Job Description
Job Number:Utilization Review RN for Behavioral Health (Job Number: ******** )
All the benefits and perks you need for you and your family: Benefits from Day OnePaid Time Off from Day OneStudent Loan Repayment ProgramMental Health Resources and SupportDebt-free Education (Certifications and Degrees without out-of-pocket tuition expense)Our promise to you: Joining UChicago Medicine AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. UChicago Medicine AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Schedule: Full-Time 36 hours/week, 11am - 7pm (hours may change based on business need, No weekends/holidays)
Location: UChicago Medicine AdventHealth GlenOaks Hospital 701 Winthrop Ave, Glendale Heights, IL
The role you'll contribute: Provides health care services regarding admissions, case management, discharge planning and utilization review.
The value you'll bring to the team: Reviews admissions and service requests within assigned unit for prospective, concurrent and retrospective medical necessity and/or compliance with reimbursement policy criteria. Provides case management and/or consultation for complex cases.Assists departmental staff with issues related to coding, medical records/documentation, precertification, reimbursement and claim denials/appeals.Assesses and coordinates discharge planning needs with healthcare team members.May prepare statistical analysis and utilization review reports as necessary.Oversees and coordinates compliance to federally mandated and third-party payer utilization management rules and regulations.The expertise and experiences you'll need to succeed: Diploma from an accredited school/college of nursing required.Behavioral Health RN experience strongly preferred.Experience in utilization review strongly preferred.Registered Nurse credentialed from the Illinois Board of Nursing obtained prior to hire date or job transfer date.Job:Case Management
Organization:UChicago Medicine AdventHealth Great Lakes
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