515 utilization jobs at 235 companies in Wheaton, IL
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Utilization Review Nurse
New Lenox, Illinois, United States
$35-$45/hrHybridFull Time
Silver Cross Hospital: General hospital providing acute and outpatient healthcare services.
Current RN licensure, current CPR, knowledge of clinical norms, strong communication and critical thinking; experience in utilization review, case management or hospital nursing preferred.
GRO Community: Provides trauma-informed mental health services for males of color.
3+ YOEMaster's degree required, 3+ years utilization review/case management/clinical documentation experience, active LCSW or LCPC preferred, proficiency in EHR and Google Office Suite, strong knowledge of payer authorization and regulatory compliance.
Universal Health ServicesNYSE: UHS: Operates acute care hospitals and behavioral health facilities.
2+ MgmtBachelor's degree required (Master's preferred); 2+ years supervisory experience in mental health; knowledge of reimbursement, UM data and regulatory standards (JC, CMS, Illinois Mental Health Code); strong communication skills.
Utilization Management Specialist (Chicago, IL, US, 60624)
Chicago, Illinois, United States
$51k-$60k/yrHybridFull Time
Gateway Foundation: Provides substance use and mental health disorder treatment services.
1+ YOEBachelor's in counseling, nursing, or related; 1+ year utilization management experience in healthcare; strong proofreading and VDT skills; ability to travel to assigned sites; daytime, hybrid schedule.
Health - Network Performance / Utilization Manager
Chicago, Illinois, United States
$80k-$294k/yrFieldFull Time
AccentureNYSE: ACN: Global provider of management consulting and technology services.
5+ YOEMinimum 5 years in network strategy/utilization analytics or healthcare market analysis; 2 years assessing providers in Medicaid- or financially stressed environments; 2 years converting claims/encounter/provider/market data into recommendations; Bachelor's degree.
Northwestern Medicine: Academic health system providing clinical care and medical research.
2+ YOEMaster's in Social Work or Psychology or BSN with RN license; 2+ years experience; knowledge of IM+CANS/IATP, documentation standards, grant and regulatory compliance.
Spectrum Billing Solutions: Provides revenue cycle management services for behavioral health providers.
3+ YOE3+ years ABA/behavioral health experience preferred, superior communication, attention to detail, insurance/benefits knowledge, strong computer skills (Word, Excel), ability to obtain authorizations and document cases.
Utilization Management and Population Health Nurse
Chicago, Illinois, United States
OnsiteFull Time
Humboldt Park Health: A community-focused hospital providing healthcare services in Chicago.
Active RN licensure and bachelor\u0002s degree required; must meet health-plan licensure/certification requirements. Skills in care coordination, utilization review, patient outreach, education, and quality improvement.
NiSourceNYSE: NI: Provides regulated natural gas and electric utility services.
1+ YOEDesigns and manages customer-requested gas and electric services; 1+ years utility distribution work management; strong communication, problem-solving, and Microsoft 365 skills; travel for local site visits may be required.
Guidehealth: AI platforms and managed services for value-based healthcare providers.
3+ YOEActive Illinois RN license, 3+ years healthcare experience, knowledge of utilization review/managed care, Microsoft 365 skills, strong clinical judgment and communication, ability to meet CE requirements.
Microsoft 365, Microsoft Word, Microsoft Excel, Microsoft PowerPoint
City of Geneva: Municipal government providing public services to the Geneva community.
Operate and maintain wastewater plant equipment, collect and analyze samples, perform basic lab tests, use Excel for data entry/analysis, and obtain required certifications including wastewater operator class 4 and CDL-A.
CVS HealthNYSE: CVS: Provides retail pharmacy, health insurance, and pharmacy benefit management services.
3+ YOEMD or DO with an unrestricted U.S. medical license, 3+ years primary care clinical practice, 1+ year UM experience with Medicare/Medicaid, strong communication, managed care knowledge, and US work authorization.
US HealthVest: Operates specialized psychiatric hospitals and outpatient behavioral health centers
1+ YOE1+ year administrative experience in healthcare preferred; associate degree preferred; typing 65 wpm; proficiency with Word and Excel; ability to work flexible hours and overtime.
Utilization Management Medical Director - Medical Oncology - Remote anywhere in US
Houston or Chicago or Atlanta or Phoenix or Los Angeles or Saint Louis or San Diego or Dallas or Philadelphia or Seattle
$249k-$373k/yrRemoteFull Time
UnitedHealth GroupNYSE: UNH: Provides health insurance and technology-enabled health care services.
5+ YOEMD or DO with current medical license; Board Certification in Oncology; 5+ years clinical experience in oncology; NCCN guideline experience; able to support utilization review and case/disease management.
Partner, AI-Enabled CDI, Care Management, and Utilization Management Transformation
Boston or Chicago or New York City or Washington or Nashville or United States
$250k-$350k/yrRemoteFull Time
Chartis: Strategic consulting and data analytics for the healthcare sector.
10+ YOEBachelor's required (advanced preferred), 10+ years in CDI/care management/utilization management or healthcare consulting, deep knowledge of DRGs/denial prevention, EHR workflows, AI-enabled solutions, and strong executive communication.
WEC Energy GroupNYSE: WEC: Provides electricity and natural gas utility services to customers.
1+ YOEHigh school diploma or GED, 1+ year mechanical aptitude and basic Microsoft Office proficiency, valid driver’s license, must pass DOT physical and Physical Capacity Exam.
AbbottNYSE: ABT: Manufactures medical devices, diagnostics, and nutritional health products.
1+ YOEHigh school diploma, at least 1 year as a utility operator, 6+ months safety/QA training, broad utilities knowledge, ability to train others and respond to emergencies.