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

Case Manager

Libertyville, IL ยท 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 โ€ข License or ...

Case Manager

Libertyville, IL

$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

Libertyville, IL

$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:

RN Case Manager

Elmhurst, IL ยท On-site

$38.16 - $59.15/hr

The RN Case Manager helps optimize patient outcomes, improve resource utilization, and enhance the overall quality of care. What you will do: * Conduct thorough assessments of patients' medical ...

Medical Case Manager II

Downers Grove, IL ยท On-site

$65K - $98K/yr

As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...

As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...

As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...

As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...

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Utilization Case Manager information

See Elgin, IL salary details

$16

$36

$59

How much do utilization case manager jobs pay per hour?

As of Jul 19, 2026, the average hourly pay for utilization case manager in Elgin, IL is $36.07, according to ZipRecruiter salary data. Most workers in this role earn between $29.23 and $38.03 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 does a utilization case manager do?

A utilization case manager reviews and authorizes healthcare services to ensure they are necessary and appropriate, often working with insurance companies and healthcare providers. They analyze patient records, coordinate care plans, and ensure compliance with policies, typically using case management software and requiring strong communication skills.

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 jobs pay 4000 a week without a degree?

Utilization Case Managers typically do not earn $4,000 weekly without relevant experience or certifications; most roles in healthcare or social services pay less. High-paying jobs that can reach this level without a degree are rare and often involve specialized skills, sales, or entrepreneurship. Generally, achieving such income without a degree requires significant experience, licensing, or working in high-demand fields like real estate or certain trades.

What is the highest paid case manager?

The highest paid case managers are often those with advanced certifications, specialized skills, or experience in high-demand fields such as healthcare or insurance. Senior or managerial roles, such as Utilization Review Managers, can earn salaries exceeding $80,000 to $100,000 annually. Compensation varies based on location, industry, and level of responsibility.

Is being a MOA a good entry level job?

A Medical Office Assistant (MOA) role is often considered an entry-level position in healthcare, requiring basic administrative and clinical skills. It provides experience with medical records, patient communication, and office procedures, which can serve as a foundation for advancing in healthcare careers. However, the job's suitability depends on individual career goals and the specific workplace environment.

What are the key skills and qualifications needed to thrive as a Utilization Case Manager, and why are they important?

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.

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 are popular job titles related to Utilization Case Manager jobs in Elgin, IL? For Utilization Case Manager jobs in Elgin, IL, the most frequently searched job titles are:
What job categories do people searching Utilization Case Manager jobs in Elgin, IL look for? The top searched job categories for Utilization Case Manager jobs in Elgin, IL are:
What cities near Elgin, IL are hiring for Utilization Case Manager jobs? Cities near Elgin, IL with the most Utilization Case Manager job openings:
Utilization Review / Case Manager (RN)

Utilization Review / Case Manager (RN)

Veracity

Chicago, IL โ€ข On-site

Other

Re-posted 6 days ago


Job description

Title: Utilization Review / Case Manager (RN)
Chicago, Illinois
Reports To: Clinical Director, Behavioral Health Services
Term: Permanent, Full-time
General Summary
The Utilization Review/Case Manager facilitates appropriate use of hospital resources by ensuring that patients meet acute inpatient criteria and anticipates discharge needs in a timely manner. The role acts as a central communicator with external and internal customers, collaborating with social workers, case managers, vendors, payers, and community agencies.
Key Responsibilities
Utilization Management
  • Perform inpatient utilization management per plan, payer requirements, and standards.
  • Collaborate with physicians and healthcare team members for timely and appropriate patient management.
  • Collect and document clinical data to support admission and continued hospitalization.
  • Provide accurate clinical information to payers as required.
  • Support DRG Assurance Program with accurate data collection and assignment.
  • Perform non-acute profiling, collect data on avoidable days, and refer cases to Physician Advisor when needed.
Discharge Planning
  • Participate in family meetings and care conferences.
  • Ensure timely referrals for discharge planning and use of regional/community resources.
  • Refer complex cases to Social Services as appropriate.
  • Ensure psychological needs of patients are met via direct intervention or referral.
Communication & Coordination
  • Act as a central communicator with patients, families, vendors, payers, and hospital staff.
  • Provide continuity of care by leveraging community resources and maintaining updated resource manuals.
  • Refer cases not meeting criteria to Physician Advisor in a timely manner.
  • Follow up with Medical Director/Physician Advisor on unresolved issues.
Other Duties
  • Maintain safe patient care environment and infection control compliance.
  • Manage departmental operations (phones, supplies, data tracking).
  • Attend in-service presentations and complete all mandatory education.
  • Perform other duties as assigned.

Knowledge, Skills & Abilities
  • Graduate of an accredited school of nursing (Required)
  • Current RN License in Illinois (Required)
  • 2+ years relevant clinical experience (Preferred)
  • Utilization management experience (Preferred)
  • Knowledge of Medicare/Medicaid, Managed Care, and Commercial insurance processes (Preferred)
  • Strong written/oral communication skills with appropriate grammar and vocabulary
  • Proficiency in Microsoft Word and Excel (Required)
  • Ability to provide excellent customer service at all times
  • Ability to anticipate and coordinate multiple functions effectively