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Utilization Review Case Manager Jobs in Normal, IL

IQVIA

Clinical Trial Psych Rater

Bloomington, IL · Remote

Review case data and prepare for rater discussions, ensuring all relevant documents and scale items ... Excellent organizational skills, attention to detail, time management, and problem-solving ability.

IQVIA

Clinical Trial Psych Rater

Bloomington, IL · Remote

$62K - $156K/yr

Review case data and prepare for rater discussions, ensuring all relevant documents and scale items ... Excellent organizational skills, attention to detail, time management, and problem-solving ability.

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All JobsUtilization Review Case JobsUtilization Review Case Manager JobsUtilization Review Case Manager Jobs in Normal, IL

Utilization Review Case Manager information

See Normal, IL salary details

$16

$35

$58

How much do utilization review case manager jobs pay per hour?

As of Aug 30, 2026, the average hourly pay for utilization review case manager in Normal, IL is $35.67, according to ZipRecruiter salary data. Most workers in this role earn between $28.89 and $37.60 per hour, depending on experience, location, and employer.

What is a utilization review case manager?

A Utilization Review Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical treatments and services provided to patients. They review clinical information, coordinate with providers and insurance companies, and ensure that patient care aligns with established guidelines and policies. Their goal is to optimize patient outcomes while managing healthcare costs and ensuring compliance with regulations.

What are some common challenges utilization review case managers face when coordinating care across multiple departments?

Utilization Review Case Managers often navigate complex communication between physicians, nursing staff, insurance providers, and patients to ensure appropriate care and resource use. Balancing timely authorizations with evolving patient needs and varying documentation standards can be challenging. Additionally, staying current with changing regulations and payer requirements requires ongoing learning and adaptability. Building strong collaborative relationships and maintaining clear, concise documentation are key strategies for overcoming these hurdles.

What are the key skills and qualifications needed to thrive as a utilization review case manager, and why are they important?

To thrive as a Utilization Review Case Manager, you need a clinical background such as an RN or LCSW license, strong knowledge of medical necessity criteria, and experience with case management. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of regulatory guidelines like Medicare and Medicaid are essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration between patients, providers, and payers. These skills ensure appropriate resource use, compliance with regulations, and high-quality patient care.

What is the difference between Utilization Review Case Manager vs Utilization Review Nurse?

AspectUtilization Review Case ManagerUtilization Review Nurse
CredentialsTypically requires a nursing license or relevant healthcare certificationRegistered Nurse (RN) license is required
Work EnvironmentOffice-based, insurance companies, healthcare organizationsHospital, clinic, insurance review departments
Primary FocusReviewing medical necessity, coordinating care, managing casesAssessing medical records, clinical review, patient care evaluation

Both roles involve healthcare review and require nursing credentials, but the Utilization Review Case Manager often focuses on coordinating care and managing cases, while the Utilization Review Nurse emphasizes clinical assessment and review of medical records. Understanding these differences helps in choosing the right career path or job search focus.

What job categories do people searching Utilization Review Case Manager jobs in Normal, IL look for?

The top searched job categories for Utilization Review Case Manager jobs in Normal, IL are:

What cities near Normal, IL are hiring for Utilization Review Case Manager jobs?

Cities near Normal, IL with the most Utilization Review Case Manager job openings:

Utilization Review Case Manager jobs near you
Infographic showing various Utilization Review Case Manager job openings in Normal, IL as of August 2026, with employment types broken down into 58% Full Time, and 42% Contract. Highlights an 100% In-person job distribution, with an average salary of $74,196 per year, or $35.7 per hour.

Case Manager RN Supervisor - Remote Bloomington Il area

OpTech LLC

Bloomington, IL • On-site, Remote

Full-time

Re-posted 21 days ago

Job description

Bloomington, Illinois
Case Management
Direct
RN Remote Case Manager Supervisor - Central Illinois Area (Local Travel)
This is a direct hire position with benefits and travel reimbursement. We are seeking a compassionate and experienced RN Case Manager Supervisor. The Case Management Supervisor is responsible for directing the operations of their designated department, which may include one or more of the following functions: human resources, customer service, as well as handling injured worker cases.
Location : This is a remote role with travel to home office in Downers Grove for meetings/training and case management assignments. NOTE - This position will also carry a caseload and travel Central Illinois - Springfield, Bloomington, and Peoria area Central
EDUCATION & EXPERIENCE:
  • Graduate of accredited school of nursing with a diploma/associate's degree - BSN preferred
  • Current RN licensure - Illinois
  • 3 + years of recent clinical experience, preferably in rehabilitation
  • Workers Comp Case Management experience
  • CCM is required

KNOWLEDGE & SKILLS:
  • Strong written and verbal communication skills to communicate complex ideas across multiple platforms
  • Ability to remain poised in stressful situations and communicate diplomatically
  • Ability to skillfully manage multiple, complex projects and competing priorities while working under pressure to meet deadlines and maintaining strong customer service orientation
  • Ability to work independently, while remaining available to others
  • Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets
  • Must have technical knowledge of applicable laws, policies, and procedures in defined territory
  • Strong interpersonal, time management and analytical skills

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
  • Responsible for directing a designated group of employees in their day-to-day operations
  • Responsible for quality of service provided
  • Responsible for human resources matters directly related to department supervised
  • May perform case management responsibilities
  • May be required to travel to client appointments and home office
  • May perform daily, weekly, monthly reviews of various reports, invoices, logs and expenses
  • May be required to oversee case management clinical activities

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