ED Utilization Mgmt RN Care Coordination Full Time Evenings
Northwestern Memorial Healthcare•Winfield, IL
•Onsite
About The Position
This position is in the ED: 6:00pm -2:00AM. Monday through Friday. No weekends /holidays. This is not a remote position. The Utilization Management nurse role is to ensure that health care services are administered with quality, cost efficiency, and within compliance by continuously reviewing the EMR and collaborating with the health care team.
Requirements
- Bachelor's degree in Nursing
- State licensure as a Registered Nurse (RN)
Nice To Haves
- Master's degree
- Minimum 2 years of prior experience in Utilization Management
- Utilization Management or Case Management certification
Responsibilities
- Concurrent review of patients clinical information for efficiency and correct level of care and admission status
- Interface with payers concurrently and after discharge to obtain authorization
- Concurrent denials management
- Collaborates with the denials management team
- Ongoing review of pre-certification requests for medical necessity
- Monitor the activities of clinical and non-clinical staff
- Collaborates with the health care team and payers to assist with coordinating patients discharge planning needs
- Employ effective use of knowledge, critical thinking and skills
- Work in an intensive, fast-paced environment with minimal supervision
- Ability to stay organized and interact well with others in any situation
- Provide updates to Director of Utilization Management for review
Benefits
- tuition reimbursement
- loan forgiveness
- 401(k) matching
- lifecycle benefits
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Number of Employees
1,001-5,000 employees
