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Utilization Manager Jobs in Illinois (NOW HIRING)

Coordinates, performs, and monitors all utilization review/management activities of the hospital to continuously improve the collection, reimbursement, coordination, and presentation of utilization ...

MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. * MUST HAVE UM experience, inpatient utilization management review. * MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of ...

Relevant hospital nursing; hospital case management; insurance case management or utilization management experience preferred Work Shift Details: Various, Day; weekend rotation; holiday rotation ...

Showing results 21-40

Utilization Manager information

See Illinois salary details

$37.8K

$88.2K

$162.3K

How much do utilization manager jobs pay per year?

As of Aug 5, 2026, the average yearly pay for utilization manager in Illinois is $88,192.00, according to ZipRecruiter salary data. Most workers in this role earn between $57,700.00 and $106,100.00 per year, depending on experience, location, and employer.

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

To thrive as a Utilization Manager, you need a solid background in healthcare management, case review, and knowledge of insurance regulations, often supported by a degree in nursing, healthcare administration, or a related field. Familiarity with utilization management software, electronic health records (EHRs), and certification such as Certified Case Manager (CCM) are typically required. Strong analytical thinking, communication, and negotiation skills help Utilization Managers effectively coordinate care and collaborate with providers. These skills ensure appropriate resource use, regulatory compliance, and optimal patient outcomes within healthcare organizations.

What are some common challenges faced by utilization managers, and how can they be addressed?

Utilization Managers often face challenges such as balancing cost containment with patient care quality, navigating complex insurance policies, and managing high caseloads. To address these, effective communication with healthcare providers and payers is essential, as is staying current with regulatory requirements and best practices. Building strong relationships within interdisciplinary teams and leveraging data analytics tools can also help Utilization Managers make informed decisions and improve workflow efficiency.

What is a utilization manager?

A utilization manager works in the insurance industry to analyze health care needs in medical cases and determine further patient care. In this career, your job duties include conducting interviews to determine what services you register for and cutting down on unnecessary costs. You may review medical records and compile documentation to improve care and report your findings. Skills in management, customer service, and health care services are vital in this career. Job experience in nursing is a benefit when applying for utilization manager positions. Additional qualifications include a bachelor’s degree and medical case management certificate.

What is the difference between Utilization Manager vs Utilization Coordinator?

AspectUtilization ManagerUtilization Coordinator
CertificationsOften requires healthcare or case management certificationsMay have similar certifications but less emphasis on management
Work EnvironmentTypically in healthcare organizations, overseeing utilization review processesSupports daily operations, assisting with case documentation and scheduling
Employer & Industry UsageCommon in healthcare, insurance, and managed care companiesFound in similar settings, often working under Utilization Managers

In summary, a Utilization Manager generally has broader responsibilities, overseeing utilization review and resource allocation, while a Utilization Coordinator focuses on supporting daily tasks and documentation. Both roles are integral in healthcare settings but differ in scope and level of responsibility.

What are the most commonly searched types of Utilization jobs in Illinois? The most popular types of Utilization jobs in Illinois are:
What cities in Illinois are hiring for Utilization Manager jobs? Cities in Illinois with the most Utilization Manager job openings:
Infographic showing various Utilization Manager job openings in Illinois as of July 2026, with employment types broken down into 83% Full Time, 15% Part Time, and 2% Contract. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution, with an average salary of $88,192 per year, or $42.4 per hour.

Utilization Specialist - Acute

Summit BHC

Champaign, IL • On-site

$3.0K/yr

Full-time

Medical, Dental, Vision, PTO

Re-posted 28 days ago


Job description

Utilization Specialist - Acute | The Pavilion at Williamsburg Place | Williamsburg, Virginia

About the Job:

About the Job:
The Pavilion is looking for a Utilization Specialist to join our team!
-Pay Range: $24-$28/hour
-Full-time Day Shift
-Complimentary Continued Education
-$3000 per year Tuition Assistance
-Benefits- Medical, Dental & Vision after 30 days
-Flex Pay-Daily pay option
-PTO package
-Much more!
PURPOSE STATEMENT:
The Utilization Specialist is responsible for reviewing of assigned admissions, continued stays, utilization practices and discharge planning according to approved clinically valid criteria which meets the daily deadlines to obtain authorizations and complete other pertinent processes. Coordinates, performs, and monitors all utilization review/management activities of the hospital to continuously improve the collection, reimbursement, coordination, and presentation of utilization review information; Educates hospital staff about requirements and trends.

Roles and Responsibilities:

Performs admission, concurrent, continued stay, and retrospective reviews using the established hospital criteria. Communicates effectively with insurance companies, health maintenance organization (HMOs) and other similar entities for approval of initial or additional inpatient days for treatment. Provides information they need in a logical, concise manner using technical language that accurately describes patient's condition and need for hospitalization.

Communicates directly with physicians and other providers with respect to specific inquires and perceived trends of issues as they relate to utilization management.

Appeals all denials ensuring accuracy of information and effective coordination of correspondence. Initiates, coordinates, and monitors the appeal process. Provides information to physicians to assist them in their role in appeals.

Assists the admissions department with pre-certifications of care. Performs pre and post admission benefit verification with managed care organizations.

Maintains accurate documentation and files as it relates to utilization management.

Provides ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.

Communicates effectively with co-workers, program, and nursing staff regarding charting deficiencies and problems/issues identified. Follows up in each instance to determine if corrective action was taken. Notifies supervisor if corrective action is not completed.

Coordinates information and findings with the business office to help recognize or resolve possible payment problems.

Monitors patient length of stay and extensions and informs clinical and medical staff on issues that may impact length of stay. Investigates short term length of stays and endeavor to create alternate financial planning which would offer the patient extended days of treatment. Participates in discharge planning as required.

Gathers and develops statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.

Conducts quality reviews for medical necessity and services provided. Facilitates peer review calls between facility and external organizations. Identifies potential review problems and discuss them with multi-disciplinary team and/or administration.

Acts as liaison between managed care organizations and the facility professional clinical staff.

Assists with any problems encountered during on-site or telephone reviews by the third-party payers or review organization, when necessary.

Education/Requirements:

Graduation from an approved/accredited school of nursing or a Bachelor's degree in social work, behavioral or mental health, or other related health field required.

Two or more years of direct clinical experience in a psychiatric or mental health setting required.

Current licensure as an LPN or RN or current clinical professional license or certification, as required, within the state where the facility provides services.

Why The Pavilion at Williamsburg Place?The Pavilion at Williamsburg Place offers a comprehensive benefit plan and a competitive salary commensurate with experience and qualifications. Qualified candidates should apply by submitting a resume. The Pavilion at Williamsburg Place is an EOE.

Veterans and military spouses are highly encouraged to apply. Summit BHC is dedicated to serving Veterans with specialized programming at our treatment centers across the country. We recognize and value the unique strengths of the military community in supporting our mission to serve those who have served.


Summit BHC logo

About Summit BHC

Sourced by ZipRecruiter

Summit BHC, based in Franklin, TN, USA, is a recognized leader in the field of addiction treatment and behavioral health care services. The company operates a nationwide network of treatment centers aimed at caring for individuals battling substance abuse and mental health disorders. Summit BHC was established with the mission to provide high-quality, addiction treatment and behavioral health services to those in need throughout the United States. With compassion, dignity, and respect as their core values, they endeavor to instill hope during the journey to recovery and beyond.

Industry

Health care and social assistance

Company size

501 - 1,000 Employees

Headquarters location

Franklin, TN, US

Year founded

2013

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