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Entry Level Utilization Review Nurse Jobs in Springfield, IL

Arcadia Care

Regional MDS Consultant

Springfield, IL · On-site

$110K/yr

... reviews to assure achievement of optimal allowable Resource Utilization Group (RUG) category ... He/she will integrate nursing, dietary, social recreation, restorative, rehabilitation and ...

Symbria

Travel Physical Therapist

Springfield, IL · On-site

$1.7K - $2.1K/wk

Responsibilities * Review and evaluate physician's referral and patient's medical record to ... Full utilization of technology provided to document and enhance client care. * Adhere to terms and ...

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All JobsUtilization Review Nurse JobsEntry Level Utilization Review Nurse JobsEntry Level Utilization Review Nurse Jobs in Springfield, IL

Entry Level Utilization Review Nurse information

See Springfield, IL salary details

$19

$39

$63

How much do entry level utilization review nurse jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for entry level utilization review nurse in Springfield, IL is $39.13, according to ZipRecruiter salary data. Most workers in this role earn between $30.91 and $44.95 per hour, depending on experience, location, and employer.

What is an entry level utilization review nurse?

An Entry Level Utilization Review Nurse is a registered nurse (RN) who is new to the field of utilization review. Their main responsibilities include assessing medical records, ensuring that patients receive appropriate and necessary care, and verifying that health services are delivered according to established guidelines and insurance requirements. They typically work for hospitals, insurance companies, or managed care organizations and collaborate with healthcare providers to support quality patient outcomes while managing costs. This role often serves as a stepping stone to more advanced positions in healthcare administration or case management.

What are the key skills and qualifications needed to thrive as an entry level utilization review nurse, and why are they important?

To thrive as an Entry Level Utilization Review Nurse, you need a registered nurse (RN) license, knowledge of clinical guidelines, and an understanding of healthcare regulations. Familiarity with utilization management software, electronic health records (EHR), and relevant certifications such as Certified Case Manager (CCM) or Accredited Case Manager (ACM) are often beneficial. Strong analytical thinking, attention to detail, and effective communication skills help you review cases accurately and collaborate with providers. These skills ensure appropriate care decisions, compliance with payer requirements, and optimal patient outcomes.

What are some common challenges faced by entry level utilization review nurses, and how can they overcome them?

Entry level Utilization Review Nurses often encounter challenges such as adapting to complex insurance policies, learning to review medical records efficiently, and communicating effectively with physicians and case managers. To overcome these challenges, new nurses should seek mentorship from experienced colleagues, participate in ongoing training sessions, and familiarize themselves with the organization's review protocols and documentation systems. Building strong communication skills and staying up to date with regulatory changes will also help in navigating the learning curve and ensuring successful case reviews.

What is the difference between Entry Level Utilization Review Nurse vs Utilization Review Nurse?

AspectEntry Level Utilization Review NurseUtilization Review Nurse
CredentialsRN license, possibly some certificationRN license, often with additional certifications
Work EnvironmentHospitals, insurance companies, healthcare facilitiesInsurance companies, healthcare organizations
Job ResponsibilitiesAssist in reviewing patient cases, gather data, support senior staffEvaluate medical necessity, review patient records, make coverage decisions

The Entry Level Utilization Review Nurse typically supports the more experienced Utilization Review Nurse by gathering information and assisting in case reviews. Both roles require an RN license and work within healthcare or insurance settings, but the entry-level position involves more support tasks, while the Utilization Review Nurse makes critical coverage decisions.

What are the most commonly searched types of Utilization Review Nurse jobs in Springfield, IL?

The most popular types of Utilization Review Nurse jobs in Springfield, IL are:

What are popular job titles related to Entry Level Utilization Review Nurse jobs in Springfield, IL?

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

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

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

What cities near Springfield, IL are hiring for Entry Level Utilization Review Nurse jobs?

Cities near Springfield, IL with the most Entry Level Utilization Review Nurse job openings:

Entry Level Utilization Review Nurse jobs near you
Infographic showing various Entry Level Utilization Review Nurse job openings in Springfield, IL as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 20% Part Time, 2% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $87,164 per year, or $41.9 per hour.

Regional MDS Consultant

Arcadia Care

Springfield, IL • On-site

$110K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 11 days ago

Arcadia Care rating

4.7

Company rating: 4.7 out of 10

Based on 21 frontline employees who took The Breakroom Quiz

230th of 247 rated social care providers

Job description

) Regional MDS Consultant
Job Summary:
The Regional MDS Consultant is responsible for the accurate and timely completion of all Medicare/Medicaid case-mix documents to assure appropriate reimbursement for care and services provided within the Facility. Conducts continual Minimum Data Set (MDS) reviews to assure achievement of optimal allowable Resource Utilization Group (RUG) category. Oversees the overall process and tracking of MDS/Prospective Payment System (PPS) documentation and submission. He/she will integrate nursing, dietary, social recreation, restorative, rehabilitation and physician services to ensure appropriate assessment and reimbursement.
Essential Duties:
  • Ensures that the facility is following the organization's policy and procedures and complies with all state regulations
  • Hybrid position in Central Illinois with travel
  • Understands and implements company policies and procedures
  • Ensures the accurate and timely completion of all MDS Assessments including PPS Medicare, quarterly, annual, significant change.
  • Verifies electronic submissions of MDS, performs corrections when necessary and maintains appropriate records.
  • Coordinates interdisciplinary participation in completing the MDS for each resident according to regulatory time frames. Ensures completeness and thoroughness of documentation as mandated by federal and state standards

Benefits Offered:
  • Extremely low-cost Health, Dental, Vision, 401K, and more
  • $25,000 Company Paid Life Insurance - at no cost to you
  • Leadership Training to enhance your management skills
  • Daily Pay - get your money when you want
  • Paid Vacations - rolls over each year
  • Paid Sick Time
  • Paid Holidays
  • Tuition Reimbursement
  • Daily, Weekly, Monthly Employee Appreciation Events
  • Birthday, Anniversary Celebrations
  • Free Employee Assistance Programs - professional support & guidance on family, money, health, legal services and more
  • Huge Discounts at all major retailers (Walmart, Costco, etc.) at no cost to you
  • Virtual Visits with Doctors 24/7, without setting up additional accounts or appointments
  • Paid Break Time for Nursing Mothers
  • Time Off to Vote

Preferred Qualifications:
  • Must have a current, unencumbered, active Illinois Registered Nurse License
  • Five years management experience with experience in long-term care
  • General knowledge of professional basic nursing, restoratives and personal care services

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