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Utilization Manager Jobs in Illinois (NOW HIRING)

Insight

ED UTILIZATION REVIEW/CASE MANAGER

Chicago, IL · On-site

$85K - $90K/yr

The ED Utilization Review/Case Manager is responsible for facilitating the appropriate use of hospital resources by ensuring that the patient meets acute inpatient criteria, and anticipates and ...

Insight

ED UTILIZATION REVIEW/CASE MANAGER

Chicago, IL

$85K - $90K/yr

The ED Utilization Review/Case Manager is responsible for facilitating the appropriate use of hospital resources by ensuring that the patient meets acute inpatient criteria, and anticipates and ...

CTSHealth

Program Manager

Chicago, IL · On-site

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 ...

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Showing results 41-60

All JobsUtilization JobsUtilization Manager JobsUtilization Manager Jobs in Illinois

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 6, 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.

More about Utilization Manager jobs
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:
What are popular job titles related to Utilization Manager jobs in IL? For Utilization Manager jobs in IL, the most frequently searched job titles are:
Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in Illinois as of July 2026, with employment types broken down into 83% Full Time, 13% Part Time, 3% Temporary, and 1% Contract. Highlights an 82% Physical, 3% Hybrid, and 15% Remote job distribution, with an average salary of $88,192 per year, or $42.4 per hour.

UTILIZATION REVIEW NURSE-ED (TR/PRN) NIGHTS

Riverside Healthcare

Kankakee, IL • On-site

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 27 days ago

Job description

Overview
Riverside Healthcare is seeking a dedicated and experienced Utilization Review Nurse to join our Emergency Department team in Kankakee, Illinois. The Utilization Review Nurse will play a crucial role in ensuring that patients receive appropriate and effective care while optimizing resource utilization. This position involves reviewing patient cases, assessing the necessity of admissions and continued stays, and collaborating with healthcare providers to enhance patient outcomes and hospital efficiency by managing documentation and optimizing resource utilization.
Essential Duties
Case Review and Assessment:
  • Conduct thorough reviews of patient cases in the Emergency Department to assess the necessity and appropriateness of admissions, continued stays, and level of care.
  • Utilize clinical knowledge and evidence-based guidelines to make determinations regarding the medical necessity of services.
Collaboration and Communication:
  • Work closely with physicians, nurses, and other healthcare professionals to gather necessary information and discuss care plans.
  • Communicate with insurance providers to obtain authorization for treatments and services, ensuring compliance with payer requirements.
  • Proactively facilitates throughput of all patients by monitoring for census peaks including surgical and procedural patient placement.
Documentation and Reporting:
  • Maintain accurate and detailed documentation of case reviews, decisions, and communications with healthcare providers and insurance companies.
  • Prepare and submit reports as required, including utilization review reports and compliance documentation.
Quality Improvement:
  • Participate in quality improvement initiatives to enhance the efficiency and effectiveness of care provided in the Emergency Department.
  • Analyze utilization patterns and outcomes to identify opportunities for improvement and contribute to the development of best practices.
Compliance and Policy Adherence:
  • Ensure adherence to hospital policies, payer guidelines, and regulatory requirements related to utilization management.
  • Stay informed about changes in healthcare regulations and payer requirements to ensure ongoing compliance.
These are duties that MUST be performed in this job, with or without reasonable accommodation.
Non-essential Duties
  • Assist with training and orientation of new staff members on utilization review processes and procedures.
  • Support administrative tasks related to the utilization review process as needed.
  • Participate in departmental meetings and contribute to discussions on process improvements and policy updates.
Responsibilities
Required Experience
  • Minimum of 3 years of clinical experience in an Emergency Department setting.
Preferred Experience
  • Prior experience in utilization review or case management is preferred
  • Strong clinical assessment and critical thinking skills.
  • Excellent communication and interpersonal skills for effective collaboration with healthcare providers and insurance representatives.
  • Proficiency in electronic health record (EHR) systems and utilization review software.
  • Ability to work independently and manage multiple tasks efficiently in a fast-paced environment.
  • Knowledge of InterQual and/or MCG and local and national coverage determinations.
Required Licensure/Education
  • Active Registered Nurse (RN) license in the State of Illinois.
  • Associates Degree of Nursing (AND)
  • *All new RN;s starting on or after 1/1/25 must complete their Bachelors of Science in Nursing within three years.
Preferred Education
  • Bachelors Degree in Nursing (BSN) from an accredited institution or higher degree*
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.
Our Commitment to You:
Riverside Healthcare offers a comprehensive suite of Total Rewards: benefits and nationally rated employee well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more so your journey at and away from work is remarkable. Our Total Rewards package includes:
Compensation:
  • Base compensation within the positions pay range based on factors such as qualifications, skills, relevant experience, and/or trainin
  • Premium pay such as shift differential, on-call
  • Opportunity for annual increases based on performance
Benefits - .5 to 1.0 FTE:
  • Paid Time Off programs
  • Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
  • Health Savings and Flexible Spending Accounts for eligible health care and dependent care expenses
  • Defined contribution retirement plans with employer match and other financial wellness programs
  • Educational Assistance Program
Benefits - .001 to .49 FTE:
  • Paid Leave Hours accrued as you work
Employee Health Requirements
Exposure/Sensory Requirements:
Exposure to:
  • Chemicals: Refer to MSDS Sheets
  • Video Display Terminals: Extreme
  • Blood and Body Fluids: Minimal potential
  • TB or Airborne Pathogens: Minimal potential
Sensory requirements (speech, vision, smell, hearing, touch):
  • Speech: Needed for presentations, training, telephone communication, facilitating meetings.
  • Vision: Needed for computer entry, reading memos and literature.
  • Smell: Needed for electrical/fire safety.
  • Hearing: Needed for telephone communication, meetings and listening to employee concerns.
  • Touch: Needed for writing, computer entry, filing.

Activity/Lifting Requirements
Percentage of time during the normal workday the employee is required to:
Sit: 50%
Twist: 0%
Stand: 35%
Crawl: 0%
Walk: 10%
Kneel: 0%
Lift: 5%
Drive: 0%
Squat: 0%
Climb: 0%
Bend: 0%
Reach above shoulders: 0%
The weight required to be lifted each normal workday according to the continuum described below:
Up to 10 lbs: Occasionally
Up to 20 lbs: Occasionally
Up to 35 lbs: Not Required
Up to 50 lbs: Not Required
Up to 75 lbs: Not Required
Up to 100 lbs: Not Required
Over 100 lbs: Not Required
Describe and explain the lifting and carrying requirements. (Example: the distance material is carried; how high material is lifted, etc.):
Brief case, notebook, computer, printed material-transported from one location/meeting to another.
Maximum consecutive time (minutes) during the normal workday for each activity:
Sit: 480
Twist: 0
Stand: 240
Crawl: 0
Walk: 60
Kneel: 0
Lift: 5
Drive: 0
Squat: 0
Climb: 0
Bend: 0
Reach above shoulders: 0
Repetitive use of hands (Frequency indicated):
Simple grasp up to 10 lbs. Normal weight:
Pushing & pulling Normal weight:
Fine Manipulation: Calculator, keyboard, writing instruments
Repetitive use of foot or feet in operating machine control: Not Required
Environmental Factors & Special Hazards
Environmental Factors (Time Spent):
Inside hours: 8
Outside hours : 0
Temperature: Normal Range
Lighting: Average
Noise levels: Average
Humidity: Normal Range
Atmosphere:
Special Hazards: None
Protective Clothing Required: None
Pay Range
USD $41.31 - USD $55.28 /Hr

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