Illinois Licensed RN Manager
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Job Summary
Providing operational leadership, the full-time salaried Illinois Licensed RN Manager will oversee a team of Registered Nurses focused on clinical revenue integrity and appeals, ensuring compliance and optimizing reimbursement while working onsite as needed and remotely.
Key responsibilities
- Leads and manages a team of Registered Nurses in clinical revenue integrity and payer appeal activities
- Establishes standardized workflows and monitors key performance indicators to enhance operational effectiveness
- Collaborates with various departments to improve documentation practices and reduce avoidable denials
Required qualifications
- Bachelor's degree in Nursing (BSN) required
- Five (5) years of progressive clinical experience in acute care, utilization management, or related healthcare operations
- Current Registered Nurse (RN) license in good standing required
- Demonstrated knowledge of medical necessity criteria and payer authorization requirements
- Certification in Case Management (CCM), Utilization Review (CPUR or equivalent), or Revenue Cycle (CRCR, CRCE) preferred
Complete Job Description
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