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Utilization Manager Jobs in Carol Stream, IL (NOW HIRING)

CTSHealth

Program Manager

Chicago, IL

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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Utilization Manager information

See Carol Stream, IL salary details

$40.3K

$94.1K

$173.2K

How much do utilization manager jobs pay per year?

As of Aug 19, 2026, the average yearly pay for utilization manager in Carol Stream, IL is $94,133.00, according to ZipRecruiter salary data. Most workers in this role earn between $61,500.00 and $113,300.00 per year, depending on experience, location, and employer.

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 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 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 cities near Carol Stream, IL are hiring for Utilization Manager jobs?

Cities near Carol Stream, IL with the most Utilization Manager job openings:

Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in Carol Stream, IL as of August 2026, with employment types broken down into 82% Full Time, 15% Part Time, 2% Contract, and 1% Nights. Highlights an 81% Physical, 2% Hybrid, and 17% Remote job distribution, with an average salary of $94,133 per year, or $45.3 per hour.

Utilization Management Clinical Consultant

Integrated Resources

Downers Grove, IL • On-site

Other

Re-posted 5 days ago

Job description

Utilization Management Clinical Consultant

Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.

Job Description

The position Title is for a Utilization Management Clinical Consultant. ( RN or LCSW only) Job Description: Develop, implement, support, and promote Health Services strategies, tactics, policies, and programs that drive the delivery of quality healthcare to establish competitive business advantage for Health Services strategies, policies, and programs are comprised of utilization management, quality management, network management and clinical coverage and policies. Position Summary/Mission Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. Applies critical thinking and knowledge in clinically appropriate treatment, evidence based care and medical necessity criteria for appropriate utilization of services. Fundamental Components & Physical Requirements include but are not limited to (* denotes essential functions) • Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function (*) • Gathers clinical information and applies the appropriate medical necessity criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation/discharge planning along the continuum of care(*) • Utilizes clinical experience and skills in a collaborative process to evaluate and facilitate appropriate healthcare services/benefits for members including urgent or emergent interventions (such as triage / crisis support)(*) • Coordinates/Communicates with providers and other parties to facilitate optimal care/treatment(*) • Identifies members who may benefit from care management programs and facilitates referral(*) • Identifies opportunities to promote quality effectiveness of healthcare services and benefit utilization(*) • Exhibits the following Manager Behaviours

Qualifications

Performance Measures Background/Experience Desired 3-5 years clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required. • Managed care/utilization review experience preferred Education and Certification Requirements Licensed independent Behavioral Health clinician in state of service or a Registered Nurse (RN) with unrestricted state license.

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About Integrated Resources

Sourced by ZipRecruiter

Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Edison, NJ, US

Year founded

1996

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