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Chart Utilization Review Jobs in Chicago, IL (NOW HIRING)

YO AI Labs

Hospitalist Physician - Remote

Chicago, IL · Remote

$70 - $100/hr

Experience with chart review or clinical documentation review . * Experience with clinical documentation improvement (CDI) . * Experience with utilization review, medical coding, or healthcare ...

PSI Health

Full Time Associate Therapist

Chicago, IL · On-site

Act as a liaison between PSI clinical team and Utilization Review (UR) for timely updates and ... * Assist with chart audits and flag missing documentation for follow-up. * Review team ...

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Chart Utilization Review information

See Chicago, IL salary details

$22

$43

$71

How much do chart utilization review jobs pay per hour?

As of Aug 29, 2026, the average hourly pay for chart utilization review in Chicago, IL is $43.56, according to ZipRecruiter salary data. Most workers in this role earn between $34.42 and $50.00 per hour, depending on experience, location, and employer.

What is chart utilization review?

Chart Utilization Review is a process commonly used in healthcare settings to assess the necessity, appropriateness, and efficiency of medical services provided to patients. It involves reviewing patient charts and medical records to ensure that treatments and procedures are justified according to established guidelines and policies. This process helps in improving patient care, managing costs, and ensuring compliance with regulatory requirements. Utilization review professionals work closely with medical staff, insurance companies, and regulatory agencies to support quality and cost-effective care.

What are some common challenges faced by professionals in chart utilization review, and how can they be addressed?

Professionals in Chart Utilization Review often encounter challenges such as navigating incomplete or inconsistent medical documentation, staying current with ever-evolving healthcare regulations, and balancing productivity with accuracy. To address these challenges, it is important to maintain open communication with clinical staff, participate in ongoing training, and utilize robust electronic health record systems. Additionally, collaborating closely with interdisciplinary teams can help clarify documentation and ensure compliance with regulatory standards.

What are the key skills and qualifications needed to thrive as a chart utilization review specialist, and why are they important?

To thrive as a Chart Utilization Review specialist, you need a background in healthcare, strong knowledge of medical terminology, and experience with patient care documentation, often supported by an RN or LPN license. Familiarity with utilization management software, electronic health records (EHR), and relevant certifications such as Certified Professional in Utilization Review (CPUR) are typically required. Attention to detail, analytical thinking, and effective communication are crucial soft skills for accurately reviewing charts and collaborating with healthcare providers. These abilities ensure compliance, optimize patient care, and support cost-effective healthcare delivery.

What is the difference between Chart Utilization Review vs Chart Review Specialist?

AspectChart Utilization ReviewChart Review Specialist
CredentialsTypically requires healthcare or insurance-related certificationsOften requires medical or coding certifications
Work EnvironmentHealthcare facilities, insurance companies, utilization management teamsMedical offices, insurance companies, coding firms
Employer & IndustryHospitals, insurance providers, healthcare organizationsMedical billing companies, insurance firms, healthcare providers
Primary FocusAssessing medical necessity and appropriateness of servicesReviewing medical records for coding accuracy and completeness

While both roles involve reviewing medical information, Chart Utilization Review focuses on evaluating the necessity of healthcare services, whereas Chart Review Specialists primarily verify medical documentation for coding and billing accuracy. Understanding these distinctions helps professionals choose the right career path or job search focus.

What are popular job titles related to Chart Utilization Review jobs in Chicago, IL?

For Chart Utilization Review jobs in Chicago, IL, the most frequently searched job titles are:

What job categories do people searching Chart Utilization Review jobs in Chicago, IL look for?

The top searched job categories for Chart Utilization Review jobs in Chicago, IL are:

What cities near Chicago, IL are hiring for Chart Utilization Review jobs?

Cities near Chicago, IL with the most Chart Utilization Review job openings:

Chart Utilization Review jobs near you
Infographic showing various Chart Utilization Review job openings in Chicago, IL as of August 2026, with employment types broken down into 100% Full Time. Highlights an 80% In-person, and 20% Remote job distribution, with an average salary of $90,598 per year, or $43.6 per hour.

Case Manager/Utilization Review - Flex

Loretto Hospital

Chicago, IL • On-site

Other

Posted 2 days ago

New

Job description

SUMMARY


The Case Manager/Utilization Review assumes responsibility for assessing and directing the clinical management of patients in specific case groups for an episode of care. The CM/UR is responsible for developing and meeting desired patient care outcomes for his/her caseload based on assessment of patient care needs and on established clinical care patterns, within an appropriate length of stay and appropriate use of resources. The CM/UR, responding to complex patient care needs from admission to discharge, works productively and cooperatively in collaboration with the physician, clinical staff nurses and managers, as well as other health care professionals. The CM/UR will also function in the Utilization Review capacity, interfacing between clinical providers, healthcare payors, and the business office to ensure appropriate clinicals are created, reviewed, and sent to payors for approval. 



ESSENTIAL DUTIES AND RESPONSIBILITIES

 

  • Conducts initial screening and assessment of patients on admission including twenty-hour observations using pre-established Intensity of Service and Severity of Illness criteria. Based on admission screening, determines diagnosis related group (DRG) and appropriate length of stay (LOS).
  • In collaboration with physicians and other health care professionals, plan, organize, directs and evaluate the continuum of patient care, The Case Manager evaluates interventions of physicians and other health care disciplines based on care pathways, severity of illness and intensity of service criteria.
  • Facilitates the patient's movement throughout the hospital system in cooperation with the clinical staff, other healthcare professionals and the physician. The Case Manager's role centers on coordinating, negotiating, procuring and managing the plan of care to facilitate cost effective quality of care and patient satisfaction. She/he also develops possible alternative to care plans.
  •  Conducts review of patient records according to established utilization review criteria to ensure appropriateness of hospitalization. Communicates with Medicare, Medicaid and third party payers to ensure coverage for services.
  • Explores strategies to reduce the length of stay and resource consumption; implements and documents results. Identifies opportunities for system improvements.
  • Prioritizes workload and focuses on problem cases; communicates with physician, nurses, department directors, and other health care providers, both internal and external.
  • Documents on worksheets, assessment forms, and progress notes on a timely basis and as per policy.
  • Facilitates appropriate referral consultation based on patient assessment, follow-up of required or delayed testing, care pathway and results of physician intervention.
  • Coordinates discharge planning, including assessment of discharge needs resource availability and communication of patient's needs among team members and family's.
  • Identifies and reports any quality, risk management or utilization issues the Director of Case Management.
  • Facilitates and coordinates patient care team conferences. Communicates utilization issues; discharge planning reviews and variances of care.
  • Completes all admission, discharge and psychosocial assessments on a timely basis. Completes monthly statistical log to reflect case activity.
  • Assists the Director of Case Management in the investigation of over and underutilization cases, implementation of corrective measures and chart review per medical staff request.
  • Performs other related duties as assigned.
  • Demonstrates working knowledge of payer requirements.
  • Directs staff nurses improvise documentation that relates to the patient’s condition and orders/services obtained from the physician. 
  • In the absence of the case manager, director serves in a leadership role by covering the department regarding staffing, issues or concerns.
  • Demonstrates awareness of regulatory requirements, including but not limited to, HFAB, IDPH, CMS.
  • Conducts initial screening and assessment of patients on admission, including 24 hour observations using preestablished Intensity of Service and Severity of Illness criteria. Based on admission screening, determines diagnosis related group (DRG) and appropriate length of stay (LOS).
  • In collaboration with physicians and other health care professionals, plan, organize, direct, and evaluate the continuum of patient care. 
  • Evaluates interventions of physicians and other health care disciplines based on care pathways, severity of illness, and intensity of service criteria.
  • Serves as a coordinator, negotiator, procurer, and manager of the plan of care to facilitate cost effective quality of care and patient satisfaction. 
  • Identifies and reports any quality, risk management, or utilization issues to the Director of Case Management.
  • Other duties as assigned.


COMPLIANCE RESPONSIBILITIES

  • Understands and adheres to Loretto Hospital’s compliance standards as they appear in the Compliance Policy, Code of Conduct and Conflict of Interest Policy. 
  • Keeps abreast of all pertinent federal, state and Hospital regulations, laws, and policies as they presently exist and as they change or are modified. 
  • Ensures that the staff are trained and evaluated on their knowledge of and adherence to compliance policies and procedures specific to their jobs.


JOB REQUIREMENTS

 

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed must be representative of the knowledge, skills, minimum education, training, licensure, experience, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 


1. High School Diploma or GED required

3. Minimum of two years’ experience in Medical/Surgical, Psychiatry and/or Critical Care.

4. At least one to two years progressive experience in utilization management, discharge planning or case management.

5. Strong communication skills, utilizes problem-solving process, acts as a team leader, demonstrates good work ethic, demonstrates good nursing assessment skills, maintains confidentiality, demonstrates flexibility and analytical skills.

6. Has working knowledge of resources available in the community for the patient and families.

7. Has basic knowledge of criteria sets.

8. Demonstrates working knowledge of payer requirements


The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of the personnel so classified.

 

For purposes of the American with Disabilities Act, “Job Duties” are essential job functions.



 PHYSICAL DEMANDS


While performing the duties of this job, the employee is frequently required to sit, stand and walk as well as occasionally stoop, kneel, crouch or crawl. Using proper body mechanics, the employee may be expected to lift, pull, push or move patients and/or equipment. Fine motor skills are required when using hands and fingers to handle, feel or reach. Normal or corrected vision, hearing and ability to speak are necessary. Specific vision abilities required include close vision, sharp eye focus and ability to distinguish colors. There will be periods of stressful intense concentration with more than average pressure used in a variety of problem solving situations.

 

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