UI Health - Extra-Help Healthcare Utilization Review Coordinator II (Precertification Nurse)

University of Illinois at Chicago•Chicago, IL

51d•$60 - $63

About The Position

UIC is among the nation's preeminent urban public research universities, a Carnegie RU/VH research institution, and the largest university in Chicago. UIC serves over 34,000 students, comprising one of the most diverse student bodies in the nation and is designated as a Minority Serving Institution (MSI), an Asian American and Native American Pacific Islander Serving Institution (AANAPSI) and a Hispanic Serving Institution (HSI). Through its 16 colleges, UIC produces nationally and internationally recognized multidisciplinary academic programs in concert with civic, corporate and community partners worldwide, including a full complement of health sciences colleges. By emphasizing cutting-edge and transformational research along with a commitment to the success of all students, UIC embodies the dynamic, vibrant and engaged urban university. Recent "Best Colleges" rankings published by U.S. News & World Report, found UIC climbed up in its rankings among top public schools in the nation and among all national universities. UIC has over 300,000 alumni, and is one of the largest employers in the city of Chicago. This position is generally not eligible for most benefits. Information regarding benefits can be found below. Click her to view eligible for benefits. This includes Health, Dental, Vision, Life Insurance, a Retirement Plan, Paid time Off, and Tuition waivers for employees and dependents. Position Summary Health Care Utilization Review Coordinator (HURC) is accountable for coordinating and facilitating patient services across the various levels of the continuum utilizing Relationship-Based Care model as the framework. The HURC takes initiative to improve patient outcomes by integrating Shared Leadership, Evidence Based Practice and Magnet's Five Models of Care into clinical practice. Through therapeutic relationships with patients, families, self and colleagues, the HURC functions as an interdisciplinary team member who assist patients and their families in navigating through the healthcare system based on individual and patient population needs. In addition to the care facilitation, the HURC will perform related duties including utilization management, discharge planning and referral to other levels of care and fulfills unit and organizational goals.

Requirements

Graduation from an accredited professional nursing program
Current licensure as a Registered Professional Nurse with the Illinois Department of Financial and Professional Regulation, Division of Professional Regulation.
Five years (60 months) of Medical Surgical experience.
BSN (or higher) required of an accredited nursing program.
Current BLS/CPR and/or other required unit specific certifications
Nationally certified through ANCC approved certifier, or within 6 months of hire in an area relevant to their clinical area.

Nice To Haves

Precertification experience within hospital or insurance company.
Master degree preferred
CCM or ACMA certified

Responsibilities

Facilitates coordination of patient services in assigned patient work queue or department.
Identifies variation in the utilization of benefits with payors to fun the continuing or alternative care.
Provides utilization management functions for patients: pre-certification (primary function of the Admission process).
Inputs and maintains utilization management data into Epic.
Verifies the admitting or referral source has pri-certified the patient admission and is scheduled.
Participates in internally and externally driven quality improvement programs.
Maintains expertise through participation in continuing education programs. Serves as experienced resource and patient services facilitation reference for care team members.
Receives and provides feedback to members of the health care team regarding performance/practice.
Collaborates with other nurses and physicians to identify, promote and provide positive learning experiences for staff and students.
Other Duties as Assigned.
Perform other related duties and participate in special projects as assigned.