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Utilization Review Case Manager Jobs in Appleton, WI

RN - Case Manager

Appleton, WI ยท On-site

$1.8K - $1.9K/wk

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Appleton, Wisconsin Start Date: September 6, 2026 Profession: Registered Nurse (RN) Facility: Estimated Pay: $1847 ...

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 ...

Residential Case Manager

Appleton, WI ยท On-site

$22 - $26/hr

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

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.

As an RN Case Manager, you will play a critical role in making our patients' final days, weeks, and ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...

RN Case Manager

Omro, WI ยท On-site

$75K - $90K/yr

As an RN Case Manager, you will play a critical role in making our patients' final days, weeks, and ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...

RN Case Manager

Neenah, WI ยท On-site

$75K - $90K/yr

As an RN Case Manager, you will play a critical role in making our patients' final days, weeks, and ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...

RN Case Manager

New London, WI ยท On-site

$75K - $90K/yr

As an RN Case Manager, you will play a critical role in making our patients' final days, weeks, and ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...

RN Case Manager

Appleton, WI ยท On-site

$75K - $90K/yr

As an RN Case Manager, you will play a critical role in making our patients' final days, weeks, and ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...

As an RN Case Manager, you will play a critical role in making our patients' final days, weeks, and ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...

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Showing results 1-20

Utilization Review Case Manager information

See Appleton, WI salary details

$16

$35

$58

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

As of Aug 29, 2026, the average hourly pay for utilization review case manager in Appleton, WI is $35.60, according to ZipRecruiter salary data. Most workers in this role earn between $28.85 and $37.55 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 Appleton, WI?

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

What cities near Appleton, WI are hiring for Utilization Review Case Manager jobs?

Cities near Appleton, WI with the most Utilization Review Case Manager job openings:

Infographic showing various Utilization Review Case Manager job openings in Appleton, WI 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 $74,049 per year, or $35.6 per hour.

Travel RN Case Manager - $2,326 per week

American Traveler

Appleton, WI โ€ข On-site

$2.3K/wk

Other

Medical, Dental, Vision, Life, Retirement

Posted 10 days ago


Job description

American Traveler is seeking a travel nurse RN Case Management for a travel nursing job in Appleton, Wisconsin.

Job Description & Requirements
  • Specialty: Case Management
  • Discipline: RN
  • Start Date: 09/06/2026
  • Duration: 13 weeks
  • 40 hours per week
  • Shift: 8 hours, days
  • Employment Type: Travel
Assignment Overview
  • Shift: Days, 5x8hrs
  • Hours: 40 hrs/wk
  • Start Date: Sep 6, 2026
  • Length: 13 weeks
  • Openings: 1
Description

American Traveler is hiring an experienced RN Case Manager for a 13-week inpatient hospital assignment requiring at least 1 year of case management experience and a WI or compact RN license.

Details
  • Inpatient hospital setting within the Case Management department
  • Day shift schedule from 08:00 to 16:30
  • 13-week contract assignment
  • May require floating to Mercy and/or Calumet facilities as needed
Requirements
  • Active WI or compact RN license required
  • Current BLS certification from the American Heart Association (AHA)
  • Minimum of 1 year inpatient hospital Case Management experience required
  • Nursys license verification required within 30 days prior to start
  • Current license and primary source verification required within 30 days prior to start
Additional Information
  • Local candidates accepted, subject to a radius rule that may affect pay rate
  • Provide case management services to inpatient hospital patients

American Traveler Job ID #P-719869. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Travel RN - Case Management/Utilization Review - Case Management

About American Traveler

With over 25 years of experience, American Traveler has established a reputation for outstanding customer service. Our team ensures a smooth, worry-free experience for those starting on or expanding their travel nursing and allied careers.

With thousands of travel nursing and allied jobs nationwide, our attentive and approachable recruiters find positions that align perfectly with your career aspirations and personal requirements.

American Traveler offers exceptional benefits, including premium medical, dental, vision and life insurance beginning day one of your assignment, generous 401(k) match, substantial housing stipends, and more. Additionally, with 24/7 support and access to our in-house clinicians, you are assured confidence and comfort throughout your assignment.

With our team behind you, you can relax and enjoy a rewarding travel career.

Why Vivian Health?

Be sure to apply via Vivian Health to increase your chances of landing your perfect job. Just complete your Vivian Health profileonce, and get access to thousands of opportunities across the country. Then keep up to date with your job application process and conversations with our easy to use app.


American Traveler logo

About American Traveler

Sourced by ZipRecruiter

With over 20 years of success in healthcare staffing, American Traveler has established a reputation for outstanding customer service. Our full-service agency has earned top ratings from healthcare professionals in every specialty and setting. We offer travel assignments in the most sought-after locations and facilities in the country. We staff major medical centers, prestigious university teaching facilities, Magnet facilities, regional community hospitals, outpatient centers, rehab centers, skilled nursing facilities and more. With our expert team behind you every step of the way, you can enjoy a rewarding travel career that exceeds your expectations. With over 20 years of experience, American Traveler has established a reputation for outstanding customer service. With our team behind you, you can relax and enjoy a rewarding travel career.

Industry

Recruiting and staffing services

Company size

501 - 1,000 Employees

Headquarters location

Boca Raton, FL, US

Year founded

1999