Utilization Management RN (Illinois) (85257)

Centurion Health; Springfield (IL); On-site; USD 81,000 - 99,000; Full time

Benefits offered by this job

Health, dental, vision insurance

401(k) with company match

Generous paid time off

Paid holidays

Flexible Spending Account

Continuing Education benefits

Job summary

Centurion Health is seeking a Full-Time Utilization Management (UM) RN to join the Springfield Regional Team in Illinois. The RN will perform utilization review for statewide systems to ensure appropriate levels of care for inpatient and outpatient cases.

Must hold an Illinois RN license and have experience in utilization review; proficiency in Word/Excel and CPR/BLS certification required. Security clearance may be needed and the role is based in Springfield, IL.

Qualifications

• Licensed RN with an active license to practice in Illinois.
• Experience performing utilization review in inpatient, outpatient, or managed care settings.
• Proficiency in Word and Excel required.
• Minimum of one year of work experience as an RN in a community outpatient clinic, hospital or long-term care facility preferred.
• Experience with InterQual preferred.
• Corrections experience preferred.
• Must be appropriately and actively certified in CPR/BLS.
• Ability to obtain a security clearance, to include drug screen and criminal background check

Responsibilities

• UM RN provides utilization review services for statewide systems.
• Reviews inpatient admissions and outpatient referrals to ensure appropriate levels of care.
• Evaluates evidence-based medical necessity and quality of care.

Skills

Utilization review

MS Word

MS Excel

CPR/BLS

Security clearance

Corrections experience

Education

Bachelor's degree

Tools

InterQual

Microsoft Word

Microsoft Excel

Job description

Job Details

Job Location: IL Regional Office - Springfield, IL, Position Type: Full-Time, Education Level: Bachelor's Degree, Salary Range: Undisclosed, Job Shift: Day, Job Category: Nursing Professional & Support, Salary of $90k+.

Must be located in Illinois.

Centurion is proud to be the provider of comprehensive services to the Illinois Department of Corrections. We are currently seeking a Full-time Utilization Management (UM) Registered Nurse (RN) to join our Regional Team in Springfield, Illinois.

The UM RN is responsible for providing utilization review services for statewide systems. This person reviews inpatient admissions and outpatient referrals to ensure appropriate levels of care and evaluate evidence based medical necessity and quality of care.

Qualifications

• Licensed RN with an active license to practice in Illinois
• Previous experience performing utilization review in an inpatient or outpatient setting or in a managed care setting
• Proficiency in Microsoft Word and Excel required
• Minimum of one year of work experience as an RN in a community outpatient clinic, hospital or long-term care facility preferred
• Experience with InterQual preferred
• Corrections experience preferred
• Must be appropriately and actively certified in Cardio-Pulmonary Resuscitation (CPR)/ BLS
• Ability to obtain a security clearance, to include drug screen and criminal background check

Benefits

• Health, dental, vision, disability and life insurance
• 401(k) with company match
• Generous paid time off
• Paid holidays
• Flexible Spending Account
• Continuing Education benefits
• Much more...