UI Health - Healthcare Utilization Review Coordinator II

University of Illinois Medical Center•Chicago, IL

50d•$41 - $91•Onsite

About The Position

The University of Illinois Hospital & Health Sciences System (UI Health) provides comprehensive care, education, and research to the people of Illinois and beyond. A part of the University of Illinois Chicago (UIC), UI Health comprises a clinical enterprise that includes a Joint Commission-accredited tertiary care hospital and outpatient clinics, and the Mile Square Health Center network of federally qualified health centers. It also includes the seven UIC health science colleges: the College of Applied Health Sciences; the College of Dentistry; the School of Public Health; the Jane Addams College of Social Work; and the Colleges of Medicine, Pharmacy, and Nursing, including regional campuses in Peoria, Quad Cities, Rockford, Springfield, and Urbana. UI Health is dedicated to the pursuit of health equity. 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.
2 to 5 years' experience as a utilization review nurse.
Excellent attendance, interpersonal skills and work history required.

Nice To Haves

Nationally certified through ANCC approved certifier, or within 6 months of hire in an area relevant to their clinical area.

Responsibilities

Advocates for patients, families, and their significant others, the community, and the nursing profession.
Facilitates coordination of patient services in assigned patient care unit, or department by collaborating with the patient, family, physicians, RNs, and multidisciplinary team to assure appropriate safe, cost effective, timely and efficient services.
Identifies variations in the utilization of benefits with payors to fund the continuing or alternative care plan, where possible
Assists in identifying system problems and issues that impede (impeding) diagnostic or treatment progression to the appropriate administrative liaison.
Collaborates with the interdisciplinary team when delays occur in consults, treatments, discharge planning, or procedures to facilitate timely, cost-effective delivery of patient services.
Facilitates daily communication (e.g. patient rounds, multidisciplinary team meetings and conferences) with the interdisciplinary team to discuss plan of care and assist with expediting care across the continuum
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.