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Utilization Case Manager Jobs in Illinois (NOW HIRING)

Guardian Angel Community Services

Case Manager

Joliet, IL · On-site

$19.75 - $25.50/hr

... care case records on children and families served. 3. Advise and consult with foster parents to ... utilization of available resources to address the service goals of the cases assigned. 6. Submit ...

Morris Hospital

MANAGER CASE MANAGEMENT

Morris, IL · On-site

$19.50 - $25/hr

Two years previous experience in case management/utilization review. * Certification in Case Management preferred. * Experience in RAC auditing / review. * DCFS Mandated Reporter Certificate of ...

Morris Hospital

MANAGER CASE MANAGEMENT

Morris, IL

$19.50 - $25/hr

Two years previous experience in case management/utilization review. * Certification in Case Management preferred. * Experience in RAC auditing / review. * DCFS Mandated Reporter Certificate of ...

Morris Hospital

MANAGER CASE MANAGEMENT

Morris, IL · On-site

$93K - $140K/yr

Two years previous experience in case management/utilization review. * Certification in Case Management preferred. * Experience in RAC auditing / review. * DCFS Mandated Reporter Certificate of ...

AHS Vista LLC

Case Manager Full Time and PRN

Waukegan, IL · On-site

$36 - $55/hr

Vista Medical Center is seeking a dedicated and detail-oriented Case Manager - Registered Nurse (RN ... Perform utilization review to assess medical necessity, care appropriateness, and compliance with ...

AHS Vista LLC

Case Manager Full Time and PRN

Waukegan, IL · On-site

$36 - $55/hr

Vista Medical Center is seeking a dedicated and detail-oriented Case Manager - Registered Nurse (RN ... Perform utilization review to assess medical necessity, care appropriateness, and compliance with ...

GQR Healthcare

Travel Case Manager RN

Mattoon, IL · On-site

$1.9K - $2.0K/wk

Travel Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Mattoon, Illinois Start Date: September 28, 2026 Profession: Registered Nurse (RN) Facility: Hospital ...

American Traveler

Travel Case Manager RN

Mattoon, IL · On-site

Travel RN - Case Management/Utilization Review - Case Management About American Traveler With over 25 years of experience, American Traveler has established a reputation for outstanding customer ...

Veracity

UR Review Case Manager (Admin)

Chicago, IL · On-site

The Utilization Review/Case Manager is responsible for facilitating the appropriate use of hospital resources by ensuring that the patient meets acute inpatient criteria, and anticipates and provides ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Springfield, IL

The Director of Case Management (Utilization Management) is responsible for the leadership, oversight, and daily operations of theUtilization Management and Case Management functions. This role ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Springfield, IL · On-site

$37.55 - $56.33/hr

Responsibilities We are hiring a Director of Case Management (Utilization Management) at Lincoln Prairie Behavioral Health Center and offering a $5,000 sign-on bonus ! Lincoln Prairie Behavioral ...

Memorial Health

Director, Case Management

Springfield, IL · On-site

$47.59 - $76.14/hr

Certified as an Accredited Case Manager (ACM) or Certified Case Manager (CCM) preferred Experience ... Progressive experience in case management, care coordination, utilization management, transitions ...

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All JobsUtilization Case JobsUtilization Case Manager JobsUtilization Case Manager Jobs in Illinois

Utilization Case Manager information

What is a utilization case manager?

A Utilization Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They review patient cases, coordinate with healthcare providers, and ensure that treatments are in line with established guidelines and insurance requirements. Their goal is to optimize patient outcomes while managing costs and ensuring compliance with regulations. Utilization Case Managers often work in hospitals, insurance companies, or managed care organizations.

What are the key skills and qualifications needed to thrive as a utilization case manager?

To thrive as a Utilization Case Manager, you need a background in nursing or social work, strong analytical skills, and a solid understanding of healthcare regulations and insurance processes, often supported by RN licensure or certification in case management (e.g., CCM). Familiarity with utilization management software, electronic health records (EHRs), and payer authorization systems is essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration among patients, providers, and payers. These skills ensure appropriate care delivery, cost management, and compliance with healthcare standards.

How does a utilization case manager typically collaborate with healthcare providers and insurance companies?

Utilization Case Managers play a key role in coordinating care between healthcare providers and insurance companies. They review patient cases to ensure that the recommended treatments are medically necessary and align with insurance policies. This often involves regular communication with doctors, nurses, and insurance representatives to gather information, clarify treatment plans, and advocate for appropriate patient care. Strong collaboration skills are essential, as Utilization Case Managers must balance the needs of patients with organizational guidelines while maintaining positive professional relationships.

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

AspectUtilization Case ManagerUtilization Review Nurse
CredentialsRN license, case management certificationRN license, certification in utilization review
Work EnvironmentCase management teams, hospitals, insurance companiesUtilization review departments, hospitals, insurance providers
Primary FocusCoordinating patient care, discharge planning, resource allocationAssessing medical necessity, reviewing patient records for appropriateness
Common UsageBroader case management roles, patient advocacySpecific review of medical necessity and insurance claims

While both roles require RN licensure and focus on patient care, the Utilization Case Manager primarily coordinates overall patient services and discharge planning, whereas the Utilization Review Nurse concentrates on evaluating the medical necessity of treatments for insurance purposes. Understanding these distinctions helps in choosing the right career path or job search focus.

What degree do I need for utilization case manager?

Utilization case managers typically need at least a bachelor's degree in healthcare, social work, nursing, or a related field. Some positions may prefer or require a master's degree or relevant certifications, such as Certified Case Manager (CCM) or Certified Professional in Healthcare Quality (CPHQ).

What are popular job titles related to Utilization Case Manager jobs in Illinois?

For Utilization Case Manager jobs in Illinois, the most frequently searched job titles are:

What job categories do people searching Utilization Case Manager jobs in Illinois look for?

The top searched job categories for Utilization Case Manager jobs in Illinois are:

What cities in Illinois are hiring for Utilization Case Manager jobs?

Cities in Illinois with the most Utilization Case Manager job openings:

Utilization Case Manager jobs near you
Infographic showing various Utilization Case Manager job openings in Illinois as of August 2026, with employment types broken down into 90% Full Time, 9% Part Time, and 1% Contract. Highlights an 81% Physical, 2% Hybrid, and 17% Remote job distribution.

Case Manager

Guardian Angel Community Services

Joliet, IL • On-site

$19.75 - $25.50/hr

Full-time

Re-posted 10 days ago

Job description

Provide services to DCFS wards and their families in order to achieve the permanency goal as outlined and explained in the client service plan.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
1. Provide casework services to accepted children, including placement supervision, counseling and other supportive methods, service plan formulation and implementation, and appropriate involvement with the natural family.
2. Maintain complete, accurate, and current service reports and foster care case records on children and families served.
3. Advise and consult with foster parents to assure adequate understanding of the case situation and the needs of the child.
4. Prepare such records, reports, and file materials as required by DCFS.
5. Coordinate effectively with DCFS and other community agencies for the maximum utilization of available resources to address the service goals of the cases assigned.
6. Submit reports as required by the program supervisor.
7. Perform on-call duties as needed to carry out the responsibilities of the Foster Care Program.
8. Communicate problems and issues within the department to the program supervisor.
9. Assist GACS administration in any investigation against conduct that is illegal.
10. Complete all mandatory agency and job specific training.
11. Perform other duties as assigned.
NON-ESSENTIAL DUTIES:
1. Attend required staff meetings, agency meetings, and such other meetings as requested by the Program Supervisor.
QUALIFICATIONS:
  1. A bachelor's degree in social work, psychology or related field and experience preferred.
  2. CERAP and DCFS Licensure Eligible.
  3. Valid Illinois driver's license.
  4. Ability to work with DCFS, courts, and other social service systems.
  5. Access to a vehicle for client transportation and outreach counseling when an agency vehicle is not available, and proof of personal auto insurance.
  6. Demonstrate sensitivity to the cultural and socio economic characteristics of persons served.
  7. Ability to exercise discretion and independent judgment.
  8. Ability to handle sensitive and confidential materials.
  9. Ability to work flexible hours.

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