleges and universities

Job description

Overview
As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA
This position is responsible for maintaining the financial integrity of both the patient and the organization through the provision of quality based patient care focusing on the medical necessity and efficiency of the delivery of such care; achieved via managing the cost of care while providing timely and accurate information to third party payers and medical care team. This position may be required to access and administer medications within their scope of practice and according to state law.
Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.
Responsibilities
Essential Functions
  • Applies approved utilization criteria to monitor appropriateness of admissions with associated levels of care and continued stay review.
  • Communication to third-party payers for initial and concurrent clinical review.
  • Reviews patient chart to ensure patient continues to meet medical necessity.
  • Documentation of all actions and information shared with care team members or third-party payer.
  • Alerts and discusses with physician/provider and case manager/discharge planner when patient no longer meets medical necessity criteria for the inpatient stay.
  • Discusses with physicians the appropriateness of resource utilization.
  • Tracks length of stay (LOS) and resource utilization to identify at risk patients.
  • Refers to UR committee any case that surpasses expected LOS, expected cost, or over/under-utilization of resources.
  • Performs verbal/fax clinical review with payer as determined by nursing judgment and/or collaboration with the payer per university contractual obligation.
  • Participant in UR Committee as needed.
  • Collects data on variances in LOS, avoidable days, costs/barriers to discharge/transition and denied days.
  • Prepares appeals on denied cases when appropriate.
  • At the discretion of department operational and patient care needs, this position is required to work rotating schedules, which may include variable hours, weekends, nights, and holidays to meet the staffing and patient care demands of a 24/7 complex health system. Regular, reliable, and punctual attendance during assigned shifts is considered an essential function of the role.
Knowledge / Skills / Abilities
  • Demonstrated availability to work variable and rotating shifts, including nights, weekends, and holidays, in a 24/7 patient care environment.
  • Ability to perform the essential functions of the job as outlined above.
  • Demonstrated team leadership, relationship building, critical analysis, and written and verbal communication skills.
  • Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria.
  • The ability to demonstrate knowledge of the principles of life span growth and development and the ability to assess data regarding the patient's status and provide care as described in the department's policies and procedures manual.
  • Ability to work autonomously and as a team member.
Qualifications
Required
  • One year Utilization Review or Case Management experience.
Licenses Required
  • Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 days of hire under the interstate compact if switching residency to State of Utah. Must maintain current Interstate Compact (multi-state) license if residency is not being changed to Utah.
* Additional license requirements as determined by the hiring department.
Qualifications (Preferred)
Preferred
  • Basic Life Support Health Care Provider card.
  • Proficiency in application of InterQual Criteria, knowledge of ICD-9, DRG's and CPT Codes.
  • Utilization Review Certification designation.
  • Knowledge of CMS Regulations.
Working Conditions and Physical Demands
Employee must be able to meet the following requirements with or without an accommodation.
  • This is a sedentary position in an office setting that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions. This position does not provide care to patients.

Physical Requirements
Color Determination, Listening, Manual Dexterity, Sitting, Speaking, Standing, Walking

What University Of Utah employees say

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About University of Utah

Sourced by ZipRecruiter

The University of Utah is the state’s flagship institution of higher education, with 18 schools and colleges, more than 100 undergraduate majors and graduate programs, and an enrollment of more than 38,000 students. It is a member of the Association of American Universities—an invitation-only, prestigious group of 71 leading research institutions. The U is advancing a new national model for higher education that delivers societal impact through education, research, health care, and community service, while making social, economic, and cultural contributions that improve lives across Utah and around the world.

Industry

Colleges, universities, and professional schools

Company size

10,000+ Employees

Headquarters location

Salt Lake City, UT, US

Year founded

1850

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