Health Care Utilization Review Coordinator - Military Veterans

Health Care Utilization Review Coordinator

Health Care Utilization Review Coordinator

Hiring Department : Health Care Utilization Review Coordinator

Location : Chicago, IL USA

Requisition ID : 1028909

FTE : 0.2

Work Schedule : Saturday and Sunday, 8 to 4:30

Shift : Days

# of Positions : 3

Posting Close Date : 01/17/2025

Salary: The previously determined range for this position was $35.72- $71.67 The final rate offered will be determined by the collective bargaining agreement, internal salary equity, candidate experience and qualifications, and budget constraints. It is not typical for an individual to be offered a rate at or near the top of the full range for a position.

This position requires Illinois residency within 180 days of the hire date.

About the University of Illinois Hospital & Health Sciences System (UI Health)

The University of Illinois Hospital & Health Sciences System (UI Health) provides comprehensive care, education, and research to the people of Illinois and beyond. A part of the University of Illinois Chicago (UIC), UI Health comprises a clinical enterprise that includes a Joint Commission-accredited tertiary care hospital and outpatient clinics, and the Mile Square Health Center network of federally qualified health centers. It also includes the seven UIC health science colleges: the College of Applied Health Sciences; the College of Dentistry; the School of Public Health; the Jane Addams College of Social Work; and the Colleges of Medicine, Pharmacy, and Nursing, including regional campuses in Peoria, Quad Cities, Rockford, Springfield, and Urbana. UI Health is dedicated to the pursuit of health equity. Learn more: https://hospital.uillinois.edu/about-ui-health

Benefits eligible positions include a comprehensive benefits package which offers: Health, Dental, Vision, Life, Disability & AD&D insurance; a defined benefit pension plan; paid leaves such as Vacation, Holiday and Sick; tuition waivers for employees and dependents. Click for a complete list of Employee Benefits .

Position Summary

Health Care Utilization Review Coordinator (HURC) is accountable for coordinating and facilitating patient
services across the various levels of the continuum utilizing Relationship-Based Care model as the framework.
The HURC takes initiative to improve patient outcomes by integrating Shared Leadership, Evidence Based
Practice and Magnet's Five Models of Care into clinical practice. Through therapeutic relationships with
patients, families, self and colleagues, the HURC functions as an interdisciplinary team member who assist
patients and their families in navigating through the healthcare system based on individual and patient
population needs. In addition to the care facilitation, the HURC will perform related duties including utilization
management, discharge planning and referral to other levels of care and fulfills unit and organizational goals

Duties & Responsibilities

Provides utilization management functions for patients: pre-certification (primarily a function of the Admissions Department), Continued stay reviews and retro-reviews.
Assist physicians with determining CLOC and medical necessity. Facilitates appropriate clinical level of care determination and conversions if necessary.
Responsible for notification to the Admissions Department of CLOC conversions.
Monitors internal and external UR guidelines for patients in assigned units or departments. Com-municates key UM information to units and attending physician or their representative and man-aged care companies.
Applies approved utilization acuity criteria to monitor appropriateness of CLOC and continued stays and documents finding based on department standards.
Inputs and maintains utilization management data into computer system.
Participates in gathering and reporting data, such as variances, LOS, cost and outcomes.
Perform other related duties and participate in special projects as assigned.

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. 2 to 4 years of utilization review & utilization management experience.
5. Current AHA BLS/CPR and other required unit specific certifications
6. Effective communication skills (oral and written) that facilitate therapeutic relationships between patients, family, and health care providers
7. Intermediate computer skills with the ability to become proficient in the Electronic Health Record (EHR) with on-the-job training
8. Excellent attendance, interpersonal skills and work history required.

Preferred Qualifications
MSN
CCM or ACMA certification

To Apply: For fullest consideration click on the Apply Now button, please fully complete all sections of the online application including adding your full work history with specific details of your duties & responsibilities for each position held. Fully complete the education, licensure, certification and language sections. You may upload a resume, cover letter, certifications, licensures, transcripts and diplomas within the application.

Please note that once you have submitted your application you will not be able to make any changes. In order to revise your application you must withdraw and reapply. You will not be able to reapply after the posting close date. Please ensure the application is fully completed and all supporting documents have been uploaded before the posting close date.

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 https://uic.csod.com/ux/ats/careersite/1/home/requisition/12865?c=uic

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