The Case Manager performs reviews of all inpatient admission records to ensure proper utilization of hospital resources and determination of admission for appropriate level of care. Assesses and ...
The Case Manager performs reviews of all inpatient admission records to ensure proper utilization of hospital resources and determination of admission for appropriate level of care. Assesses and ...
Case Manager (51692)
Port Richey, FL · On-site
$17 - $19/hr
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 ...
Case Manager (51692)
Port Richey, FL · On-site
$17 - $19/hr
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 ...
The Case Manager performs reviews of all inpatient admission records to ensure proper utilization of hospital resources and determination of admission for appropriate level of care. Assesses and ...
The Case Manager performs reviews of all inpatient admission records to ensure proper utilization of hospital resources and determination of admission for appropriate level of care. Assesses and ...
DCM Case Manager
Clearwater, FL · On-site
$18.50 - $23.75/hr
Meet regularly with the Case Management Supervisor to review caseload and receive guidance. * Provide ongoing program evaluations and suggest improvements to enhance service delivery. * Participate ...
DCM Case Manager
Clearwater, FL · On-site
$18.50 - $23.75/hr
Meet regularly with the Case Management Supervisor to review caseload and receive guidance. * Provide ongoing program evaluations and suggest improvements to enhance service delivery. * Participate ...
Telephonic Nurse Case Manager II
$75K - $119K/yr
Assists with development of utilization/care management policies and procedures. Minimum ... Ability to manage, review and respond to emails/instant messages in a timely fashion. For ...
Telephonic Nurse Case Manager II
$75K - $119K/yr
Assists with development of utilization/care management policies and procedures. Minimum ... Ability to manage, review and respond to emails/instant messages in a timely fashion. For ...
Minimum two (2) years of experience as an LPN in healthcare * Minimum one (1) year of experience as a Utilization Review Nurse or Case Manager Licenses, certification, or registration: * Active and ...
Minimum two (2) years of experience as an LPN in healthcare * Minimum one (1) year of experience as a Utilization Review Nurse or Case Manager Licenses, certification, or registration: * Active and ...
A minimum of 1 year of utilization review, home health, discharge planning experience highly desired. * A minimum of 1 year of case management experience in acute case management or ambulatory case ...
A minimum of 1 year of utilization review, home health, discharge planning experience highly desired. * A minimum of 1 year of case management experience in acute case management or ambulatory case ...
A minimum of 1 year of utilization review, home health, discharge planning experience highly desired. * A minimum of 1 year of case management experience in acute case management or ambulatory case ...
A minimum of 1 year of utilization review, home health, discharge planning experience highly desired. * A minimum of 1 year of case management experience in acute case management or ambulatory case ...
RN Care Manager - FGC Market
Tampa, FL · On-site
A minimum of 1 year of utilization review, home health, discharge planning experience highly desired. * A minimum of 1 year of case management experience in acute case management or ambulatory case ...
RN Care Manager - FGC Market
Tampa, FL · On-site
A minimum of 1 year of utilization review, home health, discharge planning experience highly desired. * A minimum of 1 year of case management experience in acute case management or ambulatory case ...
Case Manager - AMIkids Tampa
Thonotosassa, FL · On-site
$18 - $23.25/hr
We are seeking a Case Manager to oversee the service planning and transitional process for youth ... For further information, please review the Know Your Rights notice from the Department of Labor.
Case Manager - AMIkids Tampa
Thonotosassa, FL · On-site
$18 - $23.25/hr
We are seeking a Case Manager to oversee the service planning and transitional process for youth ... For further information, please review the Know Your Rights notice from the Department of Labor.
Case Manager I
Bushnell, FL · On-site
$18.25 - $23.50/hr
The Case Manager I functions as an advocate and support person to those individuals assigned to ... Based on this assessment, develop and review the service plan as required to meet consumer needs ...
Case Manager I
Bushnell, FL · On-site
$18.25 - $23.50/hr
The Case Manager I functions as an advocate and support person to those individuals assigned to ... Based on this assessment, develop and review the service plan as required to meet consumer needs ...
The Utilization Management Assistant responsibilities include: * Participating on the Utilization ... Provides assistance with coordination of case management services and various administrative duties.
The Utilization Management Assistant responsibilities include: * Participating on the Utilization ... Provides assistance with coordination of case management services and various administrative duties.
... utilization. What qualifications you will need: Bachelor's Degree in Nursing OR Licensed ... We promptly review all applications. Highly qualified candidates will be directly contacted by a ...
... utilization. What qualifications you will need: Bachelor's Degree in Nursing OR Licensed ... We promptly review all applications. Highly qualified candidates will be directly contacted by a ...
Case Manager IV
New Port Richey, FL · On-site
$23.08 - $23.09/hr
The case manager IV will provide additional support to the other case managers and review how cases are being handled to better utilize resources. ESSENTIAL DUTIES AND RESPONSIBILITIES: (These ...
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Case Manager IV
New Port Richey, FL · On-site
$23.08 - $23.09/hr
The case manager IV will provide additional support to the other case managers and review how cases are being handled to better utilize resources. ESSENTIAL DUTIES AND RESPONSIBILITIES: (These ...
Case Manager RN - Inpatient
Tampa, FL · On-site
Reviews medical record to anticipate clinical stability and to have a thorough understanding of the ... over-utilization. Creates, implements, and updates Patient Specific Action Plan (PSAP) on ED ...
Case Manager RN - Inpatient
Tampa, FL · On-site
Reviews medical record to anticipate clinical stability and to have a thorough understanding of the ... over-utilization. Creates, implements, and updates Patient Specific Action Plan (PSAP) on ED ...
... utilization. * Reliable execution of Panel Review and Burden of Disease action items. * Effective ... Have case management experience, especially if you possess the CCM (Certified Case Manager). * Have ...
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... utilization. * Reliable execution of Panel Review and Burden of Disease action items. * Effective ... Have case management experience, especially if you possess the CCM (Certified Case Manager). * Have ...
... utilization. * Reliable execution of Panel Review and Burden of Disease action items. * Effective ... Have case management experience, especially if you possess the CCM (Certified Case Manager). * Have ...
... utilization. * Reliable execution of Panel Review and Burden of Disease action items. * Effective ... Have case management experience, especially if you possess the CCM (Certified Case Manager). * Have ...
... utilization. * Reliable execution of Panel Review and Burden of Disease action items. * Effective ... Have case management experience, especially if you possess the CCM (Certified Case Manager). * Have ...
... utilization. * Reliable execution of Panel Review and Burden of Disease action items. * Effective ... Have case management experience, especially if you possess the CCM (Certified Case Manager). * Have ...
... utilization. * Reliable execution of Panel Review and Burden of Disease action items. * Effective ... Have case management experience, especially if you possess the CCM (Certified Case Manager). * Have ...
... utilization. * Reliable execution of Panel Review and Burden of Disease action items. * Effective ... Have case management experience, especially if you possess the CCM (Certified Case Manager). * Have ...
... utilization. * Reliable execution of Panel Review and Burden of Disease action items. * Effective ... Have case management experience, especially if you possess the CCM (Certified Case Manager). * Have ...
... utilization. * Reliable execution of Panel Review and Burden of Disease action items. * Effective ... Have case management experience, especially if you possess the CCM (Certified Case Manager). * Have ...
Utilization Review Case Manager information
See Spring Hill, FL salary details
$14.07 - $17.43
3% of jobs
$17.43 - $20.78
1% of jobs
$20.78 - $24.14
6% of jobs
$25.76 is the 25th percentile. Wages below this are outliers.
$24.14 - $27.50
30% of jobs
The median wage is $28.70 / hr.
$27.50 - $30.85
26% of jobs
$32.13 is the 75th percentile. Wages above this are outliers.
$30.85 - $34.21
22% of jobs
$34.21 - $37.56
3% of jobs
$37.56 - $40.92
0% of jobs
$40.92 - $44.27
5% of jobs
$44.27 - $47.63
2% of jobs
$47.63 - $50.99
1% of jobs
$14
$30
$50
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 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?
| 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 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:
Case Manager - PRN | Wiregrass Ranch Rehab
Wesley Chapel, FL • On-site
Other
Re-posted 11 days ago
Job description
Overview
BE THERE BEFORE THE DOORS OPEN!
Join PAM Health Wiregrass Ranch's brand-new rehabilitation hospital opening this fall and help shape the future of patient care from the beginning.
If you're looking for a schedule that fits your lifestyle, check out PAM Health.
Some things that our hospital can offer YOU:
Responsibilities
OT, PT, RN, RRT, SLP, LSW
The Case Manager is responsible for the interdisciplinary coordination of care for a designated patient population. The Case Manager performs reviews of all inpatient admission records to ensure proper utilization of hospital resources and determination of admission for appropriate level of care. Assesses and identifies discharge needs and coordinates appropriate discharge plan. Works collaboratively with the interdisciplinary team to facilitate achievement of desired financial and quality outcomes. The Case Manager will also maintain and enhance payor relationships.
Qualifications
About PAM Health
PAM HEALTH (PAM) based in Enola, Pennsylvania, provides specialty healthcare services through more than 80 locations, as well as wound clinics and outpatient physical therapy locations, in 17 states. PAM Health is committed to providing high-quality patient care and outstanding customer service, coupled with the loyalty and dedication of highly trained staff, to be the most trusted source for post-acute services in every community it serves. Its mission is to serve people by providing compassionate, expert care, and to support recovery through education and research. Joining our PAMily allows you to work in a collaborative environment with colleagues and leadership with exposure to a variety of patient care levels. Aside from our competitive pay, generous paid benefit time, and excellent insurance options, you will also have opportunities for professional growth through our Education Advancement Program. We are excited to learn more about you and hope that you consider joining us on a shared mission to improve the lives of others by being an integral part of our We Care Program. Please take a moment to visit us online at www.PAMHealth.com for a comprehensive look at how we're able to positively impact our local communities.
PAM Health does not discriminate and does not permit discrimination, including, without limitation, bullying, abuse or harassment, on the basis of actual or perceived race, color, religion, national origin, ancestry, age, gender, physical or mental disability, sexual orientation, gender identity or expression or HIV status, or based on association with another person on account of that person's actual or perceived race, color, religion, national origin, ancestry, age, gender, physical or mental disability, sexual orientation, gender identity or expression or HIV status.
BE THERE BEFORE THE DOORS OPEN!
Join PAM Health Wiregrass Ranch's brand-new rehabilitation hospital opening this fall and help shape the future of patient care from the beginning.
If you're looking for a schedule that fits your lifestyle, check out PAM Health.
Some things that our hospital can offer YOU:
- Opportunities for growth and advancement
- Flexible scheduling
- Employee Bonus Referral Program
- Supportive leadership
Responsibilities
OT, PT, RN, RRT, SLP, LSW
The Case Manager is responsible for the interdisciplinary coordination of care for a designated patient population. The Case Manager performs reviews of all inpatient admission records to ensure proper utilization of hospital resources and determination of admission for appropriate level of care. Assesses and identifies discharge needs and coordinates appropriate discharge plan. Works collaboratively with the interdisciplinary team to facilitate achievement of desired financial and quality outcomes. The Case Manager will also maintain and enhance payor relationships.
Qualifications
- Education and Training: Licensure in the state where the hospital resides is preferred. Professional disciplines of the designated case manager may include occupational therapist, physical therapist, registered nurse, respiratory therapist, speech therapist, or (licensed) social worker. Current BLS certification required.
- Experience: Three (3) to five (5) years of inpatient experience, preferably in an acute, IRF, or LTACH setting.
About PAM Health
PAM HEALTH (PAM) based in Enola, Pennsylvania, provides specialty healthcare services through more than 80 locations, as well as wound clinics and outpatient physical therapy locations, in 17 states. PAM Health is committed to providing high-quality patient care and outstanding customer service, coupled with the loyalty and dedication of highly trained staff, to be the most trusted source for post-acute services in every community it serves. Its mission is to serve people by providing compassionate, expert care, and to support recovery through education and research. Joining our PAMily allows you to work in a collaborative environment with colleagues and leadership with exposure to a variety of patient care levels. Aside from our competitive pay, generous paid benefit time, and excellent insurance options, you will also have opportunities for professional growth through our Education Advancement Program. We are excited to learn more about you and hope that you consider joining us on a shared mission to improve the lives of others by being an integral part of our We Care Program. Please take a moment to visit us online at www.PAMHealth.com for a comprehensive look at how we're able to positively impact our local communities.
PAM Health does not discriminate and does not permit discrimination, including, without limitation, bullying, abuse or harassment, on the basis of actual or perceived race, color, religion, national origin, ancestry, age, gender, physical or mental disability, sexual orientation, gender identity or expression or HIV status, or based on association with another person on account of that person's actual or perceived race, color, religion, national origin, ancestry, age, gender, physical or mental disability, sexual orientation, gender identity or expression or HIV status.