Nurse Manager Case Management and Utilization Review

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!

The Nurse Manager Case Management and Utilization Review will join a mission-driven, patient-first culture known for clinical excellence, strong safety performance, and consistent quality outcomes supported by real-time analytics, modern EHR optimizations, and AI-informed decision support for throughput and utilization review; this healthcare organization celebrates recent PR momentum, high brand trust in the community, Magnet-inspired professional practice, robust shared governance, and leadership that listens through inclusive town halls and frontline-driven improvement, an environment where the Nurse Manager Case Management and Utilization Review can rapidly elevate care coordination, reduce avoidable days, and drive measurable value across acute and ambulatory settings.

The Nursing Manager Case Management will guide a highly collaborative Case Management service that thrives on care coordination, utilization management, discharge planning, and transitions-of-care excellence, partnering closely with social work, pharmacy, and physician advisors to streamline denials prevention, optimize length of stay, and enhance patient flow; in this award-winning hospital environment, the Nursing Manager Case Management will leverage evidence-based criteria (InterQual/MCG), payer collaboration strategies, and data transparency to ensure the right care, at the right time, in the right setting for every patient.

Reporting to a seasoned Director of Care Management with dotted-line collaboration to Quality, Revenue Cycle, and Population Health, the Nurse Manager Case Management and Utilization Review will lead a friendly, diverse, and high-performing team of RN Case Managers, UM Reviewers, and Social Work professionals; responsibilities include daily operations and staffing, concurrent review, escalation pathways with physician advisors, readmission reduction, observation management, avoidance of condition code 44 pitfalls, regulatory and CMS compliance, denial mitigation, and interdisciplinary rounding, with strong educator support, onboarding resources, and leadership development to help the Nurse Manager Case Management and Utilization Review grow 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; to explore this high-impact leadership role, connect today with a Clinical Management Consultants recruiter for a confidential conversation and take the next step toward advancing your Nursing Manager Case Management career in Southern Arizona.