Registered Nurse Case Manager / Utilization Review Nurse Calling all Registered Nurse Case Managers. Have immediate openings for Registered Nurse Case Managers and Utilization Review Nurses in ...
Registered Nurse Case Manager / Utilization Review Nurse Calling all Registered Nurse Case Managers. Have immediate openings for Registered Nurse Case Managers and Utilization Review Nurses in ...
Experience : 4 years of recent clinical experience in a defined specialty area (e.g., oncology, cardiology, neonatology, etc.) or 4 years of utilization review/case management/clinical experience.
Experience : 4 years of recent clinical experience in a defined specialty area (e.g., oncology, cardiology, neonatology, etc.) or 4 years of utilization review/case management/clinical experience.
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
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Case Management Coordinator/Registered (cur_1_128790@curatelyai.net)
Columbia, SC · Remote
$25 - $30/hr
Utilization Review & Authorization: Conduct medical/behavioral reviews and authorize services based ... case management/clinical experience with at least 2 years clinical. * Required Education ...
New
Quick apply
Be Seen First
Case Management Coordinator/Registered (cur_1_128790@curatelyai.net)
Columbia, SC · Remote
$25 - $30/hr
Utilization Review & Authorization: Conduct medical/behavioral reviews and authorize services based ... case management/clinical experience with at least 2 years clinical. * Required Education ...
New
Currently seeking a Telephonic Nurse Case Manager. Qualified candidate will need to be located ... Responsible for the performance of Utilization Review services, including pre-admission ...
Currently seeking a Telephonic Nurse Case Manager. Qualified candidate will need to be located ... Responsible for the performance of Utilization Review services, including pre-admission ...
Telephonic Case Manager (RN)
Columbia, SC · On-site
Responsible for the performance of Utilization Review services, including pre-admission ... case management process. Works as an intermediary between carriers, attorneys, medical care ...
Telephonic Case Manager (RN)
Columbia, SC · On-site
Responsible for the performance of Utilization Review services, including pre-admission ... case management process. Works as an intermediary between carriers, attorneys, medical care ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Case Manager
$18.50 - $23.75/hr
Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications License or Certification:
Case Manager
$18.50 - $23.75/hr
Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications License or Certification:
Case Manager
Columbia, SC · On-site
Provide CLTC case management services to CLTC participants face to face and over the phone during ... Handle case assignments, draft service plans, review case progress and determine case closure
Quick apply
Case Manager
Columbia, SC · On-site
Provide CLTC case management services to CLTC participants face to face and over the phone during ... Handle case assignments, draft service plans, review case progress and determine case closure
Utilization Management Dept. PRN Any Variable Lexington Health is a comprehensive network of care ... Communicates with case management triad regarding reimbursement issues. * Uses appropriate channels ...
Utilization Management Dept. PRN Any Variable Lexington Health is a comprehensive network of care ... Communicates with case management triad regarding reimbursement issues. * Uses appropriate channels ...
Utilization Management Dept. PRN Any Variable Lexington Health is a comprehensive network of care ... Communicates with case management triad regarding reimbursement issues. * Uses appropriate channels ...
Utilization Management Dept. PRN Any Variable Lexington Health is a comprehensive network of care ... Communicates with case management triad regarding reimbursement issues. * Uses appropriate channels ...
Utilization Management Dept. PRN Any Variable Lexington Health is a comprehensive network of care ... Communicates with case management triad regarding reimbursement issues. * Uses appropriate channels ...
Utilization Management Dept. PRN Any Variable Lexington Health is a comprehensive network of care ... Communicates with case management triad regarding reimbursement issues. * Uses appropriate channels ...
Utilization Review Case Manager information
See Lexington, SC salary details
$14.20 - $17.58
3% of jobs
$17.58 - $20.97
1% of jobs
$20.97 - $24.35
6% of jobs
$25.99 is the 25th percentile. Wages below this are outliers.
$24.35 - $27.74
30% of jobs
The median wage is $28.96 / hr.
$27.74 - $31.13
26% of jobs
$32.42 is the 75th percentile. Wages above this are outliers.
$31.13 - $34.51
22% of jobs
$34.51 - $37.90
3% of jobs
$37.90 - $41.28
0% of jobs
$41.28 - $44.67
5% of jobs
$44.67 - $48.05
2% of jobs
$48.05 - $51.44
1% of jobs
$14
$31
$51
How much do utilization review case manager jobs pay per hour?
As of Aug 12, 2026, the average hourly pay for utilization review case manager in Lexington, SC is $31.23, according to ZipRecruiter salary data. Most workers in this role earn between $25.29 and $32.93 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?
| Aspect | Utilization Review Case Manager | Utilization Review Nurse |
|---|---|---|
| Credentials | Typically requires a nursing license or relevant healthcare certification | Registered Nurse (RN) license is required |
| Work Environment | Office-based, insurance companies, healthcare organizations | Hospital, clinic, insurance review departments |
| Primary Focus | Reviewing medical necessity, coordinating care, managing cases | Assessing 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 Lexington, SC? For Utilization Review Case Manager jobs in Lexington, SC, the most frequently searched job titles are:
What job categories do people searching Utilization Review Case Manager jobs in Lexington, SC look for? The top searched job categories for Utilization Review Case Manager jobs in Lexington, SC are:
What cities near Lexington, SC are hiring for Utilization Review Case Manager jobs? Cities near Lexington, SC with the most Utilization Review Case Manager job openings:
Full-time
Medical, Dental, Vision
Re-posted 12 days ago
Job description
Company Description
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Job Description
Location: Columbia, SC
Job Title: Registered Nurse Case Manager / Utilization Review Nurse
Calling all Registered Nurse Case Managers. Have immediate openings for Registered Nurse Case Managers and Utilization Review Nurses in Columbia, SC. Now is your time to apply and work for a Fortune 125 company. Will take clinical nurses.
Take advantage of flexible hours, a competitive salary, and be a RN Case Manager with one of the fastest-growing healthcare companies in the U.S. Get in NOW, while there is still huge room for growth and career development!
This exciting opportunity will require a RN Case Manager or Utilization Review Nurses who can provide a high level of service and attention to their patients. If you are a RN Case Manager and you meet the qualifications listed below, please click apply below for consideration!
Daily Responsibilities:
- This RN Case Manager will be assisting members that have dual enrollment which means age 65 and over and have low income and resources
- This RN Case Manager is a field case management position about 40% field the remainder of the time will be reporting to the North Charleston office if need be to perform assessments on members that have just signed up with the Medicare or Medicare plan
- This RN Case Manager will also be responsible for assessing, planning and coordinating all medical services especially MMT (Medicare Medical Transportation services) and supporting services across the continuum of care for select members to promote quality, cost effective car
- Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
- Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes
- Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socioeconomic needs of clients
Advantages of this Opportunity:
- Competitive salary
- Benefits offered, Medical, Dental, and Vision
- Growth Opportunity
- Fun and positive work environment
- Interested in being considered?
If you are interested in being considered for the RN Case Manager position, please click the Apply button below!
Qualifications
Requirements:
- 1+ years of clinical nursing experience in an acute care setting
- 1+ years of case management experience with the adult and geriatric population in a managed care, home health, Hospital, or Hospice setting
- Knowledge of utilization management principles and healthcare managed care
- Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs
Additional Information
Interested in being considered for this great Registered Nursing Opportunity?
If you are interested in being considered for the RN Case Manager position, please click the Apply button below! Seeking Multiple RN Case Managers and Utilization Review Nurses!
About Healthcare Support
Sourced by ZipRecruiter
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
Industry
Recruiting and staffing services
Company size
201 - 500 Employees
Headquarters location
Maitland, FL, US
Year founded
2003