Quality and Utilization Management Coordinator

Sinai Health System • Chicago, IL

3d • $32

About The Position

At Sinai Chicago, we take health care personally. Excellence in health care is about more than medicine, technology, tests, and treatments—it is about truly caring for people with dignity and respect. We are dedicated to providing the best care for our community, our patients, and our caregivers. Position Purpose The Quality and Utilization Management Coordinator supports the Associate Chief Medical Officer for System Quality & Patient Safety by coordinating activities that enhance organizational quality, patient safety, and utilization performance. This role focuses on improving patient throughput, ensuring safe care transitions, mitigating Hospital-Acquired Infections (HAIs), supporting utilization management activities, and providing data-driven insights to reduce hospital-acquired conditions and unnecessary utilization.

Requirements

• Bachelor's degree required; healthcare-related field preferred (e.g., Nursing, Public Health, Health Care Administration).
• Hospital clinical experience required.
• Experience in quality improvement, infection prevention, utilization management, case management, or care coordination strongly preferred.
• Strong organizational and project management skills with the ability to manage competing priorities.
• Familiarity with quality metrics, infection control concepts, and utilization management principles.
• Experience with EPIC and MEDITECH preferred; ability to learn additional systems as needed.
• Excellent verbal and written communication skills with the ability to interact professionally with clinical teams and leadership.
• Working knowledge of regulatory and accreditation requirements (e.g., The Joint Commission, CMS Conditions of Participation) preferred.

Nice To Haves

• Experience participating in or supporting multidisciplinary clinical teams is desirable.
• Certifications such as Certified Professional in Healthcare Quality (CPHQ), Certification in Infection Prevention and Control (CIC), or Utilization Management certification (e.g., CMAC) are beneficial but not required.

Responsibilities

• Collaborates with the Infection Control & Prevention Department to conduct surveillance of Hospital-Acquired Infections (HAIs), ensuring timely documentation, data accuracy, and appropriate escalation to clinical leadership.
• Identifies gaps in surveillance activities and assists in workflow development aimed at mitigating hospital-acquired events.
• Assists in preparing regulatory readiness materials and supports survey activities (e.g., IDPH, CMS, The Joint Commission).
• Maintains dashboards, tracking tools, and performance reports used by clinical and administrative leadership.
• Coordinates communication among care teams to promote optimal patient throughput, appropriate length of stay (LOS), early discharge planning, and timely completion of consults.
• Partners with case managers, social workers, nursing staff, attending physicians, residents, and physician advisors to identify avoidable delays and facilitate real-time solutions.
• Monitors barriers to discharge and escalates issues as needed to reduce denials, prevent avoidable days, and support efficient care transitions.
• Supports utilization review processes, including documentation follow-up and routing cases to physician advisors.
• Prepares reports and summaries for quality committees, throughput huddles, and performance improvement rounds.
• Utilizes hospital information systems (e.g., EPIC, MEDITECH, MIDAS, or comparable platforms) to gather and analyze data for leadership review.
• Maintains organized logs, trackers, and documentation related to quality, infection prevention, and utilization management activities.
• Performs other duties as assigned.

Benefits

• Sinai Health System offers a comprehensive benefits package, including medical, dental, vision, and prescription coverage; employer-paid life and AD&D insurance; supplemental life insurance; short- and long-term disability; Health Savings Account (HSA); Flexible Spending Account (FSA); Employee Assistance Program (EAP); student loan assistance; and a 403(b) retirement savings plan.
• Eligibility for certain benefits is based on employment status, scheduled hours, and waiting periods.
• Registry (per diem) caregivers work fewer than 1,000 hours annually and are eligible for limited benefits as outlined by Sinai Health System policy.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 1,001-5,000 employees