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Remote Utilization Management Jobs in Peoria, IL

All JobsUtilization Management JobsRemote Utilization Management JobsRemote Utilization Management Jobs in Peoria, IL

Remote Utilization Management information

See Peoria, IL salary details

$20

$41

$67

How much do remote utilization management jobs pay per hour?

As of Aug 30, 2026, the average hourly pay for remote utilization management in Peoria, IL is $41.49, according to ZipRecruiter salary data. Most workers in this role earn between $32.79 and $47.64 per hour, depending on experience, location, and employer.

What is remote utilization management?

Remote utilization management is a process in which healthcare professionals, such as nurses or case managers, review and assess the necessity, efficiency, and appropriateness of medical services—often from a remote location. These professionals typically work for insurance companies, hospitals, or healthcare organizations to ensure that patients receive the right care while controlling costs. By working remotely, they use electronic health records, phone calls, and other digital tools to collaborate with providers and patients. This role helps improve healthcare quality and cost-effectiveness while allowing employees flexible work arrangements.

What are the key skills and qualifications needed to thrive in remote utilization management?

Success as a Remote Utilization Management Nurse requires a registered nursing license, clinical experience, and strong knowledge of medical necessity criteria and insurance guidelines. Familiarity with utilization review software, electronic health records (EHRs), and case management systems is typically necessary. Exceptional communication, critical thinking, and organizational skills help professionals excel in evaluating cases and coordinating with providers remotely. These skills are crucial for ensuring appropriate care, cost-effective resource use, and regulatory compliance in a remote healthcare setting.

How does a remote utilization management professional typically collaborate with healthcare providers and insurance teams?

Remote Utilization Management professionals frequently interact with both healthcare providers and insurance teams through secure digital platforms, phone calls, and virtual meetings. They review patient records, assess the necessity of medical services, and communicate their recommendations or authorization decisions. Effective collaboration requires clear documentation, timely responses, and strong communication skills to ensure that care is both medically appropriate and cost-effective. While the work is often independent, regular coordination with interdisciplinary teams is essential for maintaining high-quality patient outcomes and adhering to regulatory standards.

What is the difference between Remote Utilization Management vs Remote Case Management?

AspectRemote Utilization ManagementRemote Case Management
CredentialsRN, LPN, or licensed healthcare professionalsRN, LPN, or social workers
Work EnvironmentHealthcare facilities, insurance companies, telehealthHealthcare providers, insurance, community agencies
Industry UsageInsurance, healthcare, telehealthHealthcare, social services, insurance
Primary FocusReviewing medical necessity, authorizationsCoordinating patient care, support services

Remote Utilization Management primarily involves reviewing medical necessity and authorizations, while Remote Case Management focuses on coordinating patient care and support services. Both roles require healthcare credentials and are used within healthcare and insurance industries, but they serve different functions in patient care and resource allocation.

What are popular job titles related to Remote Utilization Management jobs in Peoria, IL?

For Remote Utilization Management jobs in Peoria, IL, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Management jobs in Peoria, IL look for?

The top searched job categories for Remote Utilization Management jobs in Peoria, IL are:

What cities near Peoria, IL are hiring for Remote Utilization Management jobs?

Cities near Peoria, IL with the most Remote Utilization Management job openings:

Remote Utilization Management jobs near you
Infographic showing various Remote Utilization Management job openings in Peoria, IL as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 18% Part Time, and 3% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $86,292 per year, or $41.5 per hour.

Care Management Associate (Remote - Illinois)

CVS Health

Peoria, IL • Remote

$18.50 - $38.82/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 9 days ago

CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,355 frontline employees who took The Breakroom Quiz

91st of 113 rated pharmacies

Job description

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Position Summary

CVS Health Aetna has an opportunity for a full-time Care Management Associate (CMA). In this role, you will support the coordination of medical and social services for members by assisting with care team intake, task triage, outreach, and care plan implementation.

The CMA plays a key role in promoting effective utilization of healthcare services, supporting quality outcomes, and ensuring compliance with regulatory and accreditation standards.

Key Responsibilities
  • Review, prioritize, and triage incoming Care Team tasks to ensure timely follow-up and resolution
  • Screen members using established guidelines and business rules to identify care needs and required services
  • Initiate referrals to Case Management, Disease Management, LTSS, and other specialty programs as appropriate
  • Conduct outreach to members, providers, and care team partners to support care coordination efforts
  • Utilize internal systems to document member information, outreach, and case activity accurately and timely
  • Support the development and implementation of member care plans under the direction of clinical staff
  • Coordinate healthcare services and assist in identifying in-network, cost-effective care options
  • Perform non-clinical research to support case development, maintenance, and closure
  • Communicate effectively with internal teams, providers, and members to facilitate care delivery
  • Provide administrative and operational support, including call handling, issue resolution, and task follow-up
  • Maintain accurate, complete, and audit-ready documentation in compliance with company policies and regulatory requirements
  • Adhere to all compliance standards, including CMS, NCQA, URAC, and internal quality guidelines
Required Qualifications
  • 2-4 years of experience in a healthcare setting (e.g., medical assistant, office assistant, care coordination support)
  • Strong computer proficiency, including Microsoft Word and Excel
  • Ability to navigate multiple systems and manage tasks efficiently in a fast-paced environment
Preferred Qualifications
  • Strong verbal and written communication skills, including telephonic outreach
  • Knowledge of basic medical terminology and care management concepts
  • Excellent organizational and time management skills with attention to detail
  • Customer-focused approach with the ability to resolve issues proactively
  • Ability to collaborate effectively within a multidisciplinary team
Education
  • High School Diploma or GED required
Work Environment & Expectations
  • 100% remote position
  • Must maintain a dedicated, distraction-free workspace
  • Candidates must have reliable childcare or dependent care arrangements during working hours
  • Ability to manage a high-volume workload and meet productivity and documentation requirements

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$18.50 - $38.82

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This fulltime position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial wellbeing of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.


Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 08/22/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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