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Insurance Utilization Review Jobs in Springfield, IL

Memorial Health

STAFF PHYSICAL THERAPIST

Taylorville, IL

$37.50 - $58.02/hr

... utilization of evaluation, planning and implementation of a treatment plan in accordance with ... Kari@mhsil.com or schedule a call with me to discuss at To review Memorial's Benefits click here:

Memorial Health

STAFF PHYSICAL THERAPIST

Taylorville, IL · On-site

$37.50 - $58.02/hr

... utilization of evaluation, planning and implementation of a treatment plan in accordance with ... Kari@mhsil.com or schedule a call with me to discuss at To review Memorial's Benefits click here:

Arcadia Care

MDS CAREPLAN COORDINATOR

Springfield, IL · On-site

$34 - $43.25/hr

... Set (MDS) reviews to assure achievement of optimal allowable Resource Utilization Group (RUG ... Extremely low-cost Health, Dental, Vision, 401K, and more * $25,000 Company Paid Life Insurance ...

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Insurance Utilization Review information

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How much do insurance utilization review jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for insurance 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 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 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 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.

How do I get into an insurance utilization review?

To become an insurance utilization review specialist, candidates typically need a background in healthcare, nursing, or a related field, along with knowledge of insurance policies and medical terminology. Certification such as the Certified Professional in Healthcare Quality (CPHQ) or similar credentials can enhance job prospects. Relevant skills include attention to detail, analytical thinking, and familiarity with medical records and insurance software systems.

Is insurance utilization review a stressful job?

Insurance utilization review can be stressful due to the need for accuracy, attention to detail, and meeting strict deadlines. Reviewers often handle complex cases and must balance policy guidelines with patient needs, which can contribute to job pressure. However, the level of stress varies depending on workload, work environment, and individual coping skills.

What are popular job titles related to Insurance Utilization Review jobs in Springfield, IL?

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

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

The top searched job categories for Insurance Utilization Review jobs in Springfield, IL are:

What cities near Springfield, IL are hiring for Insurance Utilization Review jobs?

Cities near Springfield, IL with the most Insurance Utilization Review job openings:

Insurance Utilization Review jobs near you
Infographic showing various Insurance Utilization Review job openings in Springfield, 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 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $87,164 per year, or $41.9 per hour.

STAFF PHYSICAL THERAPIST

Memorial Health

Taylorville, IL

$37.50 - $58.02/hr

Full-time

Re-posted 5 days ago

Memorial Health rating

7.0

Company rating: 7.0 out of 10

Based on 176 frontline employees who took The Breakroom Quiz

414th of 891 rated healthcare providers

Job description

USD $37.50/Hr.
USD $58.02/Hr.

***Sign-on Bonuses up to $30,000.00***

The Staff Physical Therapist is responsible for providing and coordinating comprehensive care to patients of all ages through the proper utilization of evaluation, planning and implementation of a treatment plan in accordance with established standards, policies, procedures, protocols and guidelines.  Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values.

Schedule

Full-Time, Days

Contact me if interested at Watson.Kari@mhsil.com or schedule a call with me to discuss at

  https://MemorialHealthIL.as.me/KariWatson

To review Memorial's Benefits click here: Benefits - Memorial HR


Education:

  • Graduate of an approved school of Physical Therapy.
  • Basic knowledge in physical therapy practices in accordance with the P.T. Practice Act.

Licensure/Certification/Registry:

  • Illinois eligible or licensed Physical Therapist.
  • CPR certification is required.

Other Knowledge/Skills/Abilities:

  • Universal Precautions Category I.
  • Must possess valid Illinois driver’s license and must be deemed as an acceptable driver in accordance with the MHS Fleet Safety Policy (five year MVR will be required). Must show proof of automobile insurance.

  1. Provides rehabilitative care to patients of all ages. 
  1. Evaluates treatment needs of assigned physician referred patients of all ages. 
  1. Implements the patient treatment according to the program plan, assesses the patient’s response and revised the program as needed. 
  1. Effectively communicates with the patient, family members, hospital staff and the public. 
  1. Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values: 
  • SAFETY: Prevent Harm - I put safety first in everything I do.  I take action to ensure the safety of others.
  • COURTESY: Serve Others - I treat others with dignity and respect.  I project a professional image and positive attitude.
  • QUALITY: Improve Outcomes - I continually advance my knowledge, skills and performance.  I work with others to achieve superior results. 
  • EFFICIENCY: Reduce Waste - I use time and resources wisely.  I prevent defects and delays. 
  1. Attends patient care conferences and outpatient clinics or sees that the needed information is provided to appropriate personnel for reporting. 
  1. Keeps timely and accurate medical, administrative and education records. 
  1. Coordinates effective patient care with the assistance of the Physical Therapy Assistant and Physical Therapy Aide. 
  1. Participates in training programs for students, hospital staff and the community. 
  1. Maintains skills in treatment procedure through utilization of inservice and continuing education opportunities and expertise of other clinical staff personnel. 
  1. Demonstrates effective use of departmental equipment for patient care. 
  1. Contributes to the maintenance of a satisfactory work environment. 
  1. Promotes health and safety in the work environment. 
  1. Actively participates in competency assessment process. 
  1. Performs other related work as required or requested. 

 

The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by incumbents of this job.  Incumbents may be requested to perform tasks other than those specifically presented in this description.

 

 

 

 

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