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Case Manager Utilization Review Nurse Jobs in Decatur, IL

Memorial Health

Registered Nurse (RN) - Hospice

Decatur, IL · On-site

$28.25 - $45.21/hr

Provides nursing care to assigned patients through the use of nursing process in accordance with ... Function as a case manager for a group of patients in a particular geographic location. * Provide ...

Memorial Health

Registered Nurse (RN) - Hospice

Decatur, IL · On-site

$28.25 - $45.21/hr

Provides nursing care to assigned patients through the use of nursing process in accordance with ... Function as a case manager for a group of patients in a particular geographic location. * Provide ...

Memorial Health

Registered Nurse (RN) - Hospice

Decatur, IL · On-site

$28.25 - $45.21/hr

Provides nursing care to assigned patients through the use of nursing process in accordance with ... Function as a case manager for a group of patients in a particular geographic location. * Provide ...

Memorial Health

Registered Nurse (RN) - Hospice

Decatur, IL · On-site

$28.25 - $45.21/hr

Provides nursing care to assigned patients through the use of nursing process in accordance with ... Function as a case manager for a group of patients in a particular geographic location. * Provide ...

Gentiva Hospice

Registered Nurse Hospice

Lincoln, IL · On-site

$71K - $89K/yr

What You'll Do as a Hospice RN / RN Case Manager: * Be the primary point of contact for patients and families, guiding them through every step of their hospice journey. * Deliver and document skilled ...

Gentiva Hospice

Registered Nurse Hospice

Lincoln, IL · On-site

$71K - $89K/yr

What You'll Do as a Hospice RN / RN Case Manager: * Be the primary point of contact for patients and families, guiding them through every step of their hospice journey. * Deliver and document skilled ...

Gentiva Hospice

Registered Nurse Hospice

Lincoln, IL · On-site

$71K - $89K/yr

What You'll Do as a Hospice RN / RN Case Manager: * Be the primary point of contact for patients and families, guiding them through every step of their hospice journey. * Deliver and document skilled ...

Gentiva Hospice

Registered Nurse Hospice

Lincoln, IL · On-site

$71K - $89K/yr

What You'll Do as a Hospice RN / RN Case Manager: * Be the primary point of contact for patients and families, guiding them through every step of their hospice journey. * Deliver and document skilled ...

Georgia

PRN -RN

Decatur, IL · On-site

$44 - $54/hr

PRN -RN Job Requisition ID: JR0000002324 Number of Openings: 0 Shift: Any (United States of America ... May advise clients on health maintenance and disease prevention or provide case management. Job ...

Georgia

Registered Nurse 3

Decatur, IL · On-site

$72K - $94K/yr

... case management. Job Responsibilities & Performance Standards: * Administers prescribed ... Observes nurses and visits clients to ensure that proper nursing care is provided * Prepares ...

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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 Aug 21, 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 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.

How does a case manager utilization review nurse 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 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.

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.

What are popular job titles related to Case Manager Utilization Review Nurse jobs in Decatur, IL?

For Case Manager Utilization Review Nurse jobs in Decatur, IL, the most frequently searched job titles are:

What cities near Decatur, IL are hiring for Case Manager Utilization Review Nurse jobs?

Cities near Decatur, IL with the most Case Manager Utilization Review Nurse job openings:

Case Manager Utilization Review Nurse jobs near you
Infographic showing various Case Manager Utilization Review Nurse job openings in Decatur, IL as of August 2026, with employment types broken down into 72% Full Time, 18% Part Time, and 10% Contract. Highlights an 89% In-person, and 11% Remote job distribution, with an average salary of $95,900 per year, or $46.1 per hour.

Registered Nurse (RN) - Hospice

Memorial Health

Decatur, IL • On-site

$28.25 - $45.21/hr

Full-time

Re-posted 16 days ago

Memorial Health rating

7.0

Company rating: 7.0 out of 10

Based on 176 frontline employees who took The Breakroom Quiz

415th of 891 rated healthcare providers

Job description

Min
USD $28.25/Hr.
Max
USD $45.21/Hr.
Overview
****Up to $10,000.00 Sign-on Bonus****
Position Summary:
Provides nursing care to assigned patients through the use of nursing process in accordance with standard nursing practice and established nursing policies and procedures. Assumes full responsibility and accountability for coordination of patient care; services, referrals and resources for assigned caseload. Supervises care rendered by Home Health Aides. Adheres to MHS Mission, Vision and Values and the Illinois Nursing Act. Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values.
Qualifications
Education:
BSN is preferred.
Licensure/Certification/Registry:
  • License to practice professional nursing in Illinois required.
  • Current CPR certification required.
  • Must possess valid Illinois drivers license and must be deemed as an acceptable driver in accordance with the MHS Safety Policy (five year MVR will be required). Must have availability of personal vehicle with proof of insurance.
  • Meets credit range for Clinical Ladder Levels as follows:
  • Clinical Nurse I: Registered Nurse who achieves a range of 0-9 credits on the Clinical Ladder Behavior Grid.
  • Clinical Nurse II: Registered Nurse who achieves a range of 10-19 credits on the Clinical Ladder Behavior Grid with evidence of behaviors from at least two categories of the Grid.
  • Clinical Nurse III: Registered Nurse who achieves a range of 20-29 credits on the Clinical Ladder Behavior Grid with evidence of behaviors from at least three categories of the Grid. Minimum BSN, enrollment in a BSN or MSN program, or national certification required.

Experience:
A minimum of two (2) years acute care clinical experience is preferred. Home health experience preferred.
Other Knowledge/Skills/Abilities:
  • Must be able to position and/or transfer an average adult patient and possess gross coordination sufficient to perform patient care tasks as required.
  • Environmental working conditions include exposure to blood, bodily fluids/tissue, contagious diseases, animals, etc.

Responsibilities
Principal Duties & Responsibilities:
  1. Professional Nursing Care
  • Perform age appropriate assessment utilizing critical thinking skills.
  • Function as a case manager for a group of patients in a particular geographic location.
  • Provide after hours care on a rotation basis.
  • Develop and revise an individualized Plan Of Care in partnership with patient/caregiver based on Identification of patient problems/need.
  • Implement specific interventions to attain outcomes.
  • Communicate/collaborate with other disciplines to provide optimal patient care and services.
  • Participate in interdisciplinary team meetings as appropriate.
  • Participate in educational offerings (ex: skills day; oxygen inservice; etc)

  1. Supervision and Delegation
  • Appropriately supervise performance of LPN.
  • Appropriately supervise performance of HHA and provide documentation to support such.

  1. Communication and Collaboration
  • Demonstrate critical thinking skills.
  • Demonstrate effective interpersonal skills.
  • Use therapeutic communication techniques.
  • Demonstrate assertiveness.
  • Communicate relevant patient information to other disciplines and MD as appropriate.
  • Document patient care according to MHSvc policies/procedures.
  • Ensure appropriate implementation of MD orders.
  • Participate in operational meetings (ex: All staff, MHS Connect, etc).
  • Promote patient/family education.
  • Precept nursing students.
  • Participate in clinically/operationally related focus groups.

  1. Quality and Safety
  • Identify and resolve patient safety risks.
  • Participate in continuous quality improvement (Quality Initiative measures) including efforts to improve patient outcomes.

  1. Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values:
  • SAFETY: Prevent Harm - I put safety first in everything I do. I take action to ensure the safety of others.
  • COURTESY: Serve Others - I treat others with dignity and respect. I project a professional image and positive attitude.
  • QUALITY: Improve Outcomes - I continually advance my knowledge, skills and performance. I work with others to achieve superior results.
  • EFFICIENCY: Reduce Waste - I use time and resources wisely. I prevent defects and delays.

  1. Professional Accountability
  • Demonstrate ethical decision making.
  • Advocate for patients/families/caregivers.
  • Responsibly manages all equipment, supplies in his/her possession, including, but not limited to, laptop computer, FAX machine, cell phone, patient care supplies, etc.

  1. Performs other related work as required or requested.

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