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

Sinai Chicago

RN Case Manager

Chicago, IL

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 ...

Sinai Chicago

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 ...

Sinai Chicago

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 ...

Guardian Angel Community Services

Case Manager

Joliet, IL

$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 ...

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All JobsUtilization Case JobsUtilization Case Manager JobsUtilization Case Manager Jobs in Wheaton, IL

Utilization Case Manager information

See Wheaton, IL salary details

$16

$35

$58

How much do utilization case manager jobs pay per hour?

As of Jul 26, 2026, the average hourly pay for utilization case manager in Wheaton, IL is $35.26, according to ZipRecruiter salary data. Most workers in this role earn between $28.56 and $37.16 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 Wheaton, IL? For Utilization Case Manager jobs in Wheaton, IL, the most frequently searched job titles are:
What job categories do people searching Utilization Case Manager jobs in Wheaton, IL look for? The top searched job categories for Utilization Case Manager jobs in Wheaton, IL are:
What cities near Wheaton, IL are hiring for Utilization Case Manager jobs? Cities near Wheaton, IL with the most Utilization Case Manager job openings:
Utilization Case Manager jobs near you
Infographic showing various Utilization Case Manager job openings in Wheaton, IL as of July 2026, with employment types broken down into 1% As Needed, 80% Full Time, 17% Part Time, and 2% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $73,349 per year, or $35.3 per hour.
Utilization Management and Population Health Nurse

Utilization Management and Population Health Nurse

Norwegian American Hospital

Chicago, IL

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.  
  • 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

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