Nurse Manager Case Management and Utilization Review

Overview

Nurse Manager Case Management and Utilization Review opportunity at an award winning hospital in Southern Arizona, lead bold improvements in access, outcomes, and experience while having fun doing it!

• Guide a highly collaborative Case Management service that thrives on care coordination, utilization management, discharge planning, and transitions-of-care excellence.
• Partner closely with social work, pharmacy, and physician advisors to streamline denials prevention, optimize length of stay, and enhance patient flow.
• Leverage evidence-based criteria (Inter Qual/MCG), payer collaboration strategies, and data transparency to ensure the right care, at the right time, in the right setting for every patient.
• Lead a friendly, diverse, and high-performing team of RN Case Managers, UM Reviewers, and Social Work professionals.
• Manage daily operations, staffing, concurrent review, escalation pathways with physician advisors, readmission reduction, observation management, and avoidance of condition code 44 pitfalls.
• Ensure regulatory and CMS compliance, denial mitigation, and interdisciplinary rounding.
• Provide strong educator support, onboarding resources, and leadership development to foster a resilient, engaged team.

Set in Southern Arizona’s sun‑drenched desert and mountain landscapes, the Nursing Manager Case Management role offers an enviable lifestyle with year‑round outdoor recreation in saguaro‑studded parks, stellar cycling routes, trail running, and golf; the region features vibrant arts and culture, music and food festivals, acclaimed Sonoran cuisine, a lively university influence, and a growing tech and healthcare job market. Families appreciate diverse schools, parks, community programs, and plentiful youth sports, while professionals enjoy a lower cost of living than many Western metros, varied housing from historic bungalows to modern new builds, easy access to regional airports and highways, strong healthcare access, and a welcoming community vibe, making Southern Arizona a compelling home base for the Nursing Manager Case Management career path.

The Nurse Manager Case Management and Utilization Review will be offered competitive compensation aligned to experience and scope, plus a comprehensive benefits package that may include sign‑on and relocation incentives, premium differentials, robust PTO, tuition assistance and paid CEUs, certification bonuses, mental health and wellness resources, and retirement plans with employer contributions.