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Utilization Review Jobs in Wheaton, IL (NOW HIRING)

UCAN

QI Coordinator

Chicago, IL · On-site

Coordinates utilization review process; including random selection of files; and scheduling. * Conducts utilizations reviews. * Provides feedback to agency programs regarding compliance with ...

UCAN

QI Coordinator

Chicago, IL · On-site

$46K - $50K/yr

Coordinates utilization review process; including random selection of files; and scheduling. * Conducts utilizations reviews. * Provides feedback to agency programs regarding compliance with ...

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Utilization Review information

See Wheaton, IL salary details

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$40

$66

How much do utilization review jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for utilization review in Wheaton, IL is $40.87, according to ZipRecruiter salary data. Most workers in this role earn between $32.31 and $46.92 per hour, depending on experience, location, and employer.

What is a utilization review?

A Utilization Review (UR) job involves assessing the medical necessity, efficiency, and appropriateness of healthcare services. UR professionals, often nurses or healthcare specialists, review patient records, insurance claims, and treatment plans to ensure they meet industry standards and payer requirements. They work with healthcare providers, insurance companies, and regulatory agencies to optimize care while controlling costs. Their goal is to balance quality patient care with cost-effective resource utilization.

What does a utilization review do?

A typical day in Utilization Review involves reviewing patient medical records, evaluating the necessity and appropriateness of proposed treatments or services, and documenting recommendations based on clinical criteria and insurance policies. Utilization Review specialists often collaborate closely with physicians, nurses, and insurance representatives to gather additional information and clarify cases. While much of the role is desk-based and may include remote work options, it requires regular communication with both clinical and administrative teams. This position offers variety and challenge, as no two cases are exactly alike, and there are often opportunities to advance into supervisory or quality improvement roles within the department.

What are the key skills and qualifications needed to thrive in utilization review?

To thrive in Utilization Review, professionals typically need a background in nursing or healthcare, strong clinical assessment capabilities, and a thorough understanding of medical guidelines and insurance regulations. Familiarity with electronic medical records (EMR) systems and utilization management software, and often certification such as Certified Utilization Review Specialist (CURN), are important. Excellent critical thinking, attention to detail, and strong communication skills enable effective case evaluation and collaboration with healthcare teams. These skills and qualifications ensure objective, accurate decisions that support cost-effective, quality patient care within compliance standards.

How do I get into a utilization review?

To become a utilization review specialist, typically a healthcare or related degree such as nursing, health administration, or social work is required. Certification in case management or utilization review, like the Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects, and strong analytical and communication skills are essential for success in the role.

Is utilization review a stressful job?

Utilization review is a healthcare role that involves evaluating medical necessity and appropriateness of services, often under strict deadlines and documentation requirements. The job can be stressful due to high workload, the need for accuracy, and managing complex cases, but stress levels vary based on work environment and individual coping skills.

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

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

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

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

What job categories do people searching Utilization Review jobs in Wheaton, IL look for?

The top searched job categories for Utilization Review jobs in Wheaton, IL are:

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

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

Utilization Review jobs near you
Infographic showing various Utilization Review job openings in Wheaton, IL as of August 2026, with employment types broken down into 6% Internship, 3% As Needed, 88% Full Time, and 3% Part Time. Highlights an 88% In-person, 9% Hybrid, and 3% Remote job distribution, with an average salary of $85,001 per year, or $40.9 per hour.

QI Coordinator

UCAN

Chicago, IL • On-site

Full-time

Posted 28 days ago

Job description

Position Title: Quality Improvement Coordinator

Department: Management and General - Quality Improvement

Reports to: Vice President of Quality Improvement, Impact & Analysis

Position Objective and Summary:

The Quality Improvement (QI) Coordinator provides data support to the Quality Improvement (QI) team in order to drive improvement with quality priorities and metrics.

Essential Functions and Responsibilities:

  • Provides support to QI team members, program leaders, and providers with performance improvement activities.
  • Coordinates utilization review process; including random selection of files; and scheduling.
  • Conducts utilizations reviews.
  • Provides feedback to agency programs regarding compliance with utilization reviews.
  • Assists in completing reports for external funders.
  • Assist with data collection and data analyses.
  • Assists in the development, communication, and evaluation of action plans.

Program Monitoring, Evaluation & Outcomes

  • Assists with the development of plans for measuring and tracking outcome data.
  • Recommends improvements in evaluation questions, outcome measurement, analysis, presentation, and utilization.
  • Attend Performance and Quality Improvement (PQI) quarterly team meetings with identified programs.
  • Adapt individual program PQI processes to be inclusive of required outcomes, best practice standards, agency initiatives, and program goals on an ongoing basis.

Utilization Review

  • Coordinates Utilization Review processes: completes on-site reviews and provides feedback to workers regularly.
  • Analyzes, summarizes and reports on the results of the Utilization Review and prepare quarterly reports to address trends in findings
  • Assist with creating action plans with program teams to address deficiencies found in the Utilization Review Quarterly report and monitor results over time to ensure improvements are made.

Collaboration

  • Maintains knowledge of other QI functions in the agency and collaborates on team projects.
  • Conducts training and provides program education, as identified.


Other Duties as Assigned

  • Perform any other duties needed to help drive UCAN's Vision, fulfill its Mission, and abide by its Values.


Professionalism and Work Conduct

  • Behaves with integrity, demonstrates high ethical standards, and displays a positive image of UCAN.
  • Acts in a professional manner at all times and maintains appropriate boundaries with customers.
  • Demonstrates accountability for results and keeps commitments to others.
  • Reports to work, meetings, training, and job-related activities prepared and as scheduled.
  • Demonstrates openness and respect for cultural and socioeconomic characteristics of youth, families, and coworkers.
  • Understands and supports UCAN's standard of cultural proficiency and strives to meet it.


Education /Job Experience/Certification:

  • Associate Degree required.
  • BA/BS in human service field preferred.
  • Minimum 2 years work experience in social service field required.


Special Knowledge and Qualifications:

  • Proficient with Microsoft Office applications, particularly in Excel.
  • Able to create reports, graphs and other visual presentation materials, and effectively maintain statistical data.
  • Strong verbal and written communication skills.
  • Excellent decision-making and analytical skills, with the ability to resolve problems and correct errors.
  • Excellent interpersonal skills, with the ability to exercise discretion and judgment in dealing with colleagues and customers.
  • Strong multi-tasking and organizational skills, with the ability manage numerous projects simultaneously under deadline pressure.
  • Working knowledge of COA, Medicaid or DCFS standards (depending on role) preferred.
  • Automobile and valid Illinois driver's license required.

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