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Utilization Reviewer Jobs in Chicago, IL (NOW HIRING)

Insight

ED UTILIZATION REVIEW/CASE MANAGER

Chicago, IL

$85K - $90K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • PTO

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 · On-site

$85K - $90K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • PTO

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

Transfer RN/UR

Chicago, IL · On-site

$70K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • PTO

Utilization Review Experience (Preferred) * Full time 11am-7 pm * Experience with Cerner (Preferred) * Excellent communication and organizational skills * Assesses, develops, facilitates, and ...

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Showing results 21-40

All JobsUtilization Reviewer JobsUtilization Reviewer Jobs in Chicago, IL

Utilization Reviewer information

See Chicago, IL salary details

$32K

$39.2K

$45.4K

How much do utilization reviewer jobs pay per year?

As of Aug 17, 2026, the average yearly pay for utilization reviewer in Chicago, IL is $39,168.00, according to ZipRecruiter salary data. Most workers in this role earn between $35,100.00 and $43,300.00 per year, depending on experience, location, and employer.

What is the difference between Utilization Reviewer vs Medical Coder?

AspectUtilization ReviewerMedical Coder
Required CredentialsTypically requires healthcare-related certifications, such as RHIT, RHIA, or CPCUsually requires coding certifications like CPC, CCS, or CCS-P
Work EnvironmentHealthcare facilities, insurance companies, or utilization review organizationsHospitals, clinics, or medical billing companies
Employer & Industry UsageUsed in insurance, managed care, and healthcare administrationUsed in medical billing, coding, and health information management

While both roles work within healthcare settings, Utilization Reviewers focus on evaluating the necessity of medical services for insurance and care management, whereas Medical Coders translate medical records into standardized codes for billing and documentation. Understanding these differences helps professionals choose the right career path or job search focus.

How does a utilization reviewer typically collaborate with healthcare providers to ensure appropriate patient care?

Utilization Reviewers work closely with physicians, nurses, and other healthcare professionals to assess the necessity and efficiency of medical services provided to patients. They review clinical documentation, verify that treatments meet established guidelines, and may discuss care plans directly with providers to clarify information or suggest alternatives. This collaboration ensures that patients receive appropriate care while controlling costs and complying with insurance or regulatory requirements. Effective communication and a thorough understanding of medical protocols are essential for success in this role.

What does a utilization reviewer do?

A Utilization Reviewer is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They review patient records, treatment plans, and insurance policies to ensure that care meets established guidelines and standards. Their role helps control healthcare costs while maintaining quality patient care and ensuring compliance with regulatory requirements. Utilization Reviewers often communicate with healthcare providers, insurance companies, and patients to gather information and make informed decisions.

What does a utilization reviewer do?

There are different types of Utilization Reviewer jobs, including Nurse Utilization Reviewers, Insurance Utilization Reviewers, Speech Therapy, Physical Therapy, and Occupational Therapy Utilization Reviewers. Regardless of the area of focus, a Utilization Reviewer is responsible for setting best practices, reviewing healthcare program requirements, ensuring the quality of care, controlling costs, and developing and implementing initiatives for review processes. Utilization Reviewers ensure compliance of programs, regularly audit patient and client records, work with staff to implement best practices and correct problem areas, monitor industry trends, and remain up-to-date and train others on industry standards and requirements.

What are the key skills and qualifications needed to thrive as a utilization reviewer?

To thrive as a Utilization Reviewer, you need a clinical background (such as RN or LCSW), in-depth knowledge of medical terminology, and an understanding of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or URAC accreditation is typically required. Strong critical thinking, attention to detail, and effective communication skills help in evaluating patient care and collaborating with providers. These competencies are crucial for ensuring appropriate, cost-effective care while maintaining compliance with healthcare standards.
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Utilization Reviewer jobs near you
Infographic showing various Utilization Reviewer job openings in Chicago, IL as of August 2026, with employment types broken down into 2% As Needed, 84% Full Time, 12% Part Time, and 2% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $39,168 per year, or $18.8 per hour.

Utilization Management Coordinator - Full Time

UHS

Forest Park, IL • On-site

$30 - $46/hr

Full-time

Re-posted 19 days ago

Universal Health Services rating

6.8

Company rating: 6.8 out of 10

Based on 253 frontline employees who took The Breakroom Quiz

495th of 887 rated healthcare providers

Job description

Responsibilities
Shape the future of behavioral health care throughout the Forest Park community by joining our extraordinary team at Riveredge Hospital. Bring your compassion, expertise, enthusiasm, and passion for quality to a place that cultivates wellness and inspires hope.
We are currently seeking an Utilization Management Coordinator position for Riveredge Hospital. Simply apply to the posting and discuss your interests with the hiring manager if you are selected to come in for an interview.
The Utilization Management Coordinator position oversees the daily activities of the Utilization Management staff including but not limited to assigning and scheduling; reviewing and approving documentation and reports; advising and mentoring UM staff; and overseeing operational procedures involving work processes, forms, and billing. Assists with hiring, coaching, and counseling staff and compliance with internal policies and outside governmental and regulatory agencies. Conducts the Utilization Management Committee meetings, staff meetings, in-services, and participates in performance improvement teams.
Qualifications
  • Must have a Bachelor's degree, Master's degree preferred.
  • Must have an appropriate background in the mental health field to organize and achieve quality performance with a focus on securing reimbursement for the organization.
  • Possess an in depth knowledge of funding sources and government reimbursement protocols.
  • A minimum of 2-3 years supervisory experience.
  • Thoroughly understands the management of UM data obtained from admission, concurrent reviews and appeals utilizing the Severity of Illness/Intensity of Service Criteria.
  • Has knowledge of JC, CMS, Illinois Mental Health Code Act, and all other relevant state and federal regulatory standards.
  • Possesses strong verbal and written communication skills.

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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

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