ZipRecruiter

Log In

1

Case Manager Utilization Review Nurse Jobs in Springfield, IL

UHS

DIR - UTILIZATION REVIEW / MGMT

Springfield, IL · On-site

$37.55 - $56.33/hr

... managers and other assigned team members. * Ensure timely and accurate utilization review ... ) preferred; Master's-level Clinical Social Worker will be considered. * 3-5 years of case ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Springfield, IL · On-site

... managers and other assigned team members. * Ensure timely and accurate utilization review ... ) preferred; Master's-level Clinical Social Worker will be considered. * 3-5 years of case ...

Moments Hospice

RN Case Manager

Springfield, IL

$75K - $90K/yr

As an RN Case Manager, you will play a critical role in making our patients' final days, weeks, and ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...

New

Moments Hospice

RN Case Manager

Springfield, IL · On-site

$75K - $90K/yr

As an RN Case Manager, you will play a critical role in making our patients' final days, weeks, and ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...

New

Moments Hospice

RN Case Manager

Springfield, IL

$75K - $90K/yr

As an RN Case Manager, you will play a critical role in making our patients' final days, weeks, and ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...

New

next page

Showing results 1-20

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

Case Manager Utilization Review Nurse information

See Springfield, IL salary details

$19

$47

$79

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

As of Sep 12, 2026, the average hourly pay for case manager utilization review nurse in Springfield, IL is $47.11, according to ZipRecruiter salary data. Most workers in this role earn between $35.00 and $56.92 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 Springfield, IL?

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

What job categories do people searching Case Manager Utilization Review Nurse jobs in Springfield, IL look for?

The top searched job categories for Case Manager Utilization Review Nurse jobs in Springfield, IL are:

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

Cities near Springfield, 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 Springfield, IL as of August 2026, with employment types broken down into 71% Full Time, 19% Part Time, and 10% Contract. Highlights an 90% In-person, and 10% Remote job distribution, with an average salary of $97,990 per year, or $47.1 per hour.

DIR - UTILIZATION REVIEW / MGMT

Springfield, IL • On-site

UHS
Health Care and Social Assistance • 10K+ employees
Learn more about UHSexternal

$37.55 - $56.33/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 23 days ago

Key responsibilities

  • Oversee the daily operations of the Utilization Management and Case Management functions.

  • Supervise, coach, and develop case managers and team members.

  • Ensure timely and accurate utilization review activities and collaborate with clinical teams to support patient care.

Universal Health Services rating

6.8

Company rating: 6.8 out of 10

Based on 255 frontline employees who took The Breakroom Quiz

Job description

Responsibilities
We are hiring a Director of Case Management (Utilization Management) at Lincoln Prairie Behavioral Health Center and offering a $5,000 sign-on bonus!
Lincoln Prairie Behavioral Health Center is a 97-bed facility located in Springfield, Illinois. We are dedicated to providing youth with compassionate mental health treatment that encourages self-responsibility and personal growth. We are the only facility of our kind in Central Illinois! We provide psychiatric treatment to children and adolescents that present with a broad range of psychiatric and behavioral disorders. A clinically skilled multidisciplinary team works to partner with the youth and family to accomplish their goals in a supportive and therapeutic environment.
The Director of Case Management (Utilization Management) is responsible for the leadership, oversight, and daily operations of theUtilization Management and Case Management functions. This role ensures effective coordination of care, appropriate resource utilization, regulatory compliance, and collaboration with clinical andmultidisciplinary teams to support positive patient outcomes.
Qualifications
Duties and Responsibilities:
  • Provide operational and strategic leadership for the Case Management and Utilization Management
    departments.
  • Supervise, coach, and develop case managers and other assigned team members.
  • Ensure timely and accurate utilization review activities and payer communications.
  • Monitor patient progression, discharge planning, and continuity of care processes.
  • Collaborate with physicians, nursing leadership, therapists, and hospital administration.
  • Maintain compliance with regulatory, accreditation, and organizational requirements.
  • Analyze performance metrics and implement process improvement initiatives.
Benefit & Rewards Highlights
  • Retention Bonus Program
  • Loan Forgiveness Program
  • Challenging and rewarding work environment
  • Competitive Compensation & Generous Paid Time Off
  • Excellent Medical, Dental, Vision and Prescription Drug Plans
  • 401(K) with company match and discounted stock plan
  • SoFi Student Loan Refinancing Program
  • Tuition savings
  • Career development opportunities within UHS and its 300+ Subsidiaries!
  • Pet Insurance
  • More information is available on our Benefits Guest Website: benefits.uhsguest.com
About Universal Health Services
One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500® corporation, annual revenues during 2025 were $17.4 billion. In 2026, UHS was again recognized as one of Fortune World's Most Admired Companies™ and in 2025, was listed in Forbes ranking of America's Largest Public Companies.
Headquartered in King of Prussia, PA, UHS has approximately 101,500 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. For additional information visit www.uhs.com.
From Fortune, ©2025, 2026 Fortune Media IP Limited. All rights reserved. Used under license.
Requirements:
  • Registered Nurse (RN) preferred; Master's-level Clinical Social Worker will be considered.
  • 3-5 years of case management experience required.
  • 3-5 years of clinical team management or supervisory experience preferred.
  • Master's degree in healthcare administration is a plus.
  • Strong knowledge of utilization management, discharge planning, and behavioral health operations.
  • Excellent leadership, communication, and interdisciplinary collaboration skills.
EEO Statement
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
Avoid and Report Recruitment Scams
We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.
If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.

What Universal Health Services employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Universal Health Services logo

About Universal Health Services

Sourced by ZipRecruiter

Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

King of Prussia, PA, US

View All Universal Health Services Jobs

Apply