Hybrid Utilization Review RN - Impactful Case Coordination

Saint Anthony Hospital; Chicago (IL); On-site; USD 78,000 - 109,000; Full time

Benefits offered by this job

Comprehensive Health Insurance Plans (

Employer matching retirement plans

Public Service Loan Forgiveness (PSLF)

Job summary

Saint Anthony Hospital in Chicago seeks a Case Manager/Utilization Review RN to coordinate patient care and utilization management. You will collaborate with the interdisciplinary team to ensure appropriate care paths, timely discharge planning, and adherence to UM criteria.

This role requires an Illinois RN license and UR experience. The hybrid/onsite environment combines clinical oversight with documentation in the EHR and communication with payors to secure approvals and maintain efficient

Qualifications

• Illinois RN license required; BSN preferred.
• Experience with Utilization Review is preferred.
• Familiar with InterQual criteria and hospital EHR usage.

Responsibilities

• Coordinate with denial management on inpatient denials and notify provider as needed.
• Monitor delivery of care and revise plans; discuss pathways with patients and families.
• Coordinate discharge planning with attending provider and other agencies.
• Communicate with insurance payors for authorization and review; document in EHR.

Skills

RN license IL

Utilization Review

Clinical assessment

Excel

Education

BSN preferred

Tools

InterQual criteria

EHR system

Job description

Saint Anthony Hospital in Chicago seeks a Case Manager/Utilization Review RN to coordinate patient care and utilization management. You will collaborate with the interdisciplinary team to ensure appropriate care paths, timely discharge planning, and adherence to UM criteria.

This role requires an Illinois RN license and UR experience. The hybrid/onsite environment combines clinical oversight with documentation in the EHR and communication with payors to secure approvals and maintain efficient