* Utilization case review and application of criteria to approve initial and continued inpatient ... Refer patients/families to self-management support programs as needed and communicate with care ...
* Utilization case review and application of criteria to approve initial and continued inpatient ... Refer patients/families to self-management support programs as needed and communicate with care ...
* Utilization case review and application of criteria to approve initial and continued inpatient ... Refer patients/families to self-management support programs as needed and communicate with care ...
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* Utilization case review and application of criteria to approve initial and continued inpatient ... Refer patients/families to self-management support programs as needed and communicate with care ...
* Utilization case review and application of criteria to approve initial and continued inpatient ... Refer patients/families to self-management support programs as needed and communicate with care ...
* Utilization case review and application of criteria to approve initial and continued inpatient ... Refer patients/families to self-management support programs as needed and communicate with care ...
ED UTILIZATION REVIEW/CASE MANAGER
Chicago, IL · On-site
$85K - $90K/yr
The ED 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 ...
ED UTILIZATION REVIEW/CASE MANAGER
Chicago, IL · On-site
$85K - $90K/yr
The ED 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 ...
ED UTILIZATION REVIEW/CASE MANAGER
Chicago, IL · On-site
$85K - $90K/yr
The ED 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 ...
ED UTILIZATION REVIEW/CASE MANAGER
Chicago, IL · On-site
$85K - $90K/yr
The ED 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 ...
Clinical Case Manager
Munster, IN · On-site
The clinical Case Manager will promote effective utilization and assume a leadership role with the interdisciplinary team to achieve optimal clinical outcomes and resource utilization. Education ...
Clinical Case Manager
Munster, IN · On-site
The clinical Case Manager will promote effective utilization and assume a leadership role with the interdisciplinary team to achieve optimal clinical outcomes and resource utilization. Education ...
Case Manager
Libertyville, IL · On-site
$19.50 - $25/hr
Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications • License or ...
Case Manager
Libertyville, IL · On-site
$19.50 - $25/hr
Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications • License or ...
Case Manager
$19.50 - $25/hr
Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications License or Certification:
Case Manager
$19.50 - $25/hr
Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications License or Certification:
Case Manager
$19.50 - $25/hr
Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications License or Certification:
Case Manager
$19.50 - $25/hr
Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications License or Certification:
The RN Case manager provides education to physicians and other members of the team on the issues related to utilization review including appropriateness of admission, level of care and external ...
The RN Case manager provides education to physicians and other members of the team on the issues related to utilization review including appropriateness of admission, level of care and external ...
Remote RN Case Manager - Metro Chicago
Downers Grove, IL · On-site +1
Utilization Management, Utilization Review, Managed Care, or Cost Containment experience * CCM (Certified Case Manager), CIRS, or similar Case Management certification (preferred) * Ability to travel ...
Remote RN Case Manager - Metro Chicago
Downers Grove, IL · On-site +1
Utilization Management, Utilization Review, Managed Care, or Cost Containment experience * CCM (Certified Case Manager), CIRS, or similar Case Management certification (preferred) * Ability to travel ...
RN Case Manager
Chicago, IL · On-site
$37.40/hr
The RN Case manager provides education to physicians and other members of the team on the issues related to utilization review including appropriateness of admission, level of care and external ...
RN Case Manager
Chicago, IL · On-site
$37.40/hr
The RN Case manager provides education to physicians and other members of the team on the issues related to utilization review including appropriateness of admission, level of care and external ...
RN Case Manager - REGISTRY
Chicago, IL · On-site
The RN Case manager provides education to physicians and other members of the team on the issues related to utilization review including appropriateness of admission, level of care and external ...
RN Case Manager - REGISTRY
Chicago, IL · On-site
The RN Case manager provides education to physicians and other members of the team on the issues related to utilization review including appropriateness of admission, level of care and external ...
The RN Case manager provides education to physicians and other members of the team on the issues related to utilization review including appropriateness of admission, level of care and external ...
The RN Case manager provides education to physicians and other members of the team on the issues related to utilization review including appropriateness of admission, level of care and external ...
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 ...
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 ...
Lead Utilization Management Nurse
Oak Brook, IL · On-site +1
We have an innovative organization looking to add a Lead Utilization Management Nurse to its team ... Certified Case Manager (CCM) preferred * Knowledge/experience in Medicare/Medicaid and HEDIS ...
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Lead Utilization Management Nurse
Oak Brook, IL · On-site +1
We have an innovative organization looking to add a Lead Utilization Management Nurse to its team ... Certified Case Manager (CCM) preferred * Knowledge/experience in Medicare/Medicaid and HEDIS ...
The Case Manager is responsible for increasing efficient utilization of health care services; identifying chronic or catastrophic cases through the case management process and initiating intensive ...
The Case Manager is responsible for increasing efficient utilization of health care services; identifying chronic or catastrophic cases through the case management process and initiating intensive ...
Collaborates with Utilization Review regarding insurance concerns and verification of acute and ... Case Management, Utilization Management, Discharge Planning, or related experience Equal ...
Collaborates with Utilization Review regarding insurance concerns and verification of acute and ... Case Management, Utilization Management, Discharge Planning, or related experience Equal ...
The Nurse Case Manager will work closely with the multi-disciplinary team to determine ... Collaborates with Utilization Review regarding insurance concerns and verification of acute and ...
The Nurse Case Manager will work closely with the multi-disciplinary team to determine ... Collaborates with Utilization Review regarding insurance concerns and verification of acute and ...
Case Manager-Social Services Part Time Days
Palos Heights, IL · On-site
$40.50/hr
The Nurse Case Manager will work closely with the multi-disciplinary team to determine ... Collaborates with Utilization Review regarding insurance concerns and verification of acute and ...
Case Manager-Social Services Part Time Days
Palos Heights, IL · On-site
$40.50/hr
The Nurse Case Manager will work closely with the multi-disciplinary team to determine ... Collaborates with Utilization Review regarding insurance concerns and verification of acute and ...
Utilization Case Manager information
See Chicago, IL salary details
$17.09 - $21.16
3% of jobs
$21.16 - $25.24
1% of jobs
$25.24 - $29.31
6% of jobs
$31.28 is the 25th percentile. Wages below this are outliers.
$29.31 - $33.39
30% of jobs
The median wage is $34.85 / hr.
$33.39 - $37.46
26% of jobs
$39.01 is the 75th percentile. Wages above this are outliers.
$37.46 - $41.53
22% of jobs
$41.53 - $45.61
3% of jobs
$45.61 - $49.68
0% of jobs
$49.68 - $53.76
5% of jobs
$53.76 - $57.83
2% of jobs
$57.83 - $61.91
1% of jobs
$17
$37
$61
How much do utilization case manager jobs pay per hour?
What is a Utilization Case Manager?
What does a utilization case manager do?
How does a Utilization Case Manager typically collaborate with healthcare providers and insurance companies?
What jobs pay 4000 a week without a degree?
What is the highest paid case manager?
Is being a MOA a good entry level job?
What are the key skills and qualifications needed to thrive as a Utilization Case Manager, and why are they important?
What is the difference between Utilization Case Manager vs Utilization Review Nurse?
| Aspect | Utilization Case Manager | Utilization Review Nurse |
|---|---|---|
| Credentials | RN license, case management certification | RN license, certification in utilization review |
| Work Environment | Case management teams, hospitals, insurance companies | Utilization review departments, hospitals, insurance providers |
| Primary Focus | Coordinating patient care, discharge planning, resource allocation | Assessing medical necessity, reviewing patient records for appropriateness |
| Common Usage | Broader case management roles, patient advocacy | Specific 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.

Utilization Management and Population Health Nurse
Chicago, IL • On-site
Full-time
Posted 12 days ago
Job description
- Utilization case review and application of criteria to approve initial and continued inpatient services
- Identify patients in need of outreach efforts based on patient risk stratification or other defined criteria as well as defined disease management guidelines
- Work with CPHO team, patient’s Primary Care Physician and all other providers of the patients’ care to develop individualized care plans
- Facilitate communication with patients and care team, coordinate referrals, and promote optimal allocation of available resources
- Measure progress toward goals based on clinical judgment, review of patients’ self-monitoring tools and trends in clinical data
- Assess and monitor adherence to outreach and then problem-solve intrinsic and extrinsic barriers to effective patient self-management of chronic conditions
- Provide educational materials and resources to patient/family and their care providers
- Refer patients/families to self-management support programs as needed and communicate with care providers to ensure safe and effective care management. Â
- Analyze clinical data to track patient outcomes to determine improvement
- Triage patient phone calls for acute patient issues and counsel accordingly
- Oversight and management of population health quality improvement studies to reach established targets
- Interface with Commercial and Government entities on care coordination, HEDIS and other QI activities
- Report to UM/QM Committee on progress toward goals and make recommendations for improvement
- Other duties as assigned
- Minimum qualifications must be health plan requirements, including but not limited to licensure/certification, as applicable
About Norwegian American Hospital
Sourced by ZipRecruiter
Industry
Hospitals
Company size
51 - 200 Employees
Headquarters location
Chicago, IL, US
Year founded
1894