UI Health - Extra Help Healthcare Utilization Review Coordinator II

UIC; Chicago, Northern (IL, KY); Hybrid; USD 130,000 - 142,000; Full time

Job summary

UIC in Chicago seeks a Health Care Utilization Review Coordinator (HURC) to coordinate patient services across the continuum using Relationship-Based Care. You will join an interdisciplinary team and help optimize discharge planning, utilization management, and referrals to the appropriate level of care.

The role requires a BSN, an active Illinois Registered Nurse license, and at least five years of Medical-Surgical experience.

Qualifications

• Graduation from an accredited professional nursing program.
• Current licensure as a Registered Professional Nurse with the Illinois Department of Financial and Professional Regulation, Division of Professional Regulation.
• Five years (60 months) of Medical Surgical experience.
• BSN (or higher) required of an accredited nursing program.
• Current BLS/CPR and/or other required unit specific certifications

Responsibilities

• Advocates for patients, families, and their significant others, the community, and the nursing profession.
• Facilitates coordination of patient services in assigned patient care unit, or department by collaborating with the patient, family, physicians, RNs, and multidisciplinary team to assure appropriate safe, cost effective, timely and efficient services.
• Communicates and coordinates with all staff in developing and implementing the discharge planning process including appropriate Clinical Level of Care, continued stay, patient assessment, planning, implementation, interdisciplinary collaboration, and ongoing evaluation.
• Identifies variations in the utilization of benefits with payors to fund the continuing or alternative care plan, where possible
• Documents and reviews risk assessment and discharge planning information in the medical record according to department standards including applying approved utilization acuity criteria and verifying that admitting or referral source has pre-certified and considers budgetary aspects of care.
• Assists in identifying system problems and issues that impede (impeding) diagnostic or treatment progression to the appropriate administrative liaison. Collaborates with the interdisciplinary team when delays occur in consults, treatments, discharge planning, or procedures to facilitate timely, cost-effective delivery of patient services.
• Facilitates daily communication (e.g. patient rounds, multidisciplinary team meetings and conferences) with the interdisciplinary team to discuss plan of care and assist with expediting care across the continuum
• Maintains expertise through participation in continuing education programs. Serves as experienced resource and patient services facilitation reference for care team members.
• Receives and provides feedback to members of the health care team regarding performance/practice.
• Collaborates with other nurses and physicians to identify, promote and provide positive learning experiences for staff and students.
• Other Duties as Assigned.
• Perform other related duties and participate in special projects as assigned.

Skills

Clinical nursing

Patient advocacy

Communication skills

Education

BSN degree

RN license (IL)

Job description

Chicago, IL, United States

Hiring Department: Continuum of Care

Location: Chicago, IL USA

Requisition ID: 1042514

Salary: The previously determined salary range for this position is $62.81-$68.38.

About the University of Illinois Chicago

UIC is among the nation’s preeminent urban public research universities, a Carnegie RU/VH research institution, and the largest university in Chicago. UIC serves over 34,000 students, comprising one of the most diverse student bodies in the nation and is designated as a Minority Serving Institution (MSI), an Asian American and Native American Pacific Islander Serving Institution (AANAPSI) and a Hispanic Serving Institution (HSI). Through its 16 colleges, UIC produces nationally and internationally recognized multidisciplinary academic programs in concert with civic, corporate and community partners worldwide, including a full complement of health sciences colleges. By emphasizing cutting-edge and transformational research along with a commitment to the success of all students, UIC embodies the dynamic, vibrant and engaged urban university. Recent “Best Colleges” rankings published by U.S. News & World Report, found UIC climbed up in its rankings among top public schools in the nation and among all national universities. UIC has over 300,000 alumni, and is one of the largest employers in the city of Chicago.

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

• Advocates for patients, families, and their significant others, the community, and the nursing profession.


• Facilitates coordination of patient services in assigned patient care unit, or department by collaborating with the patient, family, physicians, RNs, and multidisciplinary team to assure appropriate safe, cost effective, timely and efficient services.


• Communicates and coordinates with all staff in developing and implementing the discharge planning process including appropriate Clinical Level of Care, continued stay, patient assessment, planning, implementation, interdisciplinary collaboration, and ongoing evaluation.


• Identifies variations in the utilization of benefits with payors to fund the continuing or alternative care plan, where possible


• Documents and reviews risk assessment and discharge planning information in the medical record according to department standards including applying approved utilization acuity criteria and verifying that admitting or referral source has pre-certified and considers budgetary aspects of care.


• Assists in identifying system problems and issues that impede (impeding) diagnostic or treatment progression to the appropriate administrative liaison. Collaborates with the interdisciplinary team when delays occur in consults, treatments, discharge planning, or procedures to facilitate timely, cost-effective delivery of patient services.


• Facilitates daily communication (e.g. patient rounds, multidisciplinary team meetings and conferences) with the interdisciplinary team to discuss plan of care and assist with expediting care across the continuum


• Maintains expertise through participation in continuing education programs. Serves as experienced resource and patient services facilitation reference for care team members.


• Receives and provides feedback to members of the health care team regarding performance/practice.


• Collaborates with other nurses and physicians to identify, promote and provide positive learning experiences for staff and students.


• Other Duties as Assigned.


• Perform other related duties and participate in special projects as assigned.

Minimum Qualifications

• Graduation from an accredited professional nursing program


• Current licensure as a Registered Professional Nurse with the Illinois Department of Financial and Professional Regulation, Division of Professional Regulation.


• Five years (60 months) of Medical Surgical experience.


• BSN (or higher) required of an accredited nursing program.


• Current BLS/CPR and/or other required unit specific certifications

Preferred Qualifications

• Nationally certified through ANCC approved certifier, or within 6 months of hire in an area relevant to their clinical area.

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.

Artificial Intelligence (AI) tools may be used in some portions of the candidate review process for this position, however, all employment decisions will be made by a person.

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