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Utilization Review Case Manager Jobs in Mobile, AL

Vets Recover

Licensed Mental Health Clinician

Mobile, AL · On-site

Case managers * Peer Support Specialists * Recovery Support Staff * Admissions and intake personnel * Utilization Review staff * Community providers and referral partners The clinician contributes to ...

NHS Management, LLC

RN Unit Manager (8a-5p)

Mobile, AL · On-site

$32.50 - $43/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

We are in search of a qualified RN Unit Manager : * Assists in maintaining resident care standards ... utilization review activities. * Receives physicians' instructions regarding resident care and ...

NHS Management, LLC

RN Unit Manager (8a-5p)

Mobile, AL · On-site

$32.50 - $43/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

We are in search of a qualified RN Unit Manager : * Assists in maintaining resident care standards ... utilization review activities. * Receives physicians' instructions regarding resident care and ...

Athens Health and Rehabilitation LLC

Unit Manager - RN

Mobile, AL · On-site

$32.50 - $43/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... utilization review activities. * Receives physicians' instructions regarding resident care and ... Skill in organizing and planning programs and managing personnel to provide nursing service for ...

NHS Management Services

RN Unit Manager (8a-5p)

Mobile, AL · On-site

$39.50 - $52/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

We are in search of a qualified RN Unit Manager : * Assists in maintaining resident care standards ... utilization review activities. * Receives physicians' instructions regarding resident care and ...

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Utilization Review Case Manager information

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

As of Aug 19, 2026, the average hourly pay for utilization review case manager in Mobile, AL is $36.21, according to ZipRecruiter salary data. Most workers in this role earn between $29.33 and $38.17 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 Mobile, AL?

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

What job categories do people searching Utilization Review Case Manager jobs in Mobile, AL look for?

The top searched job categories for Utilization Review Case Manager jobs in Mobile, AL are:

What cities near Mobile, AL are hiring for Utilization Review Case Manager jobs?

Cities near Mobile, AL with the most Utilization Review Case Manager job openings:

Utilization Review Case Manager jobs near you

MDS Coordinator RN

Camellia Health and Rehabilitation Center

Mobile, AL

$30.50 - $36.75/hr

Full-time

Re-posted 29 days ago

Job description

MDS Coordinator (RN)

Mobile, Alabama

Join the team at Camellia Health & Rehabilitation Center and become part of a skilled nursing and rehabilitation team that truly works together to provide outstanding care and support to our residents.

We are seeking an experienced and motivated Registered Nurse (RN) to join our team as an MDS Coordinator. This is an excellent opportunity for an RN with MDS, Medicare, case management, or skilled nursing experience who is looking for a supportive environment, strong leadership, and a team-first culture.

At Camellia Health & Rehab, we believe great outcomes start with great teamwork. You will work alongside clinical leaders who value communication, collaboration, and quality care while helping drive strong clinical and reimbursement outcomes for the facility.

Why Join Our Team?

  • Supportive and collaborative leadership team

  • Team-focused culture with strong clinical support

  • Stable skilled nursing and rehabilitation environment

  • Opportunity to make a direct impact on resident care and outcomes

  • Competitive compensation

  • Full-time position with consistent schedule

  • Career growth opportunities within a growing organization

MDS Coordinator RN Responsibilities

  • Complete and oversee MDS assessments in accordance with CMS and state regulations

  • Coordinate the RAI process and interdisciplinary care planning

  • Ensure accuracy of Medicare and PDPM documentation

  • Collaborate with nursing, therapy, dietary, and social services teams

  • Monitor clinical documentation to support reimbursement and quality outcomes

  • Participate in Medicare meetings and utilization review processes

  • Maintain compliance with federal, state, and facility guidelines

  • Assist with care plan development and resident assessments

  • Support quality measures and survey readiness initiatives

Qualifications

  • Active Registered Nurse (RN) license in Alabama

  • Previous MDS Coordinator experience preferred

  • Skilled nursing facility (SNF) experience strongly preferred

  • Knowledge of PDPM, Medicare, and case management processes

  • Strong organizational and communication skills

  • Team-oriented mindset with a positive attitude

Camellia Health & Rehabilitation Center is an Equal Opportunity Employer (EOE). We celebrate diversity and are committed to creating an inclusive environment for all employees.

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