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Utilization Case Manager Jobs in Danvers, IL (NOW HIRING)

Nursing Supervisor Page 2 of 2 · Manages the departmental budget · Evaluates own job performance and utilization of resources in planning for professional growth. · Receives and acts to resolve ...

... case-mix documents to assure appropriate reimbursement for care and services provided within the ... Leadership Training to enhance your management skills * Daily Pay - get your money when you want

Regional MDS Consultant

Bloomington, IL · On-site

$90K - $110K/yr

... case-mix documents to assure appropriate reimbursement for care and services provided within the ... Leadership Training to enhance your management skills * Daily Pay - get your money when you want

OnCall Dig Radiology APP

Peoria, IL · On-site

$60.39 - $73.68/hr

Understanding of the principles of performance improvement, case management, discharge planning, utilization review, and medical records. Demonstrated ability to work independently. PREFERRED ...

... care management, nutritional therapy and IV antibiotic therapy. Care is provided by a highly ... utilization of the nursing process, nursing trends, technology, financial and human resources ...

Understanding of the principles of performance improvement, case management, discharge planning, utilization review, and medical records. Demonstrated ability to work independently. PREFERRED ...

The RN provides care to these patients through the utilization of the nursing process, nursing trends, technology, financial and human resources. The RN performs all responsibilities and duties ...

Showing results 41-60

Utilization Case Manager information

See Danvers, IL salary details

$15

$35

$57

How much do utilization case manager jobs pay per hour?

As of Aug 20, 2026, the average hourly pay for utilization case manager in Danvers, IL is $35.01, according to ZipRecruiter salary data. Most workers in this role earn between $28.37 and $36.92 per hour, depending on experience, location, and employer.

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 job categories do people searching Utilization Case Manager jobs in Danvers, IL look for?

The top searched job categories for Utilization Case Manager jobs in Danvers, IL are:

What cities near Danvers, IL are hiring for Utilization Case Manager jobs?

Cities near Danvers, IL with the most Utilization Case Manager job openings:

Full-time

Re-posted 20 days ago


Job description

RN Supervisor


Job Summary:

A RN who has complete oversight of the provider’s service delivery. The Nursing Supervisor is approved by the Governing Body at the recommendation of the Administrator.

Organizational Relationship: Reports directly to the Administrator.

Risk Of Occupational Exposure To Blood Borne Pathogens: C: no exposure Qualifications:

Will hold a current license to practice professional nursing (RN) in GA.

Prefer a BA degree. In lieu of a BA degree, two (2) years’ experience in a home care setting.

Will have a minimum of two (2) years of nursing experience, one (1) of which has been in a supervisory or administrative role in a home care setting.

Must have a criminal background check/Attestation upon hire.

Never have shown by credible evidence, to have abused, neglected, sexually assaulted, exploited or deprived any person or to have subjected any person to serious injury as a result of intentional or grossly negligent misconduct.

Have not made any material false statements concerning qualifications requirements either to the Department or the provider.



Responsibilities:

· Oversees the supervision of the Provider’s services (PCA and companion), including intake assessments, reassessments.

· Assist the Administrator in planning the overall development and administration of the Provider as set forth in the policies and procedures relating to the Provider’s programs.

· Participates in the development of administrative policies and procedures relating to the Provider.

· Directs implementation of approved work methods and procedures that reflect elements essential to rendering high quality care throughout the provider office.

· Participates in the review, analysis, and appraisal of the effectiveness of the total Provider program.

· Utilizes the data reports to quantify Provider’s service performance against the established norms. Recommends to the Administrator methodology to change outcomes and improve scores.

· Oversees the implementation and evaluation of client care services.

· Aggregates the client record review summaries for the provider to present at the QI committee.

· Works closely in achieving satisfactory staffing leadership in promoting and maintaining standards for giving high quality care by all members of the client care team.

· Assures that established QI committees maintain the goals per provider policy.

· Assists the Administrator in planning for the delivery of service.

· Assists the Administrator in collecting data for inclusion in the Annual Provider Evaluation and formulating the Annual report.

· Recognizes leadership potential and offers opportunities for leadership training and development.


Nursing Supervisor Page 2 of 2


· Manages the departmental budget

· Evaluates own job performance and utilization of resources in planning for professional growth.

· Receives and acts to resolve complaints subject to the Provider’s grievance procedure in the capacity of “next higher level authority”.

· Apprises Administrator of potential legal risks.

· Participates in the employee termination process assuring that full and complete documentation exists prior to executing disciplinary actions including written warnings through termination.

· Ensures implementation of Provider continuing education program.

· Perform other duties as assigned by the administrator.

· Projects a concerned, professional attitude and develops a positive rapport with all staff.

· Establish mutual goal setting and achievement of standards.

· Develops an open, positive rapport with community resources affiliated with provider services.

· Maintain high visibility and availability.

· Assists the Sales/Marketing efforts of the provider as needed.

· Serves as a member of various committees.

· Accommodates regulatory personnel during site visits.

· Participates in local organizations and activities relative to the health professions and community health services.

· Participates in state and national organizations, meetings, seminars, workshops and activities relating to the health professions and health care services, when appropriate.



Functional Abilities:

Must be able to read 12 point or larger type.

Must be able to hear, speak and effectively communicate in English.




Employee Signature: ______________________________________ Date: _______________