Utilization Management RN (79937)
Centurion Health•Springfield, IL
•Remote
About The Position
Centurion is proud to be the provider of comprehensive services to the Illinois Department of Corrections. We are currently seeking a Full-time Utilization Management (UM) Registered Nurse (RN) to join our Regional Team in Springfield, Illinois. The UM RN is responsible for providing utilization review services for statewide systems. This person reviews inpatient admissions and outpatient referrals to ensure appropriate levels of care and evaluate evidence based medical necessity and quality of care.
Requirements
- Licensed RN with an active license to practice in Illinois
- Previous experience performing utilization review in an inpatient or outpatient setting or in a managed care setting
- Proficiency in Microsoft Word and Excel required
- Minimum of one year of work experience as an RN in a community outpatient clinic, hospital or long-term care facility
- Must be appropriately and actively certified in Cardio-Pulmonary Resuscitation (CPR)/ BLS
- Ability to obtain a security clearance, to include drug screen and criminal background check
Nice To Haves
- Experience with InterQual preferred
- Corrections experience preferred
Responsibilities
- Providing utilization review services for statewide systems.
- Reviewing inpatient admissions and outpatient referrals to ensure appropriate levels of care.
- Evaluating evidence-based medical necessity and quality of care.
Benefits
- Health, dental, vision, disability and life insurance
- 401(k) with company match
- Generous paid time off
- Paid holidays
- Flexible Spending Account
- Continuing Education benefits
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
