Illinois Licensed Utilization Management RN
Job Summary
To support a growing healthcare organization, the full-time Illinois Licensed Utilization Management RN will perform utilization review activities, ensuring compliance with regulations and standards while collaborating with providers and internal teams in a remote setting.
Key responsibilities
- Conduct timely reviews of healthcare services and document clinical findings in accordance with regulatory standards
- Collaborate with medical directors and providers on cases requiring further review and communicate determinations effectively
- Initiate referrals for patients to disease management programs and participate in quality management activities
Required qualifications
- Active and unrestricted Illinois State License as a Registered Nurse
- Three years of experience in various healthcare settings
- Knowledge of utilization review, managed care, and community health
- Proficiency in Microsoft 365 applications
- Commitment to ongoing professional growth and compliance with the Illinois Nurse Practice Act
Complete Job Description
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