RN Utilization Management & Care Coordination

Accolade Healthcare; Champaign (IL); Hybrid; USD 75,000 - 90,000; Full time

Benefits offered by this job

Medical, Dental, Vision and voluntary

401k with company match

Paid Leave Policy

Daily Pay partner

Job summary

Accolade Healthcare in Champaign, IL, seeks a Utilization Management/Case Manager to coordinate the continuum of care for SNF patients with a focus on insurance authorizations and discharge planning.

You will collaborate with interdisciplinary teams to ensure timely authorizations, effective case management, and compliant documentation while maintaining high patient care standards. On-site or hybrid work depending on facility needs.

Qualifications

• RN license or equivalent clinical credential required.
• Minimum 2 years of case management experience in SNF/hospital/managed care.
• Strong knowledge of insurance authorization processes and appeal strategies.
• Experience with CMS guidelines, QIO processes, and discharge planning.
• Proficient in documentation and interdisciplinary collaboration.

Responsibilities

• Coordinate and manage care for a caseload of SNF patients with timely authorizations.
• Collaborate with physicians, therapists, social workers, and payors to ensure seamless transitions.
• Obtain and manage authorizations for inpatient SNF care across plans.
• Negotiate reimbursement rates for non-contracted payors when needed.
• Review denials and prepare appeals; participate in QIO or health plan appeals.
• Identify patient care needs and develop appropriate care plans.
• Advocate for patient access while maintaining compliance with guidelines.
• Maintain accurate, up-to-date documentation per standards.

Skills

Case management

Insurance authorizations

Interdisciplinary collaboration

Communication

EHR proficiency

Education

RN license

Tools

Electronic Health Records (EHR)

Case management software

Job description

Accolade Healthcare in Champaign, IL, seeks a Utilization Management/Case Manager to coordinate the continuum of care for SNF patients with a focus on insurance authorizations and discharge planning.

You will collaborate with interdisciplinary teams to ensure timely authorizations, effective case management, and compliant documentation while maintaining high patient care standards. On-site or hybrid work depending on facility needs.