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Utilization Review Case Manager Jobs in Spring Hill, FL

Case Manager

Brooksville, FL · On-site

$45K/yr

Case Manager - Youth Behavioral Health Location: Brooksville, FL Job Type: Full-Time | Monday ... reviews to ensure policy compliance Qualifications Required: Bachelor's degree in counseling ...

Clinical Navigator

Tampa, FL · Remote

$61K - $84K/yr

The ideal candidate will have an active RN license and 3-5 years of workers' compensation and/or catastrophic case management experience. Experience with DME, utilization review, EMRs, care ...

Assess service utilization, identify gaps in care, and support initiatives that improve quality ... Participate in huddles, case reviews, committees, and workflow improvement initiatives while ...

Assess service utilization, identify gaps in care, and support initiatives that improve quality ... Participate in huddles, case reviews, committees, and workflow improvement initiatives while ...

Clinical Navigator

Tampa, FL · Remote

$61K - $84K/yr

The ideal candidate will have an active RN license and 3-5 years of workers' compensation and/or catastrophic case management experience. Experience with DME, utilization review, EMRs, care ...

DCM Case Manager Supervisor

Clearwater, FL · On-site

$18.50 - $23.75/hr

Review assigned cases weekly to verify compliance, progression toward goals, and timely updates of Individual Recovery Plans (IRPs) and Service Plans. * Provide case guidance and technical support to ...

Assists with development of utilization/care management policies and procedures, chairs and ... Prospective employees required to be screened under Florida law should review the education and ...

Clinical Navigator

Tampa, FL · On-site

$73K - $88K/yr

The ideal candidate will have an active RN license and 3-5 years of workers' compensation and/or catastrophic case management experience. Experience with DME, utilization review, EMRs, care ...

The Case Manager is responsible for developing individualized reentry case management plans, conducting client assessments, documenting daily case notes, and completing monthly case reviews. This ...

Showing results 21-40

Utilization Review Case Manager information

See Spring Hill, FL salary details

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

As of Aug 18, 2026, the average hourly pay for utilization review case manager in Spring Hill, FL is $30.95, according to ZipRecruiter salary data. Most workers in this role earn between $25.10 and $32.64 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 Spring Hill, FL?

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

What job categories do people searching Utilization Review Case Manager jobs in Spring Hill, FL look for?

The top searched job categories for Utilization Review Case Manager jobs in Spring Hill, FL are:

What cities near Spring Hill, FL are hiring for Utilization Review Case Manager jobs?

Cities near Spring Hill, FL with the most Utilization Review Case Manager job openings:

Infographic showing various Utilization Review Case Manager job openings in Spring Hill, FL as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 21% Part Time, and 1% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $64,386 per year, or $31 per hour.

Case Management Director

Encompass Health Corporation

Wesley Chapel, FL • On-site

Full-time, Part-time

Medical, Dental, Vision, Retirement, PTO

Posted 18 days ago


Encompass Health rating

7.0

Company rating: 7.0 out of 10

Based on 422 frontline employees who took The Breakroom Quiz

414th of 888 rated healthcare providers


Job description


Case Management Director Career Opportunity
Highly regarded for your Case Management Director expertise
Are you an experienced and compassionate healthcare professional with a background in case management, seeking a career that aligns with your professional expertise and resonates with your personal values? As the Director of Case Management at Encompass Health, you have the unique opportunity to lead a team and make a profound impact on the lives of individuals within your local community. This role combines fulfilling career opportunities close to home with the chance to make a meaningful difference in the well-being of those around you. Join us in this journey of care, compassion, and leadership as we work together to make a difference where it matters most, serving as a key member of our leadership team overseeing the day-to-day operations and management of our Case Management department.
A Glimpse into Our World
At Encompass Health, you'll experience the difference the moment you become a part of our team. Being at Encompass Health means aligning with a rapidly growing national inpatient rehabilitation leader. We take pride in the growth opportunities we offer and how our team unites for the greater good of our patients. Our achievements include being named one of the "World's Most Admired Companies" and receiving the Fortune 100 Best Companies to Work For® Award, among other accolades, which is nothing short of amazing.
Starting Perks and Benefits
At Encompass Health, we are committed to creating a supportive, inclusive, and caring environment where you can thrive. From day one, you will have access to:
• Affordable medical, dental, and vision plans for both full-time and part-time employees and their families.
• Generous paid time off that accrues over time.
• Opportunities for tuition reimbursement and continuing education.
• Company-matching 401(k) and employee stock purchase plans.
• Flexible spending and health savings accounts.
• A vibrant community of individuals passionate about the work they do!
Become the Case Management Director you've always aspired to be
• Assume responsibility for the day-to-day operations and human resource management of the Case Management department.
• Oversee the interdisciplinary plan of care and the discharge planning process to ensure the effectiveness and appropriateness of services with a central focus on census management, patient care outcomes, and key care indicators.
• Act as a patient and family advocate, ensuring that services are delivered to meet the needs of patients and their families.
• Provide guidance and support to Case Managers and other staff, including training on managing caseloads and interpreting regulations, policies, operational procedures, and objectives. Review operations to ensure a high level of quality consistent with organizational standards.
• Build relationships with insurance companies, self-insured employers, case management firms, and other healthcare networks.
• Celebrate the accomplishments and successes of our dedicated employees along the way.
Qualifications
• Current CCM® or ACMTM certification is preferred.
• Must be qualified to independently complete an assessment within the scope of practice of his/her discipline.
• If licensure is required for the discipline within the hospital's state, individual must hold an active license.
• For Nursing, must possess bachelor's degree in nursing (BSN) with RN licensure.
• For other eligible health care professionals, must possess a minimum of a bachelor's degree; a graduate degree is preferred.
• Three years of hospital-based Case Management experience, including Utilization Review and Discharge Planning experience.
• May be required to work weekdays and/or weekends, evenings and/or night shifts.
• May be required to work on religious and/or legal holidays on scheduled days/shifts.
#LI-BG1
About Us
The Encompass Health Way
We proudly set the standard in care by leading with empathy, doing what's right, focusing on the positive, and standing stronger together. Encompass Health is a trusted leader in post-acute care with over 150 nationwide locations and a team of 36,000 exceptional individuals and growing!
At Encompass Health, we celebrate and welcome diversity in our inclusive culture. We provide equal employment opportunities regardless of race, ethnicity, gender, sexual orientation, gender identity or expression, religion, national origin, color, creed, age, mental or physical disability, or any other protected classification.

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About Encompass Health

Sourced by ZipRecruiter

Helping patients regain hope and independence, Encompass Health is a national leader in post-acute care. We operate rehabilitation hospitals in 36 states as well as Puerto Rico. Following the Encompass Way, we are driven by our core values: We proudly set the standard, lead with empathy, do what's right, focus on the positive, and remain stronger together.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Birmingham, AL, US