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Case Manager Utilization Review Nurse Jobs in Decatur, IL

Memorial Health

Case Manager

Decatur, IL · On-site

$25.72 - $39.86/hr

Ensures optimum utilization of resources, service delivery and compliance with clinical cost ... Serves as a liaison with nursing and medical staff and community agencies to facilitate problem ...

Memorial Health

Case Manager

Decatur, IL · On-site

$25.72 - $39.86/hr

Ensures optimum utilization of resources, service delivery and compliance with clinical cost ... Serves as a liaison with nursing and medical staff and community agencies to facilitate problem ...

Memorial Health

Case Manager

Decatur, IL · On-site

$25.72 - $39.86/hr

Ensures optimum utilization of resources, service delivery and compliance with clinical cost ... Serves as a liaison with nursing and medical staff and community agencies to facilitate problem ...

Traditions Health

RN Case Manager

Forsyth, IL

Nursing skills as defined as generally accepted standards of practice * Good interpersonal skills * Proof of current CPR Transportation: Reliable transportation and valid and current driver's license ...

Traditions Health

RN Case Manager

Forsyth, IL · On-site

Nursing skills as defined as generally accepted standards of practice * Good interpersonal skills * Proof of current CPR Transportation: Reliable transportation and valid and current driver's license ...

Pacs

Resident Care Manager

Sullivan, IL · On-site

Performs utilization review activities to provide resident appropriate, timely and cost effective ... RN Valid Licensee in the state you are working. Certificate as a certified Case Manager (CCM) a ...

The GEO Group

CASE MANAGER, DRC

Decatur, IL · On-site

$23/hr

The Case Manager provides ongoing support and structure to participants in developing program plans ... Review plan with participants on a weekly basis and document progress or revisions so that they are ...

The GEO Group

CASE MANAGER, DRC

Decatur, IL · On-site

$23/hr

The Case Manager provides ongoing support and structure to participants in developing program plans ... Review plan with participants on a weekly basis and document progress or revisions so that they are ...

The GEO Group

CASE MANAGER, DRC

Decatur, IL

$19.50 - $25/hr

The Case Manager provides ongoing support and structure to participants in developing program plans ... Review plan with participants on a weekly basis and document progress or revisions so that they are ...

The GEO Group

CASE MANAGER, DRC

Decatur, IL

$23/hr

The Case Manager provides ongoing support and structure to participants in developing program plans ... Review plan with participants on a weekly basis and document progress or revisions so that they are ...

The GEO Group

CASE MANAGER, DRC

Decatur, IL

$23/hr

The Case Manager provides ongoing support and structure to participants in developing program plans ... Review plan with participants on a weekly basis and document progress or revisions so that they are ...

VIVA USA INC

Field Case Management Coordinator

Decatur, IL · On-site

$18.75 - $25.25/hr

Through the use of care management tools and information/data review, conducts comprehensive ... nursing, counseling, etc.) or non-licensed masters-level clinician. Field Based Case Managers:

Memorial Health

RN - New Graduate

Lincoln, IL · On-site

$30.23 - $48.37/hr

The New Graduate Registered Nurse will receive support from their Nurse Manager, Preceptor, Mentor ... To review Memorial's Benefits click here: Benefits - Memorial HR Qualifications Licensure ...

Memorial Health

RN - New Graduate

Lincoln, IL

$30.23 - $48.37/hr

The New Graduate Registered Nurse will receive support from their Nurse Manager, Preceptor, Mentor ... To review Memorial's Benefits click here: Benefits - Memorial HR Licensure/Certification/Registry:

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All JobsCase Utilization Review Nurse JobsCase Manager Utilization Review Nurse JobsCase Manager Utilization Review Nurse Jobs in Decatur, IL

Case Manager Utilization Review Nurse information

See Decatur, IL salary details

$18

$46

$77

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

As of Jul 8, 2026, the average hourly pay for case manager utilization review nurse in Decatur, IL is $46.11, according to ZipRecruiter salary data. Most workers in this role earn between $34.28 and $55.72 per hour, depending on experience, location, and employer.

What is the difference between Case Manager Utilization Review Nurse vs Case Manager?

AspectCase Manager Utilization Review NurseCase Manager
CredentialsRN license, certification in utilization review (e.g., URAC)RN license, case management certification (e.g., CCM)
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community health, insurance providers
Primary FocusReviewing medical necessity and appropriateness of careCoordinating patient care and discharge planning

While both roles involve patient care coordination, the Case Manager Utilization Review Nurse primarily focuses on reviewing medical necessity and insurance approvals, whereas the Case Manager handles broader patient care coordination and discharge planning. Both roles require nursing credentials and are vital in healthcare settings, but their specific responsibilities differ.

How do Case Manager Utilization Review Nurses typically collaborate with physicians and other healthcare providers?

Case Manager Utilization Review Nurses regularly work with physicians, social workers, and other healthcare professionals to ensure patients receive appropriate care while managing resource utilization. They often participate in interdisciplinary team meetings to discuss care plans, review patient progress, and address any barriers to discharge. Building strong communication channels and maintaining up-to-date clinical knowledge are essential, as nurses must advocate for patients while also supporting evidence-based practices and regulatory compliance. This collaborative environment helps streamline patient care and optimize outcomes.

What is a Case Manager Utilization Review Nurse?

A Case Manager Utilization Review Nurse is a registered nurse who evaluates the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, coordinate with healthcare providers, and ensure that treatments meet established guidelines and insurance requirements. Their goal is to optimize patient outcomes while controlling healthcare costs and ensuring compliance with regulations. These nurses also help facilitate communication between patients, providers, and payers to support effective care management.

What are the key skills and qualifications needed to thrive as a Case Manager Utilization Review Nurse, and why are they important?

To excel as a Case Manager Utilization Review Nurse, you need a solid background in nursing, strong clinical assessment skills, and a valid RN license, often with case management certification. Familiarity with utilization review software, electronic health record (EHR) systems, and knowledge of insurance and regulatory guidelines is essential. Exceptional communication, critical thinking, and negotiation abilities set top performers apart in this role. These qualifications ensure effective patient advocacy, cost-effective care, and compliance with healthcare standards.
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Case Manager Utilization Review Nurse jobs near you
Case Manager

Case Manager

Memorial Health

Decatur, IL • On-site

$25.72 - $39.86/hr

Full-time

Posted 12 days ago

Memorial Health rating

6.9

Company rating: 6.9 out of 10

Based on 174 frontline employees who took The Breakroom Quiz

441st of 880 rated healthcare providers

Job description

USD $25.72/Hr.
USD $39.86/Hr.

Coordinates and facilitates patient care across a multidisciplinary care continuum within a clinical service unit structure. Ensures optimum utilization of resources, service delivery and compliance with clinical cost education initiatives. Secures best possible outcomes for our patients by being advocates and resource managers to facilitate patient centered solutions.


Education:

Bachelor’s degree in the field of human services, psychology, and sociology, or social work or related healthcare field is required. 


  1. Maintains appropriate documentation
    • Assesses and evaluates patients’ ability to provide self care; develops discharge plan and goals of care with patient and involved caregivers.
    • Assists with making referrals to related agencies taking into consideration freedom of choice.
    • Provides information to social service/discharge planners to facilitate discharge planning process.
    • Participates in multidisciplinary rounding and care conferences with other departments.
    • Serves as a resource person to physicians and hospital staff in the appropriate use of health care resources.
    • Serves as a liaison with nursing and medical staff and community agencies to facilitate problem solving and to coordinate services.
  2. Assesses and develops plan early upon admission and revises as needed depending on needs of the patient.
  3. Accepts on-call as scheduled and responds as needed.
  4. Takes responsibility for upgrading professional skills and knowledge.
  5. Prepares and completes reports; participates in special projects.
  6. Demonstrates clinical competency by completing BLS CPR assigned by Education and ACMA Compass training modules for new employees assigned by Director of Case Management.
  7. Performs other duties as assigned.

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