Illinois Licensed Utilization Management RN
Job Summary
To ensure effective patient care and resource utilization, the full-time Illinois Licensed Utilization Management RN will oversee and manage the functional and financial outcomes for hospitalized patients, working remotely during day shifts from Monday to Friday.
Key responsibilities
- Conduct initial assessments and concurrent reviews of patient charts to determine appropriate care status and resource utilization
- Communicate with physicians regarding status changes, documentation, and facilitate referrals for secondary and escalated medical reviews
- Document utilization reviews and track avoidable days while educating physicians on resource utilization and participating in extended care reviews
Required qualifications
- Licensed Registered Professional Nurse (RN) in Illinois
- Associate's Degree in Nursing or equivalent college diploma in Nursing
- Experience in acute care settings and knowledge of medical necessity criteria
- Strong data management skills, including proficiency in Word, Excel, Outlook, and EPIC Case Management software
- Ability to effectively communicate with healthcare professionals and build rapport with medical staff
Complete Job Description
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