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Flex Schedule Remote Utilization Review Jobs in Springfield, IL

AltaStaff, LLC

Care Review Clinician

Springfield, IL · Remote

$40 - $42/hr

This is a fully remote role but candidates must have a valid RN license in Illinois*** Position ... Care Review Clinician works with the Utilization Management team primarily responsible for medical ...

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See Springfield, IL salary details

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$41

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How much do flex schedule remote utilization review jobs pay per hour?

As of Aug 19, 2026, the average hourly pay for flex schedule remote utilization review in Springfield, IL is $41.91, according to ZipRecruiter salary data. Most workers in this role earn between $33.12 and $48.12 per hour, depending on experience, location, and employer.

What is the difference between Flex Schedule Remote Utilization Review vs Flex Schedule Remote Case Manager?

AspectFlex Schedule Remote Utilization ReviewFlex Schedule Remote Case Manager
Primary RoleReview healthcare services for medical necessity and appropriatenessCoordinate patient care, develop care plans, and facilitate services
CredentialsTypically requires nursing, medical, or healthcare-related certificationsOften requires nursing, social work, or healthcare certifications
Work EnvironmentRemote, independent review setting, often within insurance or healthcare companiesRemote or hybrid, involving direct patient interaction and care coordination
Industry UsageCommon in insurance, healthcare, and utilization management sectorsCommon in healthcare, insurance, and patient advocacy sectors

Flex Schedule Remote Utilization Review focuses on evaluating medical necessity remotely, while Flex Schedule Remote Case Manager involves coordinating patient care and services. Both roles often require healthcare certifications and are performed remotely, but their core responsibilities differ in review versus patient management.

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For Flex Schedule Remote Utilization Review jobs in Springfield, IL, the most frequently searched job titles are:

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The top searched job categories for Flex Schedule Remote Utilization Review jobs in Springfield, IL are:

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Cities near Springfield, IL with the most Flex Schedule Remote Utilization Review job openings:

Flex Schedule Remote Utilization Review jobs near you
Infographic showing various Flex Schedule Remote Utilization Review job openings in Springfield, IL as of June 2026, with employment types broken down into 18% Full Time, 72% Part Time, 2% Temporary, 7% Contract, and 1% Nights. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $87,164 per year, or $41.9 per hour.

Care Review Clinician

AltaStaff, LLC

Springfield, IL • Remote

$40 - $42/hr

Full-time

Posted yesterday

New

Job description

AltaStaff is a staffing agency currently looking for a Care Review Clinician I to work with our Managed Care Client!

Pay Rate: $40 - 42.00 hourly

Schedule: Monday-Friday 9am-5:30pm CST, Rotating Saturday 7-11am CST, Rotating Holidays

***This is a fully remote role but candidates must have a valid RN license in Illinois***

Position Purpose: Care Review Clinician works with the Utilization Management team primarily responsible for medical necessity/utilization review aimed at providing members with the right care.

  • Assess and analyze clinical service requests (e.g., surgeries, outpatient therapies, DME) using evidence-based MCP/MCG criteria.

  • Verify member benefits and eligibility and Process prior authorization determinations within regulatory timelines

  • Collaborate with multidisciplinary teams

  • Completes/reviews Authorizations, reviewing faxes that can be 50-100 pages long

  • Will be expected to manage 25-30 cases successfully daily.

  • Should be able to quickly and accurately determine whether the criteria meet medical necessity.

  • Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review.

  • Assesses services for Molina Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and

  • guidelines.

  • Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina members as part of the Utilization Management team.

  • Additional duties assigned

Education/Experience: 

  • RN license in IL required

  • Must have 2+ years clinical practice experience (hospital, case management, utilization management)

  • Must have 1-3+ years of hospital or medical clinic, utilization review

  • Must have 2-3 years of Prior Authorization OR Med-Surg experience; Familiarity with Inpatient Medical Necessity

  • Must have solid experience within a clinical setting as RN’s must be able to use their knowledge to extrapolate key information during the authorization process

If you've applied and would like to view your application status, please visit: https://altastaff.zenople.com/login/ALTA

AltaStaff is an Equal Employment Opportunity Employer. We provide equal employment opportunities to all qualified applicants for employment without regard to age, race, color, creed, religion, sex, marital status, national origin, ancestry, citizenship, disability, veteran status, sexual orientation, or any other protected status, in accordance with applicable federal, state, and local laws.

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