Part-Time RN Utilization Specialist: Optimize Care & Utilization

SmartRecruiters, Inc.; Palos Park (IL); On-site; USD 53,000 - 85,000; Part time

Job summary

Northwestern Medicine seeks an RN Utilization Specialist in Illinois to review admissions and lengths of stay, ensure medical necessity, and coordinate with care teams to optimize hospital utilization.

The role requires an Illinois-licensed RN with inpatient experience, strong analytical skills, and comfort with data reporting; part-time schedule and collaborative environment are offered.

Qualifications

• Licensed Registered Nurse in Illinois (IDFPR).
• Three years of experience in acute inpatient hospital care.
• Analytical skills to collect, analyze, and interpret data.
• Computer skills including word processing and spreadsheets.
• Preferred: Bachelor’s Degree in Nursing.

Responsibilities

• Applies medical necessity screening criteria and level of care guidelines to ensure appropriate admissions and length of stay.
• Completes admission and continuing stay reviews for hospitalized patients.
• Collaborates with Payor Specialists and third‑party payors to communicate clinical information.
• Acts as liaison to ensure compliance with contracts and payor guidelines while maintaining quality of care.
• Works with leadership to identify and implement utilization processes that improve care efficiency.
• Monitors data elements related to utilization through reporting tools.
• Assists in education programs and prepares updates for clinicians and interdisciplinary teams.
• Participates in quality improvement initiatives and audit follow‑ups.

Skills

RN licensure Illinois

Inpatient care experience

Analytical skills

Computer skills

Education

Bachelor's degree in Nursing

Tools

Word processing

Excel

Job description

Northwestern Medicine seeks an RN Utilization Specialist in Illinois to review admissions and lengths of stay, ensure medical necessity, and coordinate with care teams to optimize hospital utilization.

The role requires an Illinois-licensed RN with inpatient experience, strong analytical skills, and comfort with data reporting; part-time schedule and collaborative environment are offered.