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Senior Rn Utilization Review Nurse Jobs in Springfield, IL

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Senior Rn Utilization Review Nurse information

See Springfield, IL salary details

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$68

How much do senior rn utilization review nurse jobs pay per hour?

As of Jun 16, 2026, the average hourly pay for senior rn utilization review nurse 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 Senior Rn Utilization Review Nurse vs Rn Case Manager?

AspectSenior Rn Utilization Review NurseRn Case Manager
CertificationsRN license, possibly UR or case management certificationRN license, often case management certification
Work EnvironmentHospitals, insurance companies, healthcare organizationsHospitals, community health, insurance providers
Primary FocusReviewing medical necessity and utilization of servicesCoordinating patient care and discharge planning
Common UsageUsed in insurance and healthcare review settingsUsed in patient care coordination and discharge planning

The Senior Rn Utilization Review Nurse primarily focuses on evaluating the necessity and appropriateness of healthcare services, often working within insurance companies or healthcare organizations. In contrast, Rn Case Managers concentrate on coordinating patient care, discharge planning, and ensuring smooth healthcare delivery. Both roles require RN licensure and relevant certifications, but their daily responsibilities and work environments differ slightly.

What does a Senior RN Utilization Review Nurse do?

A Senior RN Utilization Review Nurse is a registered nurse who evaluates the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, apply clinical guidelines, and collaborate with healthcare providers to ensure that treatments are cost-effective and meet established standards of care. Additionally, they often mentor junior staff, participate in policy development, and help optimize resource utilization within healthcare organizations. Their work supports quality patient care while managing healthcare costs.

What are some typical challenges faced by Senior RN Utilization Review Nurses when coordinating with multidisciplinary teams?

Senior RN Utilization Review Nurses often collaborate with physicians, case managers, and insurance representatives to ensure patients receive appropriate, cost-effective care. A common challenge is balancing clinical guidelines with payer requirements, which can sometimes lead to differing opinions on the necessity of certain treatments or services. Effective communication, strong negotiation skills, and up-to-date knowledge of regulatory standards are essential to navigate these situations successfully. Being proactive and maintaining strong professional relationships helps facilitate smoother approvals and promotes patient-centered care.

What are the key skills and qualifications needed to thrive as a Senior RN Utilization Review Nurse, and why are they important?

To thrive as a Senior RN Utilization Review Nurse, you need a strong clinical nursing background, active RN licensure, and in-depth knowledge of medical necessity criteria and healthcare regulations. Familiarity with utilization review software, electronic health records (EHRs), and certifications like CCM (Certified Case Manager) or URAC are highly beneficial. Exceptional critical thinking, attention to detail, and effective communication skills distinguish top performers in this role. These skills ensure accurate case evaluations, compliance with regulations, and optimized patient care while controlling healthcare costs.
What are popular job titles related to Senior Rn Utilization Review Nurse jobs in Springfield, IL? For Senior Rn Utilization Review Nurse jobs in Springfield, IL, the most frequently searched job titles are:
What job categories do people searching Senior Rn Utilization Review Nurse jobs in Springfield, IL look for? The top searched job categories for Senior Rn Utilization Review Nurse jobs in Springfield, IL are:
What cities near Springfield, IL are hiring for Senior Rn Utilization Review Nurse jobs? Cities near Springfield, IL with the most Senior Rn Utilization Review Nurse job openings:
Infographic showing various Senior Rn Utilization Review Nurse job openings in Springfield, IL as of June 2026, with employment types broken down into 1% As Needed, 71% Full Time, 7% Part Time, and 21% Contract. Highlights an 86% Physical, 5% Hybrid, and 9% Remote job distribution, with an average salary of $87,164 per year, or $41.9 per hour.
Registered Nurse (RN), Cath Lab

Registered Nurse (RN), Cath Lab

Memorial Health

Niantic, IL

$48.37/hr

Full-time

Posted 12 days ago


Memorial Health rating

6.8

Company rating: 6.8 out of 10

Based on 170 frontline employees who took The Breakroom Quiz

485th of 872 rated healthcare providers


Job description

Min
USD $30.23/Hr.
Max
USD $48.37/Hr.
Overview
*** $20,000 Sign on Bonus Available***
This is a Full Time, Day Shift Position
(Three 12-hour shifts, with On-Call)
The Full Time Cath Lab Registered Nurse (RN) offers fast paced multidisciplinary teams, performing vascular diagnostic and interventional, coronary diagnostic and interventional, and structural heart procedures. The Cath Lab RN also performs high acuity electrophysiology studies and ablations, and permanent pacemaker/ICD device implants.
Responsible for delegation, supervision, and provision of nursing care for a designated group of patients through utilization of the nursing process. Provides age-appropriate care. Participates in research when appropriate and incorporates research findings into evidence-based clinical practice. Contributes to quality improvement processes. Adheres to MMC Mission, Vision, and Values, the Nursing Division Mission, Vision, and Philosophy, the ANA Code of Ethics and the Illinois Nursing Act. Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values.
A Registered Nurse at Springfield Memorial Hospital (SMH) means becoming a part of a Magnet hospital that raises the bar for excellence. The SMH environment expects high quality care for patients and RNs who want to advance learning to ensure they can be the best nurse possible. Quality nurses not only understand, but also exhibit, that "care starts with caring." Nursing is about caring for people. Above all else, working at Memorial means we expect you to exceed customer expectations. You can do this by treating each patient as if they are the only one you are caring for that day, being the calm voice for the family, finding the answers when you don't have one, and displaying compassion in all interactions.
Recruiter:
Sandy Dunn, Senior Talent Acquisition Partner
Dunn.Sandy@mhsil.com
To review Memorial's Benefits click here: Benefits - Memorial HR
Qualifications
Licensure/Certification/Registry:
  • Licensed as RN in State of Illinois required.
  • Current BLS/CPR certification per policy.

Other Knowledge/Skills/Abilities:
  • Must be able to position and/or transfer an average adult patient and possess gross coordination sufficient to perform other patient care duties as required. Must be able to withstand prolonged periods of standing.
  • Must be able to perform difficult manipulative skills such as IV insertion and IM injections.
  • Environmental working conditions include exposure to blood, bodily fluids and tissue, contagious diseases and/or radioactive or other potentially hazardous materials.

Responsibilities
1. Professional Nursing Care
• Age appropriate assessment.
• Data analysis to identify nursing problems.
• Defines individualized patient outcomes.
• Develops an interdisciplinary, individualized plan of care in partnership with patients and families.
• Implements specified interventions to attain expected outcomes.
• Evaluates the patient's progress toward attainment of outcomes, revising the plan when indicated.
2. Supervision and Delegation
• Delegates patient care tasks to LPNs and unlicensed assistive personnel based on job description, individual capability and patient needs.
• Communicates patient status and caregiver performance expectations.
• Appropriately supervises performance of LPNs and unlicensed assistive personnel.
• Directs performance improvement for LPNs and unlicensed assistive personnel.
• Builds teamwork when supervising and delegating to others.
3. Communication and Collaboration
• Demonstrates effective interpersonal skills.
• Uses therapeutic communication techniques.
• Demonstrates assertiveness.
• Communicates relevant patient information to other members of the health team.
• Documents patient care according to Memorial policies and procedures. .
• Ensures appropriate implementation of physician's orders.
• Creates and maintains a collaborative work environment.
• Participates in interdisciplinary planning and decision making.
• Precepts new nursing employees and/or nursing students.
4. Quality and Safety
• Identifies and resolves safety risks.
• Participates in continuous quality improvement.
• Participates in the periodic review and revision of policies, procedures, and standards of care.
• Complies with all safety policies.
5. 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.
6. Professional Accountability
• Demonstrates ethical decision making.
• Advocates for patients and families.
• Appropriately follows the chain of command.
• Adheres to the Memorial Health Behavioral Standards
• Develops annual plan for own professional development
• Participates in community health initiatives
• Participates in community organizations.
• Contributes to nursing research activities and applies findings in clinical practice.
• Participates in nurse peer review process.

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