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Utilization Review Coordinator Jobs in Springfield, IL

This role ensures effective coordination of care, appropriate resource utilization, regulatory ... Ensure timely and accurate utilization review activities and payer communications. * Monitor ...

Credit Review Manager

Chatham, IL · On-site

$110K - $150K/yr

Assures effective utilization of supervised staff * Perform daily administrative tasks to ensure ... coordination of the department's activities and the Bank's loan files * Develop and maintain ...

MDS CAREPLAN COORDINATOR

Springfield, IL · On-site

$34 - $43.25/hr

MDS / Care Plan Coordinator Job Summary: The MDS / Care Plan Coordinator is responsible for ... Set (MDS) reviews to assure achievement of optimal allowable Resource Utilization Group (RUG ...

MGR - CLINICAL SVCS

Springfield, IL · On-site

$77K - $100K/yr

Qualifications The Clinical Services Manager coordinates and oversees the delivery of hospital ... Develops policies and procedures to support social work, utilization review and recreational ...

Develops policies and procedures to support social work, utilization review and recreational ... The Clinical Services Manager coordinates and oversees the delivery of hospital clinical services ...

Pharmacy Technician III (4060)

Springfield, IL · On-site

$17.25 - $21/hr

Coordinates multiple pharmaceutical student rotation and internship programs. 20% * Reviews ... Gathers and maintains statistical data for administrative reports, clinic utilization statistics ...

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Utilization Review Coordinator information

See Springfield, IL salary details

$14

$27

$43

How much do utilization review coordinator jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for utilization review coordinator in Springfield, IL is $27.40, according to ZipRecruiter salary data. Most workers in this role earn between $19.81 and $32.02 per hour, depending on experience, location, and employer.

What does a utilization review coordinator do?

A Utilization Review Coordinator is responsible for evaluating the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, treatment plans, and insurance information to ensure that care meets established guidelines and regulatory requirements. By coordinating between healthcare providers, insurance companies, and patients, Utilization Review Coordinators help optimize resource use and manage healthcare costs while ensuring quality patient care.

What skills and qualifications are needed to be a utilization review coordinator?

To thrive as a Utilization Review Coordinator, you need expertise in healthcare regulations, clinical guidelines, and case management, often supported by an RN license or a background in health administration. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of insurance approval processes are typically required. Strong analytical thinking, attention to detail, and effective communication skills help you collaborate with providers and advocate for appropriate patient care. These skills ensure compliance, optimize resource use, and support quality care delivery within healthcare organizations.

How does a utilization review coordinator collaborate with healthcare providers and insurance companies?

A Utilization Review Coordinator regularly communicates with both healthcare providers and insurance companies to ensure that patients receive appropriate care while managing costs. They review medical records and treatment plans, discuss cases with physicians to clarify medical necessity, and submit documentation to insurance payers for approval. This role requires strong interpersonal skills, as coordinators often need to negotiate coverage decisions and resolve discrepancies between clinical teams and insurers. Effective collaboration ensures timely authorizations and helps avoid unnecessary delays in patient care.

What is the difference between Utilization Review Coordinator vs Utilization Review Nurse?

AspectUtilization Review CoordinatorUtilization Review Nurse
CredentialsTypically requires a healthcare-related certification or associate degreeRegistered Nurse (RN) license required
Work EnvironmentOffice setting, administrative tasks, coordinationClinical setting, patient chart review, direct communication with healthcare providers
Employer & IndustryInsurance companies, healthcare organizationsHospitals, insurance companies, healthcare providers
Common Search & ComparisonFocuses on administrative review processesInvolves clinical assessment and patient care considerations

While both roles involve reviewing healthcare utilization, the Utilization Review Coordinator primarily handles administrative and coordination tasks, often without direct patient contact, whereas the Utilization Review Nurse performs clinical assessments as a licensed RN, often in hospital or clinical settings. Understanding these differences helps job seekers identify the right role based on their credentials and career goals.

What are the most commonly searched types of Utilization Review jobs in Springfield, IL?

The most popular types of Utilization Review jobs in Springfield, IL are:

What are popular job titles related to Utilization Review Coordinator jobs in Springfield, IL?

For Utilization Review Coordinator jobs in Springfield, IL, the most frequently searched job titles are:

What cities near Springfield, IL are hiring for Utilization Review Coordinator jobs?

Cities near Springfield, IL with the most Utilization Review Coordinator job openings:

Infographic showing various Utilization Review Coordinator job openings in Springfield, IL as of August 2026, with employment types broken down into 100% Full Time. Highlights an 89% In-person, and 11% Remote job distribution, with an average salary of $56,997 per year, or $27.4 per hour.

DIR - UTILIZATION REVIEW / MGMT

UHS

Springfield, IL

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted yesterday


Universal Health Services rating

6.9

Company rating: 6.9 out of 10

Based on 254 frontline employees who took The Breakroom Quiz

456th of 891 rated healthcare providers


Job description

Responsibilities

We are hiring a Director of Case Management (Utilization Management) at Lincoln Prairie Behavioral Health Center and offering a $5,000 sign-on bonus!

Lincoln Prairie Behavioral Health Center is a 97-bed facility located in Springfield, Illinois. We are dedicated to providing youth with compassionate mental health treatment that encourages self-responsibility and personal growth. We are the only facility of our kind in Central Illinois! We provide psychiatric treatment to children and adolescents that present with a broad range of psychiatric and behavioral disorders. A clinically skilled multidisciplinary team works to partner with the youth and family to accomplish their goals in a supportive and therapeutic environment.

The Director of Case Management (Utilization Management) is responsible for the leadership, oversight, and daily operations of theUtilization Management and Case Management functions. This role ensures effective coordination of care, appropriate resource utilization, regulatory compliance, and collaboration with clinical andmultidisciplinary teams to support positive patient outcomes.


Qualifications

Duties and Responsibilities:

  • Provide operational and strategic leadership for the Case Management and Utilization Management
    departments.
  • Supervise, coach, and develop case managers and other assigned team members.
  • Ensure timely and accurate utilization review activities and payer communications.
  • Monitor patient progression, discharge planning, and continuity of care processes.
  • Collaborate with physicians, nursing leadership, therapists, and hospital administration.
  • Maintain compliance with regulatory, accreditation, and organizational requirements.
  • Analyze performance metrics and implement process improvement initiatives.

Benefit & Rewards Highlights

  • Retention Bonus Program
  • Loan Forgiveness Program
  • Challenging and rewarding work environment
  • Competitive Compensation & Generous Paid Time Off
  • Excellent Medical, Dental, Vision and Prescription Drug Plans
  • 401(K) with company match and discounted stock plan
  • SoFi Student Loan Refinancing Program
  • Tuition savings
  • Career development opportunities within UHS and its 300+ Subsidiaries!
  • Pet Insurance
  • More information is available on our Benefits Guest Website: benefits.uhsguest.com

About Universal Health Services

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500® corporation, annual revenues during 2025 were $17.4 billion. In 2026, UHS was again recognized as one of Fortune World’s Most Admired Companies™ and in 2025, was listed in Forbes ranking of America’s Largest Public Companies.

Headquartered in King of Prussia, PA, UHS has approximately 101,500 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. For additional information visit www.uhs.com.

From Fortune, ©2025, 2026 Fortune Media IP Limited. All rights reserved. Used under license.

Requirements:

  • Registered Nurse (RN) preferred; Master's-level Clinical Social Worker will be considered.
  • 3-5 years of case management experience required.
  • 3-5 years of clinical team management or supervisory experience preferred.
  • Master’s degree in healthcare administration is a plus.
  • Strong knowledge of utilization management, discharge planning, and behavioral health operations.
  • Excellent leadership, communication, and interdisciplinary collaboration skills.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

Avoid and Report Recruitment Scams

We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.

Qualifications:

Duties and Responsibilities:

  • Provide operational and strategic leadership for the Case Management and Utilization Management
    departments.
  • Supervise, coach, and develop case managers and other assigned team members.
  • Ensure timely and accurate utilization review activities and payer communications.
  • Monitor patient progression, discharge planning, and continuity of care processes.
  • Collaborate with physicians, nursing leadership, therapists, and hospital administration.
  • Maintain compliance with regulatory, accreditation, and organizational requirements.
  • Analyze performance metrics and implement process improvement initiatives.

Benefit & Rewards Highlights

  • Retention Bonus Program
  • Loan Forgiveness Program
  • Challenging and rewarding work environment
  • Competitive Compensation & Generous Paid Time Off
  • Excellent Medical, Dental, Vision and Prescription Drug Plans
  • 401(K) with company match and discounted stock plan
  • SoFi Student Loan Refinancing Program
  • Tuition savings
  • Career development opportunities within UHS and its 300+ Subsidiaries!
  • Pet Insurance
  • More information is available on our Benefits Guest Website: benefits.uhsguest.com

About Universal Health Services

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500® corporation, annual revenues during 2025 were $17.4 billion. In 2026, UHS was again recognized as one of Fortune World’s Most Admired Companies™ and in 2025, was listed in Forbes ranking of America’s Largest Public Companies.

Headquartered in King of Prussia, PA, UHS has approximately 101,500 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. For additional information visit www.uhs.com.

From Fortune, ©2025, 2026 Fortune Media IP Limited. All rights reserved. Used under license.

Requirements:

  • Registered Nurse (RN) preferred; Master's-level Clinical Social Worker will be considered.
  • 3-5 years of case management experience required.
  • 3-5 years of clinical team management or supervisory experience preferred.
  • Master’s degree in healthcare administration is a plus.
  • Strong knowledge of utilization management, discharge planning, and behavioral health operations.
  • Excellent leadership, communication, and interdisciplinary collaboration skills.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

Avoid and Report Recruitment Scams

We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.

Education:UNAVAILABLEEmployment Type: FULL_TIME

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About Universal Health Services

Sourced by ZipRecruiter

Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

King of Prussia, PA, US