Job Description
Health Care Utilization Review Coordinator Health Care Utilization Review Coordinator Hiring Department : Health Care Utilization Review Coordinator
Location : Chicago, IL USA
Requisition ID : 1026708
Posting Close Date : 08/23/2024
FTE: 1.0
Shift: Days
About the University of Illinois Chicago UIC is among the nation's preeminent urban public research universities, a Carnegie RU/VH research institution, and the largest university in Chicago. UIC serves over 34,000 students, comprising one of the most diverse student bodies in the nation and is designated as a Minority Serving Institution (MSI), an Asian American and Native American Pacific Islander Serving Institution (AANAPSI) and a Hispanic Serving Institution (HSI). Through its 16 colleges, UIC produces nationally and internationally recognized multidisciplinary academic programs in concert with civic, corporate and community partners worldwide, including a full complement of health sciences colleges. By emphasizing cutting-edge and transformational research along with a commitment to the success of all students, UIC embodies the dynamic, vibrant and engaged urban university. Recent 'Best Colleges' rankings published by U.S. News & World Report, found UIC climbed up in its rankings among top public schools in the nation and among all national universities. UIC has over 300,000 alumni, and is one of the largest employers in the city of Chicago.
Description: Position Summary
a. Facilitates coordination of patient services in assigned patient care unit, or department.
b. Collaborates with patient, family, physician(s), RN(s), and multidisciplinary team to ensure appropriate safe, cost effective, timely and efficient services. Utilize critical and social work experts as needed to ensure delivery of comprehensive patient services.
c. Collaborates and communicates with all staff in developing and implementing the Admission planning process including appropriate Clinical Level of Care (CLOC), continued stay and patient assessment (for appropriate CLOC), planning, Implementation, interdisciplinary collaboration and ongoing evaluation.
d. Identifies variations in the utilization of benefits with payers to fund the continuing or alternative care plan where possible,
e. Documents risk assessment and pre-certification information in the electronic medical record according to department standards.
f. Communicates key UM information to units and attending physicians o
Duties & Responsibilities
a. Facilitates coordination of patient services in assigned patient care unit, or department.
b. Collaborates with patient, family, physician(s), RN(s), and multidisciplinary team to ensure appropriate safe, cost effective, timely and efficient services. Utilize critical and social work experts as needed to ensure delivery of comprehensive patient services.
c. Collaborates and communicates with all staff in developing and implementing the Admission planning process including appropriate Clinical Level of Care (CLOC), continued stay and patient assessment (for appropriate CLOC), planning, Implementation, interdisciplinary collaboration and ongoing evaluation.
d. Identifies variations in the utilization of benefits with payers to fund the continuing or alternative care plan where possible,
e. Documents risk assessment and pre-certification information in the electronic medical record according to department standards.
f. Communicates key UM information to units and attending physicians or their representatives and managed care companies as it relates to pre-certifications.
g. Applies approved utilization acuity criteria to monitor appropriateness of CLOC and documents findings based on department standards.
h. Inputs and maintains UM data into electronic medical record.
i. Maintains expertise through participation in continuing education program. Serves as experienced resource and patient services facilitation reference for care team members.
j. Participates in internally and externally driven quality improvement programs
Perform other related duties and participate in special projects as assigned.
Qualifications: Minimum Qualifications
1. Graduation from an accredited professional nursing program
2. Current licensure as a Registered Professional Nurse with the Illinois Department of Financial and Professional Regulation, Division of Professional Regulation.
3.
Five years (60 months) of RN experience .
4. Current AHA BLS/CPR and other required unit specific certifications
5. Effective communication skills (oral and written) that facilitate therapeutic relationships between patients, family, and health care providers
6. Intermediate computer skills with the ability to become proficient in the Electronic Health Record (EHR) with on-the-job training
7. Excellent attendance, interpersonal skills and work history required.
The University of Illinois System is an equal opportunity employer, including but not limited to disability and/or veteran status, and complies with all applicable state and federal employment mandates. Please visit Required Employment Notices and Posters to view our non-discrimination statement and find additional information about required background checks, sexual harassment/misconduct disclosures, and employment eligibility review through E-Verify. The university provides accommodations to applicants and employees. Request an Accommodation Looking for more University of Illinois positions? We invite you to search for positions at each of the University of Illinois locations, the University of Illinois System Office and the University of Illinois Foundation. The University of Illinois System Office supports the primary missions of teaching, research, public service, and economic development for all of the Universities and offers positions in all locations. The University of Illinois Foundation is the official fundraising and private gift-receiving agency for the University of Illinois and also offers position in all locations. Click the links below to search for other University of Illinois positions.
University of Illinois Urbana-Champaign
University of Illinois Springfield
University of Illinois System Office
University of Illinois Foundation
The University of Illinois System is an equal opportunity employer, including but not limited to disability and/or veteran status, and complies with all applicable state and federal employment mandates. Please visit Required Employment Notices and Posters to view our non-discrimination statement and find additional information about required background checks, sexual harassment/misconduct disclosures, and employment eligibility review through E-Verify. To apply, visit Copyright 2024 Jobelephant.com Inc. All rights reserved.
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About University of Illinois - Chicago
The University of Illinois Chicago is the city’s largest university and its only public Carnegie Research 1 institution. Its 16 academic colleges serve close to 34,000 undergraduate, graduate and professional students. UIC is recognized as one of the best public universities and one of the most ethnically rich and culturally diverse campuses in the nation, located in the heart of Chicago, it is an integral part of the city's educational, technological and cultural fabric.
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