RN Utilization Specialist - Optimize Hospital Care

Northwestern Medicine; Palos Park (IL); On-site; USD 90,000 - 110,000; Full time

Benefits offered by this job

Benefits package

Job summary

Northwestern Medicine seeks an experienced RN Utilization Specialist to support appropriate admissions and length of stay. You will review medical necessity and level of care, collaborate with clinicians and payors, and ensure documentation aligns with coverage plans.

You will participate in discharge planning, education, and ongoing utilization improvement initiatives within a hospital setting. IL RN licensure and inpatient experience are required.

Qualifications

• Licensed Registered Nurse in Illinois (IDFPR).
• Three years of experience in acute inpatient hospital care.
• Strong organizational and conflict management abilities.
• Proficient in word processing and spreadsheets.

Responsibilities

• Apply medical necessity screening and level of care guidelines.
• Perform initial admission and continuing stay reviews.
• Collaborate with payor specialists and clinicians on care decisions.
• Participate in discharge planning and education for patients.
• Monitor utilization data and participate in performance improvement.

Skills

Analytical skills

Organizational skills

Coaching / conflict management

Computer skills

Education

Registered Nurse Illinois

Tools

Microsoft Word

Microsoft Excel

Job description

Northwestern Medicine seeks an experienced RN Utilization Specialist to support appropriate admissions and length of stay. You will review medical necessity and level of care, collaborate with clinicians and payors, and ensure documentation aligns with coverage plans.

You will participate in discharge planning, education, and ongoing utilization improvement initiatives within a hospital setting. IL RN licensure and inpatient experience are required.