Case Manager, Utilization Review Registered Nurse

Job overview

The Case Manager, Utilization Review Registered Nurse role is onsite in Chicago, IL, with pay of $43.47–$53.00 per hour. The position supports patient care and utilization review at Community First Medical Center, under the general direction of the Director of Behavioral Health. The registered nurse provides clinically based case management and utilization review to support high-quality, cost-effective care. Through medical-necessity review, denial prevention, discharge planning, care coordination, and resource management, the role helps promote safe transitions, appropriate hospital resource use, regulatory compliance, and optimal reimbursement.

What you'll do

• Conduct concurrent utilization review and medical-necessity determinations
• support denial prevention and appeals
• coordinate discharge planning and patient care
• manage resources across the continuum of care
• collaborate with physicians, interdisciplinary teams, physician advisors, social workers, revenue cycle staff, and third-party payers
• support regulatory compliance and safe patient transitions.

What we're looking for

Skills & competencies

case manager

utilization review

registered nurse

part-time

chicago il

community first medical center

discharge planning

care coordination

medical necessity

denial prevention

illinois rn license

$43.47–$53/hr

Work arrangement

• Weekend coverage required

Benefits & perks

• Medical PPO/HMO/HSA plans, dental and vision, paid time off, six paid holidays, company-paid life insurance and short-term disability, 401(k) after 90 days, continuing education reimbursement, two paid education days separate from PTO, free parking, and internal growth opportunities.

Why this role

Requires an associate degree in nursing, an active Illinois Registered Nurse license, and at least three years of acute-care nursing experience; BSN and ACM, CCM, or CMAC certification are preferred.

About the employer

Community First Medical Center is hiring for this role. Industry: General Medical and Surgical Hospitals. Sector: 62.