Illinois Licensed RN Utilization Specialist

Job Summary

A company is looking for a RN Utilization Management and Review Specialist.

Key Responsibilities

• Evaluate patient care and activities against objective criteria to determine appropriate admission status
• Identify and resolve utilization issues related to the over or under utilization of services
• Review medical records to assess the appropriateness and medical necessity of admissions and hospital stays

Required Qualifications

• Bachelor's Degree in Nursing must be obtained within 3 years of hire
• 2 years of clinical experience in an acute care or managed care setting
• Current state license as a Registered Nurse (IL)
• Working knowledge of clinical EMR systems