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Utilization Jobs in Illinois (NOW HIRING)

Utilization Review Nurse

New Lenox, IL · On-site

$34.73 - $45.15/hr

BSN preferred. 2-5 years previous Utilization Review experience preferred. * Current CPR * Relevant hospital nursing; hospital case management; insurance case management or utilization management ...

Responsibilities Full-time Utilization Review Coordinator Opening The Pavilion Behavioral Health System has been the leading provider of behavioral health and addictions treatment for families in ...

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 ...

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 ...

Showing results 21-40

Utilization information

See Illinois salary details

$20

$40

$66

How much do utilization jobs pay per hour?

As of Aug 19, 2026, the average hourly pay for utilization in Illinois is $40.97, according to ZipRecruiter salary data. Most workers in this role earn between $32.36 and $47.07 per hour, depending on experience, location, and employer.

What is a utilization specialist?

Utilization specialists are professionals who review and evaluate the necessity, appropriateness, and efficiency of the use of healthcare services, procedures, and facilities. They work closely with healthcare providers, insurance companies, and patients to ensure that care is delivered according to established guidelines and that resources are used effectively. Their goal is to help manage costs while ensuring patients receive the appropriate level of care.

What are some of the common challenges faced by utilization review specialists when assessing medical necessity of services?

Utilization Review Specialists often encounter the challenge of balancing patient advocacy with cost-effective care. They must stay updated on evolving insurance policies and clinical guidelines, which can be complex and change frequently. Additionally, coordinating with physicians and healthcare staff to obtain necessary documentation and clarifying treatment plans can be time-consuming. Strong communication skills and attention to detail are essential to ensure timely and accurate reviews, while also maintaining positive working relationships with clinical teams.

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

To thrive as a Utilization Review Specialist, you need a background in healthcare (often as an RN or LPN/LVN), strong analytical skills, and knowledge of insurance and medical necessity criteria. Familiarity with utilization management software, ICD-10/CPT coding, and regulatory guidelines like Medicare and Medicaid is typically required. Excellent attention to detail, critical thinking, and effective communication skills set top performers apart in this role. These abilities are crucial to accurately evaluating patient care needs, ensuring regulatory compliance, and optimizing resource use within healthcare organizations.

What is the difference between Utilization vs Resource Coordinator?

AspectUtilizationResource Coordinator
Primary FocusMeasuring and optimizing how staff time is usedManaging and assigning resources for projects
Required CredentialsOften no specific credentials, but industry experience helpsTypically requires organizational or project management skills
Work EnvironmentCorporate, healthcare, or consulting firmsProject teams, staffing agencies, or departments
Common UsageTracking staff utilization ratesAllocating resources to projects or tasks

Utilization focuses on measuring how effectively staff time is used, often to improve productivity. Resource Coordinator involves actively managing and assigning resources to ensure project needs are met. While related, utilization is more about analysis, and resource coordination is about execution and management.

How to become a utilization reviewer?

To become a utilization reviewer, candidates typically need a background in healthcare, nursing, or a related field, along with knowledge of medical coding and insurance policies. Relevant certifications such as Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS) can enhance job prospects. Strong analytical skills and attention to detail are essential for reviewing medical records and determining appropriate service utilization.

What are the most commonly searched types of Utilization jobs in Illinois?

The most popular types of Utilization jobs in Illinois are:

What cities in Illinois are hiring for Utilization jobs?

Cities in Illinois with the most Utilization job openings:

Infographic showing various Utilization job openings in Illinois as of August 2026, with employment types broken down into 2% As Needed, 89% Full Time, 7% Part Time, and 2% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $85,222 per year, or $41 per hour.

Utilization Review Nurse

Silver Cross Hospital

New Lenox, IL • On-site

$34.73 - $45.15/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 8 days ago


Silver Cross Hospital rating

6.9

Company rating: 6.9 out of 10

Based on 51 frontline employees who took The Breakroom Quiz

552nd of 1,060 rated hospitals


Job description

Silver Cross Hospital is an extraordinary place to work. We're known for our culture of excellence and delivery of unrivaled experiences for our patients, their families, the communities we serve...and for each other. Come join us! It's the way you want to be treated.
Position Summary: Performs medical record review for severity of illness and intensity of service; liaison function with external review agencies to ensure compliance with regulations affecting financial reimbursement; identifies variance from established pathways
Essential Duties and Responsibilities:
  • Collects information from clinical medical record for severity of illness and intensity of service and documents such in clinical database
  • Monitors all levels of care for appropriateness and communicates variance; evaluates plan of care to ensure it is based on accepted standards
  • Provides information to external review organizations, documents pertinent communications
  • Refers to designated physician advisor those patients not meeting criteria as well as quality of care concerns
  • Maintains knowledge and incorporates current standards into practice
Required Qualifications: Knowledge of clinical norms; excellent communication skills; critical thinking skills; organized and efficient time management skills
Education and Training:
  • Nurse, Registered (RN) licensure
  • BSN preferred. 2-5 years previous Utilization Review experience preferred.
  • Current CPR
  • Relevant hospital nursing; hospital case management; insurance case management or utilization management experience preferred

Work Shift Details:
Various, Day; weekend rotation; holiday rotation; occasional on site requirement for meetings and mandatory training
Department:
CONTINUUM OF CARE
Benefits for You
At Silver Cross Hospital, we care about your health and well-being and that is why we work hard to provide quality and affordable benefit options for you and your eligible family members.
Silver Cross Hospital and Silver Cross Medical Groups offer a comprehensive benefit package available for Full-time and Part-time employees which includes:
• Medical, Dental and Vision plans
• Life Insurance
• Flexible Spending Account
• Other voluntary benefit plans
• PTO and Sick time
• 401(k) plan with a match
• Wellness program
• Tuition Reimbursement
Registry employees who meet eligibility may participate in our 401(k) Savings plan with a potential match. However,registry employees are ineligible for Health and Welfare benefits.
The final pay rate offered may be more than the posted range based on several factors including but not limited to: licensure, certifications, work experience, education, knowledge, demonstrated abilities, internal equity, market data, and more.
The expected pay for this position is listed below:
$34.73 - $45.15

What Silver Cross Hospital employees say

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About Silver Cross Hospital

Sourced by ZipRecruiter

At Silver Cross, we pride ourselves on delivering unrivaled care to every patient, every time. As a result, our focus on safety, quality and patient experience has earned us numerous national awards over the years. As the needs of our community have grown, so has Silver Cross—in both size and stature. Our many healthcare services rapidly expanded, evolved and increased in complexity. To serve you and your loved ones even better than before, we've proudly partnered with many of Chicago's leading academic medical centers, bringing extraordinarily advanced care close to home.

Industry

Health care and social assistance

Company size

1,001 - 5,000 Employees

Headquarters location

New Lenox, IL, US

Year founded

1895

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