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Utilization Review Case Manager Jobs in Wisconsin

RN CASE MANAGER

Milwaukee, WI ยท On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... 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.

RN CASE MANAGER

Menomonee Falls, WI ยท On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... 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.

Vocational Services Case Manager

Oconto, WI ยท On-site

$56K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Attend and participate in staff, agency and other required meetings, and record reviews. Provide ... Proficient computer utilization skills. We offer a complete benefits package to full-time employees ...

Residential Case Manager

Appleton, WI ยท On-site

$22 - $26/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Residential Case Manager provides case management, program management, staff supervision, and ... Applications are actively retained & reviewed for current and/or future openings for 60 days.

Residential Case Manager

Appleton, WI ยท On-site

$22 - $26/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Residential Case Manager provides case management, program management, staff supervision, and ... Applications are actively retained & reviewed for current and/or future openings for 60 days.

Registered Nurse Case Manager

Stoughton, WI ยท On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Stoughton Health Rn Case Manager Stoughton Health has an excellent opportunity for an RN Case ... This is a multi-focal role involving review of benefits for planned admissions, concurrent review ...

Showing results 41-60

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

Cities in Wisconsin with the most Utilization Review Case Manager job openings:

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 - Drug Treatment Court (DTC)

Wisconsin Community Services

Milwaukee, WI โ€ข On-site

$19 - $24.25/hr

Other

This job post hasย expired today.ย Applications are no longer accepted.


Job description

Wisconsin Community Services
Case Manager - Waukesha Drug Treatment Court (DTC)
Job Summary

The case manager is responsible for the day-to-day operations of the Waukesha County Drug Treatment Court, a post-plea and pre-disposition specialty court, which provides intensive support and monitoring of eligible drug offenders. Other responsibilities include providing routine updates and working collaboratively with the Drug Treatment Court Staffing Team, which includes the Drug Court Judge, as well as a representative from the District Attorneyโ€™s Office, Public Defenderโ€™s Office, Department of Corrections (DOC) and Waukesha County Health and Human Services (WCHHS).

 

Essential Duties and Responsibilities

  • Responsible for a range of case management services, providing structure, accountability, evidence-based programming and support for successful compliance while in the community.
  • Engage in supervision case management activities, including but not limited to: reviewing applications and discussing with the Supervisor and Drug Court Team, completing all required assessments prior to admission and intake and following through on the results; conducting new intakes and explaining the program components to participants, conducting face-to-face supervision appointments with participants to monitor compliance/non-compliance with all phase requirements and terms of supervision, refer to supportive services based on need, routine alcohol and drug testing, working with local treatment providers to ensure participantsโ€™ enrollment in and compliance with treatment, and monitor all participantsโ€™ compliance with all related fees (program, court, treatment), etc.
  • Creation of and maintenance of a hard file for each person in the program according to program protocols.
  • Create and follow case plans for each person in the DTC program, tracking progress made and phases/goals achieved.
  • Make referrals and monitor community-based services including treatment, employment, education and other supportive services.
  • Coordinate treatment provider referrals and monitor provider standards and accountability.
  • Ensure that the Treatment Court supervision model and its core elements are followed, including use of the LS/CMI risk and need assessment tool.
  • Enter appropriate data into the WCS AWARDS and CORE databases, ensuring timely and complete data entry.
  • Develop the weekly court calendar and attend and contribute to pre-hearing staffings and court hearings.
  • Collaborate closely with the Treatment Court Team.
  • Assist in representing the Drug Treatment Court at local, state and national meetings and training courses.
  • Assist with drug testing in the Waukesha Court Services programs, ensuring the integrity of all alcohol and drug testing procedures. Employees will also conduct drug and alcohol screens as needed, including weekend testing every 4-6 weeks as scheduled on Saturdays, from 7am to 10am.
  • Network with and maintain positive relationships with community resource providers.
  • Make recommendations and assist Court in determining Phase levels, sanctions, and incentives.
  • Assist with maintaining quality assurance of all written and electronic files and court communication.
  • Ensure protection of client confidentiality and compliance with all HIPAA policies.
  • Develop creative incentives and reward celebrations for persons served; may include soliciting potential donations for incentive gifts.
  • Coordinate utilization of the SCRAM system; work with WCS SCRAM staff, including the Program Director of Post Conviction Services to address issues โ€“ especially outstanding balances with fees owed by people in the program.
  • Responsible for assisting the Lead Case Manager and Program Director of Post Conviction Services with reporting and evaluation to fulfill the requirements of the funding source.
  • Assist the Program Director of Post Conviction Services to add people to the drug testing calling line and communicate with other WCS staff involved.
  • Notify the lead case manager, or in her absence, the program director, of any issues of non-compliance with people served immediately.
  • Attend the Waukesha County Victim Impact Panel at least once per year.
  • Attend all required training, including discipline-specific training on case management.
  • Maintain a flexible work schedule when needed to provide coverage in the office when necessary.
  • Other job-related duties may be necessary to carry out the responsibilities of the position.

Required Qualifications

  • Bachelorโ€™s degree in criminal justice, Social Work or other related field; Clinical Substance Use Counselor credentials preferred. Associateโ€™s degree with 5 years of related experience in case management for individuals in the justice system.
  • Court system experience with a preference for case management experience
  • Working knowledge of substance use issues and treatment
  • Ability to work with justice system and Waukesha County Jail Facility staff
  • Possess a valid Wisconsin Driverโ€™s License and insured auto
  • Must pass driverโ€™s license and criminal background checks

 

Knowledge, Skills and Abilities

  • Communication โ€“ strong verbal and written communication skills, including the ability to provide information effectively with a diverse population - the persons we serve, supervisor, colleagues, and program partners in writing and oral communications.
  • Technological Aptitude โ€“ Ability to use general technological skills throughout daily job i.e., Email, Internet, company specified systems, (ex. Microsoft 365, Windows, Word, Excel).
  • Managing Priorities/Deadlines โ€“ Ability to organize and maintain schedules, meet deadlines and manage multiple projects.
  • Problem-Solving Skills โ€“ Ability to think critically and be solution-oriented in a fast-paced environment and adapt to program changes and challenges, including crisis situations.
  • Adaptability โ€“ Ability to manage change, deal with situations as they arise and work independently or as part of a team.
  • Teamwork โ€“ Ability to work as a team participant productively while also managing independent duties and responsibilities.
  • Motivation โ€“ Possess a commitment to the assigned job, mission and core values of the organization while also supporting a respectful and harmonious work setting.
  • Professionalism โ€“ Ability to conduct oneself with a high level of integrity, ethics and boundaries.
  • Knowledge of Evidence-Based principles, including Motivational Interviewing, Trauma-Informed Care, Person-centered care, and other agency adopted principles, as well as following models for fidelity established by the agency. Complete training in all agency-required EBPโ€™s within six months of hire unless otherwise directed at the agency employment orientation.
  • Sensitivity to Backgrounds โ€“ The role involves working and interacting directly with a variety of populations, including persons served, partners, and service providers. As such, the employee must demonstrate professionalism, sensitivity, belonging, and strong interpersonal skills while representing the organization in a variety of settings.
  • Program Specific Knowledge, Skills and Abilities โ€“ Knowledge of the Wisconsin Justice System; knowledge of local treatment programs and community resources to include housing, education, public transportation; knowledge of the Circuit Court Access Program (CCAP)


PHYSICAL DEMANDS:

Duties require good hearing and the ability to communicate verbally; hand and finger dexterity for data entry and typing; involves some driving in Waukesha County and direct observation drug testing.

WORK ENVIRONMENT:

The employee has contact with a wide variety of individuals to include justice-involved individuals, court officials, law enforcement, jail staff, treatment and other services providers, DOC staff, other criminal justice agencies, other WCS staff, and family members of clients. The employee also works closely with the Treatment Court Judge and Team.  Work is performed primarily in an office setting but also includes going to weekly team staffing and court, and rarely, other locations.  The employee also is responsible for observing and supervising participant drug screens.  Participants may exhibit disruptive behavior at times.  The position is full-time, 40 hours each week to include some Saturdays (7:00-10:00am) for drug and alcohol testing.

Wisconsin Community Services, Inc. is an equal opportunity employer. All applicants will be considered for employment without attention to race, ethnicity, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. 


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