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Utilization Management Auditor Jobs in Naperville, IL

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Senior Auditor

Chicago, IL · On-site

$77K - $87K/yr

Senior Auditor The Senior Auditor, primarily as a leader of a team (normally 1-3 Auditors), is ... Aim to achieve an agreed utilization rate by communicating regularly with Managers on availability ...

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Senior Auditor

Chicago, IL · On-site

$77K - $87K/yr

Senior Auditor The Senior Auditor, primarily as a leader of a team (normally 1-3 Auditors), is ... Aim to achieve an agreed utilization rate by communicating regularly with Managers on availability ...

Government Programs Compliance Lead

Chicago, IL · On-site

$161K/yr

... auditing, and issue investigation and remediation while proactively identifying and mitigating ... utilization management, and appeals, with a strong emphasis on enterprise risk assessment and ...

... with external auditors * Conduct interviews with all levels of Federal Signal Management and ... O assistance including GRC Tool updates, utilization, and functionality * Update company-wide ...

... with external auditors * Conduct interviews with all levels of Federal Signal Management and ... O assistance including GRC Tool updates, utilization, and functionality * Update company-wide ...

Premium Auditor I

Chicago, IL · Remote

$57K - $101K/yr

Description Our professional auditors are integral to our company's mission by ensuring the ... Exhibit effective workload management skills through efficient time utilization including managing ...

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 ...

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 ...

Coordinate with Lead Therapist and Supervise Lead Case Manager (individual and group -PSR/OPT) Oversee administrative office manager, compliance auditor and utilization manager. * Collaborate with ...

MDS Coordinator RN

Chicago, IL · On-site

$38.50 - $46.50/hr

... utilization management process in accordance with current federal, state, and local standards ... auditor requirements. 7. Perform regular audits of documentation to assure accuracy. 8. Assist ...

Transportation Manager

Naperville, IL · On-site

$57K - $76K/yr

This includes driver management, load planning, and customer service functions needed to ensure ... Manage driver utilization to meet and exceed account goals to provide customer value. * Monitor ...

Senior Benefits Analyst

Chicago, IL · On-site

$70 - $90/hr

... plan testing, auditing, and administration. The analyst independently interprets and applies ... This role routinely manages complex projects, analyzes benefit trends and utilization, and leads ...

Senior Benefits Analyst

Chicago, IL · Hybrid

$90K - $115K/yr

... plan testing, auditing, and administration. The analyst independently interprets and applies ... This role routinely manages complex projects, analyzes benefit trends and utilization, and leads ...

Inventory Control Manager II

Monee, IL · On-site

$70K - $115K/yr

... management. Business benefits of the role: * Ensuring the right product is in the right place at ... Proper utilization of information technology * Provide required documentation to customer, customer ...

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Utilization Management Auditor information

See Naperville, IL salary details

$15

$31

$53

How much do utilization management auditor jobs pay per hour?

As of Aug 29, 2026, the average hourly pay for utilization management auditor in Naperville, IL is $31.89, according to ZipRecruiter salary data. Most workers in this role earn between $22.31 and $40.58 per hour, depending on experience, location, and employer.

What is a utilization management auditor?

A Utilization Management Auditor is a healthcare professional responsible for reviewing medical records, claims, and utilization data to ensure that healthcare services provided to patients are necessary, appropriate, and comply with established guidelines and policies. They help identify overuse, underuse, or misuse of medical resources and ensure regulatory compliance. Utilization Management Auditors work closely with healthcare providers, insurance companies, and regulatory agencies to improve the quality and cost-effectiveness of patient care.

What are the key skills and qualifications needed to thrive as a utilization management auditor?

To thrive as a Utilization Management Auditor, you need a strong background in healthcare administration, case management, and medical coding, often supported by a clinical degree or certification such as RN, LPN, or RHIA. Familiarity with utilization management software, electronic health records (EHRs), and regulatory standards like CMS guidelines is essential. Analytical thinking, attention to detail, and effective communication are crucial soft skills for identifying compliance issues and collaborating with healthcare teams. These skills ensure accurate audits, regulatory compliance, and optimal resource utilization within healthcare organizations.

What are some common challenges faced by utilization management auditors and how can they be addressed?

Utilization Management Auditors often encounter challenges such as keeping up with constantly changing healthcare regulations and payer requirements, interpreting complex medical documentation, and ensuring compliance with both internal and external policies. To address these challenges, auditors should engage in ongoing professional development, collaborate closely with clinical and administrative teams for accurate information, and make use of robust audit tools and resources. Effective communication and a proactive approach to regulatory changes can help streamline the audit process and maintain high standards of accuracy.

What is the difference between Utilization Management Auditor vs Utilization Review Nurse?

AspectUtilization Management AuditorUtilization Review Nurse
CredentialsTypically requires a nursing license, certifications like CCM or CUCLicensed Registered Nurse (RN), often with additional certifications
Work EnvironmentOffice-based, insurance companies, healthcare organizationsHospital, clinics, insurance companies, often in clinical settings
Primary FocusAuditing and reviewing utilization data for compliance and cost managementAssessing patient care needs and determining appropriate services

While both roles involve healthcare utilization, the Utilization Management Auditor primarily reviews data for compliance and cost efficiency, whereas the Utilization Review Nurse focuses on patient care assessments. Both require nursing credentials and work within healthcare or insurance settings, but their core responsibilities differ.

What job categories do people searching Utilization Management Auditor jobs in Naperville, IL look for?

The top searched job categories for Utilization Management Auditor jobs in Naperville, IL are:

What cities near Naperville, IL are hiring for Utilization Management Auditor jobs?

Cities near Naperville, IL with the most Utilization Management Auditor job openings:

Infographic showing various Utilization Management Auditor job openings in Naperville, IL as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 14% Part Time, and 3% Contract. Highlights an 82% Physical, 3% Hybrid, and 15% Remote job distribution, with an average salary of $66,337 per year, or $31.9 per hour.

Senior Auditor

Prado & Renteria CPAs

Chicago, IL • On-site

$77K - $87K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 20 days ago

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Job description

Prado & Renteria is growing, and we're looking for a Senior Auditor who enjoys building client relationships, mentoring staff, and delivering high-quality audit services.

Senior Auditor

The Senior Auditor, primarily as a leader of a team (normally 1-3 Auditors), is responsible for accomplishing all aspects of assigned engagements. The Senior Role oversees audit staff during attest and consulting engagements. The Senior Auditor is able to work with limited supervision.

What You'll Do

Lead Audit Engagements

  • Oversees audit planning, field work, and audit reporting; prepare reports, and communicate findings and recommendations to line and senior management.
  • Develops budgets and timelines for engagements.
  • Understands and able to distinguish and apply the standards applicable to the scope and type of engagement (i.e., GAAS, GAGAS, SSAE, UG ...).
  • General planning workpaper documentation integrates the elements of planning required by the applicable standards (i.e., independence, continuing professional education, risk assessment, audit work programs, examination/AUP procedures).
  • Efficiently and effectively applies the Risk Assessment methodology to engagements.
  • As part of Risk Assessment, identify engagement risks, including risk of material misstatement, whether due to fraud or error.

Manage Fieldwork

  • Review automated audit work papers prepared by the audit staff to ensure alignment with audit programs and compliance with the Firm’s methodology.
  • Ensures that engagements are completed in compliance with the applicable standards.
  • Communicate audit status to management on regular basis.

Reporting & Client Communication

  • Identifies and includes sufficient documentation to support conclusions regarding findings and exceptions. Coordinate with the team to review audit findings.
  • Analyzes and resolves audit issues in a timely fashion.
  • Prepares reports with audit findings and recommendations.
  • Discusses with management about audit observations, recommendations, and actions to be taken
  • Prepares report drafts that result in minimal review comments from management.

Client Relationship Management

  • Performs risk assessment procedures and concludes on the sufficiency of the engagement testing and documentation.
  • Addresses and documents responses to all review comments in a timely manner.
  • Completes tasks within timeframes by effectively planning & organizing own work effort.

Productivity

  • Understands performance expectations and manages own and others’ work to meet those expectations.
  • Aim to achieve an agreed utilization rate by communicating regularly with Managers on availability and assignment progress.

Technical Knowledge/Firm Systems

  • Further build a depth of knowledge and understanding of tools, systems and processes (within discipline) and practical application (includes Advance Flow, PPC tools & other CPA firms’ systems such as CaseWare).
  • Follow the firm’s systems and processes and apply them effectively (i.e., Humanforce HR, PracticeCS).

Client Service

  • Visit clients on-site and be a point of contact for the client throughout the year.
  • Manage day-to-day client relationships.
  • Take responsibility for quality client service.

People Development and Teamwork

  • Actively pursue learning and development opportunities in line with the competency model.
  • Build a strong rapport with Auditors/Accountants and guide and coach them in their learning.

Qualifications

  • Professional audit certifications preferred (CPA is a plus)
  • BS Degree (required)
  • Must be capable of presenting results to line and/or senior management/partners.

Skills

  • Good analytical, interpersonal, time management, research, and communication skills.
  • Demonstrated technical abilities in select areas (audit, accounting, regulatory, compliance, etc.)

Company Description

Prado & Renteria is a pillar to career growth. Our vision is to create value and engagement opportunities for organizations and individuals to fulfill their purpose.

Today, Prado & Renteria CPAs, Prof. Corp. is the largest Hispanic woman-owned CPA firm in the State of Illinois. Through our trusted support and expertise, Prado & Renteria is a champion for other minority and woman-owned small businesses.

The firm serves a variety of clients through its specialized practice areas: government, corporations, private companies, and nonprofit organizations. We are comprised of professionals with experience in audit and management consulting services.