Utilization Review Nurse: Case Management & Payer Liaison

Advocate Aurora Health; Oak Brook (IL); On-site; USD 50,000 - 73,000; Part time

Benefits offered by this job

Paid Time Off

Health benefits

Educational Assistance Program

Job summary

Advocate Aurora Health is seeking a part-time Utilization Management RN to document and review care using established criteria. You will collaborate with medical staff and multi-disciplinary teams to expedite appropriate service delivery and ensure regulatory compliance.

The role requires a Bachelor’s in Nursing and an RN license, with typical UM experience. Office-based in Illinois, with the department focused on Utilization Management.

Qualifications

• Bachelor's Degree in Nursing (or equivalent) required.
• Typically requires 3 years of experience in clinical nursing, utilization and/or quality management.
• Registered Nurse license issued by the state where you practice.

Responsibilities

• Documents utilization review activity per department and medical center standards in a timely manner.
• Communicates effectively with the healthcare team and expedites care delivery.
• Collaborates with physicians, managers, and teams to ensure accurate status and regulatory compliance.
• Maintains knowledge of healthcare regulations and reimbursement issues affecting UM activities.

Skills

Nursing experience

Communication skills

Critical thinking

Education

Bachelor's Degree in Nursing

Tools

Microsoft Office

IRR competency

Job description

Advocate Aurora Health is seeking a part-time Utilization Management RN to document and review care using established criteria. You will collaborate with medical staff and multi-disciplinary teams to expedite appropriate service delivery and ensure regulatory compliance.

The role requires a Bachelor’s in Nursing and an RN license, with typical UM experience. Office-based in Illinois, with the department focused on Utilization Management.