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Insurance Utilization Review Jobs in Chicago, IL

Insight

Transfer RN/UR

Chicago, IL · On-site

$70K/yr

Ability to decipher whether a patient meets criteria from a utilization review standpoint. * Knowledgeable of criteria for Medicare, Medicaid, HMO and private insurance coverage. * Document discharge ...

Insight

Transfer RN/UR

Chicago, IL

$70K/yr

Ability to decipher whether a patient meets criteria from a utilization review standpoint. * Knowledgeable of criteria for Medicare, Medicaid, HMO and private insurance coverage. * Document discharge ...

INSIGHT HEALTH SYSTEMS, INC.

Transfer RN/UR

Chicago, IL · On-site

Ability to decipher whether a patient meets criteria from a utilization review standpoint. * Knowledgeable of criteria for Medicare, Medicaid, HMO and private insurance coverage. * Document discharge ...

Veracity

UR Review Case Manager (Admin)

Chicago, IL · On-site

... utilization management experience preferred. • Knowledge of Medicare/Medicaid, Managed Care and Commercial insurance review processes preferred. • Ability to proactively anticipate and coordinate ...

Saint Anthony Hospital

Insurance Verifier

Chicago, IL · On-site

$22.29 - $26.74/hr

... Utilization Review • Nursing Units • Patient Financial Services • Provide timely updates ... insurance or authorization barriers impacting patient care or reimbursement. • Assist departments ...

Saint Anthony Hospital

Insurance Verifier

Chicago, IL

$22.29 - $26.74/hr

... Utilization Review · Nursing Units · Patient Financial Services · Provide timely updates ... insurance or authorization barriers impacting patient care or reimbursement. · Assist departments ...

Med-Metrix

Physician Advisor - Remote

Chicago, IL · On-site +1

... Insurance Portability and Accountability Act (HIPAA) standards * Understand and comply with ... Board Certification by the American Board of Quality Assurance and Utilization Review Physicians ...

Loretto Hospital

Chief Financial Officer

Chicago, IL · On-site

Revenue Cycle (Case Management, Utilization Review, CDI, Care Coordination) * Materials Management ... Reviews and approves financial terms of contracts, including MCOs, insurance agreements, vendor ...

Loretto Hospital

Chief Financial Officer

Chicago, IL · On-site

Revenue Cycle (Case Management, Utilization Review, CDI, Care Coordination) * Materials Management ... Reviews and approves financial terms of contracts, including MCOs, insurance agreements, vendor ...

Socket.dev

Chief Financial Officer

Chicago, IL · On-site

$180 - $280/hr

Monitors utilization patterns to support efficient patient flow and financial sustainability. * Reviews and approves financial terms of contracts, including MCOs, insurance agreements, vendor ...

Dane Street

Board Certified-General Surgeon

Frankfort, IL · On-site

$245K - $294K/yr

... peer review services, trusted by insurance carriers and organizations across the country for ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...

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Showing results 21-40

All JobsInsurance Utilization Review JobsInsurance Utilization Review Jobs in Chicago, IL

Insurance Utilization Review information

See Chicago, IL salary details

$22

$43

$71

How much do insurance utilization review jobs pay per hour?

As of Aug 7, 2026, the average hourly pay for insurance utilization review in Chicago, IL is $43.59, according to ZipRecruiter salary data. Most workers in this role earn between $34.47 and $50.05 per hour, depending on experience, location, and employer.

What are the most common challenges faced by insurance utilization review professionals?

One common challenge in Insurance Utilization Review is balancing the need for cost-effective care with the clinical needs of patients, which often requires careful analysis and decision-making. Professionals in this role frequently navigate complex medical records, strict policy guidelines, and collaborate with healthcare providers who may advocate strongly for particular treatments. Managing challenging conversations while maintaining professionalism and ensuring timely determinations are also a regular part of the role. Developing expertise in these areas can make the job both demanding and rewarding, while building a strong foundation for career growth within healthcare administration.

What are the key skills and qualifications needed to thrive in insurance utilization review?

To thrive in Insurance Utilization Review, you generally need a strong background in healthcare or nursing, an understanding of medical terminology, and analytical thinking skills, often supported by an RN license or relevant clinical experience. Familiarity with utilization management software, coding systems like ICD-10, and knowledge of regulatory requirements (such as Medicare or Medicaid) are important. Strong communication, attention to detail, and problem-solving abilities help professionals excel when interacting with providers and insurers. These skills are essential to ensure appropriate care is authorized while maintaining regulatory compliance and cost-effectiveness.

What is an insurance utilization review?

An Insurance Utilization Review job involves evaluating medical treatments and services to determine if they are necessary, appropriate, and covered by a patient's insurance plan. Professionals in this role review medical records, treatment plans, and insurance policies to ensure compliance with guidelines and cost-effectiveness. They work closely with healthcare providers, insurance companies, and patients to facilitate approvals or appeals. The goal is to balance quality patient care with cost containment in the healthcare system.

What are the most commonly searched types of Insurance Utilization Review jobs in Chicago, IL? The most popular types of Insurance Utilization Review jobs in Chicago, IL are:
What are popular job titles related to Insurance Utilization Review jobs in Chicago, IL? For Insurance Utilization Review jobs in Chicago, IL, the most frequently searched job titles are:
What job categories do people searching Insurance Utilization Review jobs in Chicago, IL look for? The top searched job categories for Insurance Utilization Review jobs in Chicago, IL are:
What cities near Chicago, IL are hiring for Insurance Utilization Review jobs? Cities near Chicago, IL with the most Insurance Utilization Review job openings:
Insurance Utilization Review jobs near you
Infographic showing various Insurance Utilization Review job openings in Chicago, IL as of August 2026, with employment types broken down into 1% As Needed, 74% Full Time, 20% Part Time, and 5% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $90,669 per year, or $43.6 per hour.

Transfer RN/UR

Insight

Chicago, IL • On-site

$70K/yr

Full-time

Medical, Dental, Vision, Life, PTO

Re-posted 23 days ago

Job description

WE ARE INSIGHT:
At Insight Hospital and Medical Center Chicago, we believe there is a better way to provide quality healthcare while achieving health equity. Our Chicago location looks forward to working closely with our neighbors and residents, to build a full-service community hospital in the Bronzeville area of Chicago; creating a comprehensive plan to increase services and meet community needs. With a growing team that is dedicated to delivering world-class service to everyone we meet, it is our mission to deliver the most compassionate, loving, expert, and impactful care in the world to our patients. Be a part of the Insight Chicago team that provides PATIENT CARE SECOND TO NONE! If you would like to be a part of our future team, please apply now!
These duties are to be performed in a highly confidential manner, following the mission, values, and behaviors of Insight Hospital and Medical Center. Employees are further expected to provide a high quality of care, service, and kindness toward all patients, staff, physicians, volunteers, and guests.
GENERAL SUMMARY: Seeking a full-time candidate to work as a transferring registered nurse hospital wide. Responsibilities include transferring patients in and out using a step-by-step process. The candidate will be responsible for evaluating and screening admissions from a utilization review standpoint, as well as collecting data and documenting in real time. This will include direct communication between physicians, admitting, registration, and other transferring facilities and healthcare professionals.
QUALIFICATIONS:
  • Registered Nurse
  • Transfer Center Experience (Preferred)
  • Utilization Review Experience (Preferred)
  • Full time 11am-7 pm
  • Experience with Cerner (Preferred)
  • Excellent communication and organizational skills

JOB DESCRIPTION:
  • Assesses, develops, facilitates, and monitors transfers into and out of the hospital through communication with all parties involved.
  • Communicates effectively and routinely with the physicians, admitting, medical staff, nursing staff, and any other third party.
  • Assist in facilitating patients with transportation via ambulance out of the facility.
  • Ability to decipher whether a patient meets criteria from a utilization review standpoint.
  • Knowledgeable of criteria for Medicare, Medicaid, HMO and private insurance coverage.
  • Document discharge planning as an ongoing review.
  • Educates physicians and staff regarding appropriate level of care/utilization issues.
  • Responsible for evaluating and screening potential admissions to the facility when appropriate.
  • Ensuring clinical profiles are sent to the payers in a timely manner.
  • Identifies issues that may delay patients transfer and facilitates timely resolution of these issues and communicates the reasoning for the delay.
  • Follows through with finalizing all aspects of the transfer process including facilitating hand-off communication between sending and receiving patients.
  • Maintains timely and up to date documentation within Cerner. Ability to collect data and document in real time within Microsoft Excel Spreadsheet.
  • Uses appropriate channels of communication when initiating a change, reporting information, or addressing a concern.
  • Hospital and skilled nursing facility outreach.
  • Ability to be resourceful and self-sufficient.
  • Any other job duties, as assigned.

Benefits:
  • Paid Sick Time - effective 90 days after employment
  • Paid Vacation Time - effective 90 days after employment
  • Health, vision & dental benefits - eligible at 30 days, following the 1st of the following month
  • Short and long-term disability and basic life insurance - after 30 days of employment

Insight Employees are required to be vaccinated for COVID-19 as a condition of employment, subject to accommodation for medical or sincerely held religious beliefs.
Insight is an equal opportunity employer and values workplace diversity!

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