Utilization Management and Population Health Nurse

Humboldt-Park-Health; Chicago (IL); In loco; USD 51.000 - 69.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical, dental, and vision coverage

Employer-paid life and AD&D insurance

403(b) retirement plan with employer-m

Paid Time Off (PTO)

Descrizione del lavoro

Humboldt Park Health is seeking a Utilization Management and Population Health Nurse in Chicago, IL. The role focuses on day-to-day utilization review, care coordination, and quality improvement for identified Century PHO enrollees.

You will work with care teams to identify at-risk patients, develop care plans, and support transitions across the continuum of care to improve outcomes. A current IL RN license and BLS are required, with opportunities for growth.

Competenze

• Active RN license in Illinois.
• BLS certification required or eligible.
• Experience with utilization management/review processes preferred.

Mansioni

• Perform utilization review for inpatient services using criteria.
• Identify at-risk patients and coordinate with care teams.
• Develop individualized care plans with providers.
• Coordinate referrals and optimize resource use.
• Monitor patient outcomes and adherence to care plans.
• Educate patients and families on self-management and resources.
• Interface with care teams to support quality improvement initiatives.
• Triage calls and counsel patients on acute issues.

Conoscenze

RN licensure

BLS certification

Utilization review

Formazione

Bachelor's degree or better

RN license

BLS - Basic Life Support

Descrizione del lavoro

Utilization Management and Population Health Nurse

• Posted on November 6, 2026

Locations

Showing 1 location

Chicago, IL 60622, USA

• Pay or shift range: $37 USD to $50 USD The estimated range is the budgeted amount for this position. Final offers are based on various factors, including skill set, experience, location, qualifications and other job-related reasons.
• Nursing
• Full-Time
• Requisition #: UTILI004245

Description

About Humboldt Park Health

As a community-based hospital, Humboldt Park Health reinvests in the community through programs that serve the poor and uninsured, manage chronic conditions such as diabetes, provide health education, and promote initiatives and outreach for older adults. We work hard every day to be a place of healing, caring, and connection for the patients and families in the community we call home.

Since its founding in 1894, Humboldt Park Health has been deeply committed to serving the Humboldt Park community. Humboldt Park Health is a 200-bed acute care facility providing patient-centered healthcare services focused on quality and compassionate care, ranging from everyday healthcare needs to treatment for the most critical conditions.

Join a Team That Cares for You, Too

Caring for others starts with supporting the people who make it possible. We are committed to supporting our employees with meaningful benefits, retirement planning support, and opportunities for continued growth and development. Whether you are seeking a full-time, part-time, or Registry position, you will be part of a compassionate, team-oriented environment dedicated to caring for both our patients and our staff.

Benefits eligibility and offerings vary based on employment status and applicable plan requirements. Eligible employees may have access to:

• Medical, dental, and vision coverage
• Employer-paid life and AD&D insurance
• Flexible Spending Account (FSA) options
• 403(b) retirement plan with employer match, subject to eligibility requirements
• Paid Time Off (PTO), which may increase with years of service
• Employee discount at the Humboldt Park Health Wellness Center
• Education reimbursement, subject to eligibility requirements
• Employee wellness programs
• Additional voluntary benefits
• Opportunities for additional shifts, where applicable

Benefits, eligibility, and employer contributions are subject to the applicable plan documents, employment status, and organizational policies.

Position Summary

The UM/Population Nurse is a health professional and possesses an active, unrestricted IL professional license, and is responsible for the day-to-day utilization review activities. The UM/Population Nurse of Care Coordination and Quality Improvement is responsible for the oversight and management of all aspects of care coordination and quality improvement activities for identified Century PHO enrollees, including but not limited to, identification of at risk patients and assisting them with navigating the continuum of care to achieve optimal clinical outcomes.

Essential Duties and Responsibilities:

• Utilization case review and application of criteria to approve initial and continued inpatient services
• Identify patients in need of outreach efforts based on patient risk stratification or other defined criteria as well as defined disease management guidelines
• Work with CPHO team, patient’s Primary Care Physician and all other providers of the patients’ care to develop individualized care plans
• Facilitate communication with patients and care team, coordinate referrals, and promote optimal allocation of available resources
• Measure progress toward goals based on clinical judgment, review of patients’ self-monitoring tools and trends in clinical data
• Assess and monitor adherence to outreach and then problem-solve intrinsic and extrinsic barriers to effective patient self-management of chronic conditions
• Provide educational materials and resources to patient/family and their care providers
• Refer patients/families to self-management support programs as needed and communicate with care providers to ensure safe and effective care management.
• Analyze clinical data to track patient outcomes to determine improvement
• Triage patient phone calls for acute patient issues and counsel accordingly
• Oversight and management of population health quality improvement studies to reach established targets
• Interface with Commercial and Government entities on care coordination, HEDIS and other QI activities
• Report to UM/QM Committee on progress toward goals and make recommendations for improvement
• Other duties as assigned
• Minimum qualifications must be health plan requirements, including but not limited to licensure/certification, as applicable
• Current RN licensure

Qualifications

Education

Required

Bachelors or better.

Licenses & Certifications

Required

BLS - Basic Life Supt

RN License

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.