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Clinical Review Rn Jobs in Illinois (NOW HIRING)

US Tech Solutions

Utilization Review Nurse

Chicago, IL · On-site

Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and ... Active and unrestricted RN licensure in state of residence Questionnaire: * Do you have experience ...

Elevance Health

Nurse Reviewer I

Chicago, IL · On-site

$35.54 - $55.73/hr

Seeking RNs that have a current, unrestricted RN license in either the state of Illinois and/or ... Clinical review for the RBM and Surgical solution on a client specific basis. * Notifying providers ...

Elevance Health

Nurse Reviewer I

Chicago, IL · On-site

$35.54 - $55.73/hr

Seeking RNs that have a current, unrestricted RN license in either the state of Illinois and/or ... Clinical review for the RBM and Surgical solution on a client specific basis. * Notifying providers ...

Elevance Health

Nurse Reviewer I

Springfield, IL · On-site

$35.54 - $55.73/hr

Seeking RNs that have a current, unrestricted RN license in either the state of Illinois and/or ... Clinical review for the RBM and Surgical solution on a client specific basis. * Notifying providers ...

Elevance Health

Nurse Reviewer I

Chicago, IL · On-site

$35.54 - $55.73/hr

Seeking RNs that have a current, unrestricted RN license in either the state of Illinois and/or ... Clinical review for the RBM and Surgical solution on a client specific basis. * Notifying providers ...

VIVA USA INC

HEDIS Review Nurse

Chicago, IL · On-site +1

$31.25 - $41.25/hr

... relevant clinical data during HEDIS. HEDIS abstractions are completed in accordance with NCQA ... Registered Nurse (RN)/ Licensed Practical Nurse (LPN) with unrestricted license 2 years' HEDIS ...

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Showing results 21-40

All JobsClinical Review Rn JobsClinical Review Rn Jobs in Illinois

Clinical Review Rn information

What is a clinical review RN?

Clinical Review RNs, or Clinical Review Registered Nurses, are licensed nurses who evaluate medical records, treatment plans, and health care documentation to ensure that patient care meets established standards and guidelines. They play a critical role in reviewing the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. Clinical Review RNs often work for insurance companies, hospitals, or healthcare organizations to help with utilization management, case review, and quality assurance. Their expertise helps improve patient outcomes and manage healthcare costs by ensuring the right care is delivered at the right time.

What skills and qualifications are needed to thrive as a clinical review RN?

To thrive as a Clinical Review RN, you need a robust clinical nursing background, strong assessment skills, and an active RN license, often with experience in case management or utilization review. Familiarity with utilization management software, electronic health records, and knowledge of insurance regulations or CMS guidelines is typically required. Excellent communication, critical thinking, and attention to detail help set outstanding Clinical Review RNs apart. These skills ensure accurate clinical evaluations, compliance with regulations, and effective coordination between patients, providers, and payers.

How does a clinical review RN collaborate with other healthcare professionals during the patient care review process?

A Clinical Review RN regularly works with physicians, case managers, social workers, and insurance representatives to assess the medical necessity and appropriateness of patient care plans. They participate in interdisciplinary meetings, provide clinical insights, and help ensure that care decisions align with policies and regulations. This collaboration is key to streamlining the review process, minimizing delays in patient care, and supporting optimal outcomes for both patients and the healthcare organization.

What is the difference between Clinical Review Rn vs Medical Reviewer?

AspectClinical Review RnMedical Reviewer
CredentialsRegistered Nurse (RN) license, clinical experienceMedical degree (MD or DO), specialized training
Work EnvironmentHealthcare facilities, insurance companies, telehealthHospitals, insurance companies, consulting firms
Employer & Industry UsageInsurance, healthcare providers, government agenciesInsurance, legal, healthcare consulting
Primary FocusAssessing medical records, determining coverage eligibilityEvaluating medical cases, providing expert opinions

While both roles involve reviewing medical information, Clinical Review Rns primarily assess insurance claims and medical records as registered nurses, whereas Medical Reviewers are typically physicians with advanced medical training who evaluate complex cases and provide expert opinions. Understanding these differences helps in choosing the right career path or job search focus.

How to become a clinical review RN?

To become a clinical review RN, you typically need to earn a Bachelor of Science in Nursing (BSN) or an associate degree in nursing, pass the NCLEX-RN exam to obtain licensure, and gain clinical experience in healthcare settings. Additional certifications in case management or utilization review can enhance qualifications for this role.

What does a clinical review RN do?

A clinical review RN evaluates medical records, treatment plans, and patient data to determine coverage, appropriateness, and compliance with healthcare policies. They often work for insurance companies or healthcare organizations, requiring strong clinical knowledge, attention to detail, and certification such as a registered nurse license. Their assessments help ensure proper patient care and cost-effective treatment decisions.
Clinical Review Rn jobs near you
Infographic showing various Clinical Review Rn job openings in Illinois as of August 2026, with employment types broken down into 1% As Needed, 86% Full Time, 10% Part Time, 2% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution.

Travel Case Manager RN - $1,970 per week

Mattoon, IL • On-site

GQR Healthcare
Recruiting and Staffing Services • 201 - 500 employees
Learn more about GQR Healthcareexternal

$1.9K/wk

Other

Medical, Dental, Vision

This job post has expired 2 days ago. Applications are no longer accepted.

Job description

GQR Healthcare is seeking a travel nurse RN Case Management for a travel nursing job in Mattoon, Illinois.

Job Description & Requirements
  • Specialty: Case Management
  • Discipline: RN
  • Start Date: 09/28/2026
  • Duration: 13 weeks
  • 40 hours per week
  • Shift: 8 hours, days
  • Employment Type: Travel

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job
Location: Mattoon, Illinois
Start Date: September 28, 2026
Profession: Registered Nurse (RN)
Facility: Hospital
Estimated Pay: $1969.85 - $2064.85
Duration:13 weeks
Specialty:Case Management/Utilization Review
Shift: Day
Shift Details: null Day
Job Type: Travel
*Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates. Actual weekly pay and per diems may differ from the amount shown and are subject to change during an assignment.
Benefits:

  • Day 1 Insurance
  • Cigna medical, MetLife dental and vision insurance
  • License reimbursement for new licenses needed for each assignment
  • Discounts with hotels and rental cars
  • A dedicated recruiter and support team that will help you every step of the way to sure you start on time and have an exceptional experience
  • Referral bonus up to $700
About the Company:
Finding the right role is about more than just matching skills to a job—it’s about aligning with your goals, values, and the way you want to work.
As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. From our first conversation to your first day on the job (and beyond!), we’re here to help you move forward with confidence.

GQR Job ID #839125. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Registered Nurse (RN)

About GQR Healthcare

GQR’s Healthcare team specializes in connecting experts within the industry to highly skilled healthcare professionals across the US market.

In the competitive healthcare market, we recognize that the industry’s common goals of improved quality of care and patient outcomes are wholly reliant upon the professionals directly supporting these initiatives. Leveraging our extensive candidate network, we deliver continuity of care for the communities our partners serve to ensure the patient experience is of the highest quality.

Through deep market specialization and a unique approach to talent acquisition, GQR Healthcare provides an unparalleled and personalized experience across all medical specialties in nursing and within diverse healthcare platforms across the industry.

Why Vivian Health?

Be sure to apply via Vivian Health to increase your chances of landing your perfect job. Just complete your Vivian Health profileonce, and get access to thousands of opportunities across the country. Then keep up to date with your job application process and conversations with our easy to use app.

GQR Healthcare logo

About GQR Healthcare

Sourced by ZipRecruiter

Leveraging our extensive candidate network, we deliver continuity of care for the communities our partners serve to ensure the patient experience is of the highest quality. Through deep market specialization and a unique approach to talent acquisition, GQR Healthcare provides an unparalleled and personalized experience across all medical specialties in nursing and within diverse healthcare platforms across the industry.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Austin, TX, US

Year founded

2019

Social media

Facebook

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