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Manager Utilization Management Jobs in Illinois (NOW HIRING)

UHS

Utilization Management Coordinator

Forest Park, IL · On-site

$30 - $46/hr

Simply apply to the posting and discuss your interests with the hiring manager if you are selected to come in for an interview. The Utilization Management Coordinator position oversees the daily ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Springfield, IL · On-site

$37.55 - $56.33/hr

The Utilization Review Director o versees utilization management including, but not limited to: utilization review, case documentation, payer relationships, regulatory requirements, staff management ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Springfield, IL

Oversees all utilization management functions. * Oversees precertification, concurrent, and discharge utilization reviews. * Facilitates regulatory compliance by ensuring proper documentation and ...

GRO Community

Utilization Review Manager

Chicago, IL · On-site

GRO services include mental health and wellness, stress management, and community outreach. Position Summary: The Utilization Review Manager (URM) is responsible for coordinating and monitoring ...

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All JobsUtilization Management JobsManager Utilization Management JobsManager Utilization Management Jobs in Illinois

Manager Utilization Management information

See Illinois salary details

$37.8K

$88.2K

$162.3K

How much do manager utilization management jobs pay per year?

As of Aug 3, 2026, the average yearly pay for manager utilization management in Illinois is $88,192.00, according to ZipRecruiter salary data. Most workers in this role earn between $57,700.00 and $106,100.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Manager Utilization Management, and why are they important?

To thrive as a Manager Utilization Management, you need a thorough understanding of healthcare regulations, utilization review processes, and case management, often supported by a clinical degree (such as RN) and relevant experience. Familiarity with utilization management software, claims processing systems, and potentially certifications like CCM (Certified Case Manager) or ACM (Accredited Case Manager) is important. Strong leadership, analytical thinking, and effective communication help you guide teams and collaborate with providers and payers. These skills ensure efficient resource use, compliance, and quality patient care within managed care organizations.

What is the difference between Manager Utilization Management vs Utilization Review Nurse?

AspectManager Utilization ManagementUtilization Review Nurse
CredentialsRN, often with management or utilization review certificationsRN, with certifications in utilization review or case management
Work EnvironmentSupervises teams, manages policies, oversees utilization review processesPerforms patient chart reviews, assesses medical necessity, collaborates with providers
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, insurance companies, healthcare organizations
Search & Comparison IntentYesYes

While both roles focus on utilization review, the Manager Utilization Management oversees teams and policies, ensuring efficient resource use, whereas the Utilization Review Nurse conducts patient-specific reviews to determine medical necessity. The manager role involves leadership and strategic planning, while the nurse role is more clinical and review-focused.

What are some common challenges faced by a Manager in Utilization Management, and how can they effectively address them?

Managers in Utilization Management often encounter challenges such as balancing quality patient care with cost containment, navigating evolving healthcare regulations, and managing diverse teams. To effectively address these issues, successful managers develop strong communication skills, stay updated on industry standards, and foster collaboration between clinical and administrative staff. Implementing robust training programs and utilizing data-driven decision-making can also help ensure compliance and improve overall team performance.

What does a Manager of Utilization Management do?

A Manager of Utilization Management oversees the process of evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. They lead a team that reviews medical claims and care plans to ensure compliance with clinical guidelines and regulatory requirements. Their role often involves collaborating with physicians, nurses, insurance companies, and other stakeholders to optimize patient outcomes while managing healthcare costs. Additionally, they are responsible for implementing policies, training staff, and ensuring that utilization management activities align with organizational goals.
What are the most commonly searched types of Utilization Management jobs in Illinois? The most popular types of Utilization Management jobs in Illinois are:
What are popular job titles related to Manager Utilization Management jobs in Illinois? For Manager Utilization Management jobs in Illinois, the most frequently searched job titles are:
What job categories do people searching Manager Utilization Management jobs in Illinois look for? The top searched job categories for Manager Utilization Management jobs in Illinois are:
What cities in Illinois are hiring for Manager Utilization Management jobs? Cities in Illinois with the most Manager Utilization Management job openings:
Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Illinois as of July 2026, with employment types broken down into 1% As Needed, 81% Full Time, 15% Part Time, 1% Temporary, and 2% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $88,192 per year, or $42.4 per hour.

Case Manager - Utilization Review RN

Community First Medical Center

Chicago, IL • On-site

$53/hr

Full-time, Part-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 6 days ago

Community First Medical Center rating

3.9

Company rating: 3.9 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

1,040th of 1,054 rated hospitals

Job description

Under the general direction of the Director of Behavioral Health, the Case Manager - Utilization Review RN provides clinically based case management and utilization review services to support the delivery of high-quality, cost-effective patient care. The RN is responsible for concurrent utilization review, medical necessity determination, denial prevention, discharge planning, care coordination, and resource management across the continuum of care.
The Case Manager - Utilization Review RN collaborates with physicians, interdisciplinary team members, physician advisors, social workers, revenue cycle staff, and third-party payers to ensure appropriate utilization of hospital resources, regulatory compliance, optimal reimbursement, and safe patient transitions.
Community First Medical Center offers benefits to all its full-time and part-time employees:
  • United Healthcare Medical PPO/HMO/HSA Plans, premiums as low as $50.00/full time, $85.00/Part Time
  • Met Life Dental and Vision
  • Paid Time Off (PTO) with annual accruals up to 168 hrs./year
  • Six paid holidays
  • Company Paid Life insurance and Short-term Disability
  • 401(k) after 90 days
  • Continuing Education reimbursement and 2 days paid off separate from PTO
  • Free Parking Garage
  • Internal Growth Opportunities

Requirements
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
QUALIFICATIONS
Education
  • Associate Degree in Nursing required.
  • Bachelor of Science in Nursing (BSN) preferred.

Experience
  • Minimum three (3) years of acute care nursing experience required.
  • Minimum two (2) years of Case Management and/or Utilization Review experience preferred.
  • Experience with discharge planning, utilization review, denial management, and payer authorization preferred.

Licensure
  • Current Illinois Registered Nurse license required.
  • ACM, CCM, or CMAC certification preferred.

KNOWLEDGE, SKILLS & ABILITIES
  • Knowledge of Medicare, Medicaid, and commercial insurance regulations.
  • Working knowledge of InterQual and/or MCG criteria.
  • Behavioral Health background knowledge
  • Access to Behavioral Health Networks
  • Understanding of utilization management and care coordination principles.
  • Knowledge of discharge planning and post-acute care resources.
  • Strong analytical and critical thinking skills.
  • Excellent verbal and written communication skills.
  • Ability to prioritize multiple complex patient cases.
  • Ability to build collaborative relationships with physicians and interdisciplinary teams.
  • Computer proficiency and electronic medical record experience.

PERFORMANCE EXPECTATIONS
Success in this role is measured by:
  • Appropriate admission status determination
  • Denial prevention and appeal success
  • Timely discharge planning
  • Reduction in avoidable days
  • Average Length of Stay management
  • Readmission reduction
  • Documentation compliance
  • Regulatory compliance
  • Patient throughput
  • Patient and physician satisfaction

Salary Description
43.47-$53.00

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