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Utilization Review Case Manager Jobs in Wisconsin

Center for Veterans Issues, Inc.

Case Manager

Green Bay, WI · On-site

$19.50 - $25/hr

Case Manager - Veterans Housing Stability Are you passionate about serving those who have served ... Review intake assessments and identify individualized service needs * Develop and monitor Housing ...

Froedtert

RN, Denials Management

Menomonee Falls, WI · On-site

$36.38 - $56.39/hr

Assists the case managers with utilization review issues, and provides recommendations for process improvement in the areas of utilization review and denial management. Other duties as assigned.

Opportunities, Inc.

Case Manager

Fort Atkinson, WI · On-site

$18.25 - $23.50/hr

Facilitate annual and semi-annual review meetings to evaluate progress and update goals. * Train ... case management, or disability services * Excellent communication, organization, and problem ...

Catholic Charities

Medical Case Manager

Madison, WI · On-site

$22.74/hr

The Medical Case Manager is responsible for coordinating and managing appropriate services as they ... Obtains and reviews lists of prescribed medications along with signed medication orders from client ...

Oconto County (WI)

Child Welfare Case Manager

Oconto, WI

$29.07 - $32.09/hr

Attend and participate in staffing, agency and other required meetings, and record reviews. Provide ... Proficient computer utilization skills. Supplemental Information When applying please attach a ...

Oconto County, WI

Child Welfare Case Manager

Oconto, WI · On-site

$29.07 - $32.09/hr

Attend and participate in staffing, agency and other required meetings, and record reviews. Provide ... Proficient computer utilization skills. Supplemental Information When applying please attach a ...

FROEDTERT HEALTH

RN CASE MANAGER

Menomonee Falls, WI · On-site

... utilization and monitoring of healthcare resources. The RN Case Manager utilizes standards, guidelines, and protocols for care delivery and incorporates data to continuously improve care and outcomes.

Froedtert

RN CASE MANAGER

Milwaukee, WI · On-site

... utilization and monitoring of healthcare resources. The RN Case Manager utilizes standards, guidelines, and protocols for care delivery and incorporates data to continuously improve care and outcomes.

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All JobsUtilization Review Case JobsUtilization Review Case Manager JobsUtilization Review Case Manager Jobs in Wisconsin

Utilization Review Case Manager information

See Wisconsin salary details

$16

$36

$60

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

As of Aug 16, 2026, the average hourly pay for utilization review case manager in Wisconsin is $36.83, according to ZipRecruiter salary data. Most workers in this role earn between $29.86 and $38.80 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 Wisconsin?

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

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

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

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

Cities in Wisconsin 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 Wisconsin as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 15% Part Time, and 1% Contract. Highlights an 93% Physical, 3% Hybrid, and 4% Remote job distribution, with an average salary of $76,601 per year, or $36.8 per hour.

Case Manager - Inpatient Rehab

Select Medical Rehabilitation - Madison

Madison, WI • On-site

Per diem

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 8 days ago

Job description

Overview
Select Medical Madison Rehabilitation Hospital
*A joint venture with Select Medical & Hospital*
Madison, Wisconsin
Case Manager (RN, SW, RT, LPN)
M-F 8HR Shifts *As Needed Basis*
Why Join Us?
  • Start Strong: Extensive and thorough orientation program to ensure a smooth transition into our setting
  • Recharge & Refresh: Generous PTO and Paid Sick Time for full-time team members to maintain a healthy work-life balance
  • Your Health Matters: Comprehensive medical/RX, health, vision, employee assistance program (EAP) and dental plan offerings for full-time team members
  • Invest in Your Future: Company-matching 401(k) retirement plan, as well as life and disability protection for full-time team members
  • Your Impact Matters: Join a team of over 44,000 committed to providing exceptional patient care

Responsibilities
Position Summary
The Case Manager is responsible for the coordination of health care decisions by using a systematic approach to assure treatment plans that improve quality and outcomes, coordination of care across the continuum; promotion of cost-effective care within the allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and appropriate discharge plans. The Case Manager assesses the psychosocial needs of the patient and provides intervention as part of the discharge planning process.
The primary job functions in Case Management include:
  • Clinical Interventions/Discharge Planning
  • Care Planning Management
  • Fiscal Management
  • Payer/Referral Management

Qualifications
Minimum Qualifications
  • Current Licensure per sate guidelines in a clinical or related discipline OR a Bachelor's or Master's in health or human services discipline.

Previous Experience
  • Previous experience in Case Management and Discharge Planning preferred.
  • CCM Certification Preferred.

Additional Data
Equal Opportunity Employer/including Disabled/Veterans

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