Mid Level Utilization Review Nurse Jobs

UI Health - Healthcare Utilization Review Coordinator II

Hiring Department: Continuum of Care

Location: Chicago, IL USA

Requisition ID: 1042977

FTE: 0.2

Work Schedule: week days and weekends

Shift: Days

# of Positions: 2

This position requires Illinois residency within 180 days of the hire date.

Pay Range: The previously determined range for this position was $42.12- $94.29. The final rate offered will be determined by the collective bargaining agreement, internal salary equity, candidate experience and qualifications, and budget constraints. It is not typical for an individual to be offered a rate at or near the top of the full range for a position.

About the University of Illinois Hospital & Health Sciences System (UI Health)

The University of Illinois Hospital & Health Sciences System (UI Health) provides comprehensive care, education, and research to the people of Illinois and beyond. A part of the University of Illinois Chicago (UIC), UI Health comprises a clinical enterprise that includes a Joint Commission-accredited tertiary care hospital and outpatient clinics, and the Mile Square Health Center network of federally qualified health centers. It also includes the seven UIC health science colleges: the College of Applied Health Sciences; the College of Dentistry; the School of Public Health; the Jane Addams College of Social Work; and the Colleges of Medicine, Pharmacy, and Nursing, including regional campuses in Peoria, Quad Cities, Rockford, Springfield, and Urbana. UI Health is dedicated to the pursuit of health equity. Learn more: https://hospital.uillinois.edu/about-ui-health

This position is intended to be eligible for benefits. This includes Health, Dental, Vision, Life Insurance, a Retirement Plan, Paid time Off, and Tuition waivers for employees and dependents.

Position Summary
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

Preferred Qualifications

• Case management certification

• EPIC experience

• Prior discharge planning experience

To Apply: For fullest consideration click on the Apply Now button, please fully complete all sections of the online application including adding your full work history with specific details of your duties & responsibilities for each position held. Fully complete the education, licensure, certification and language sections. You may upload a resume, cover letter, certifications, licensures, transcripts and diplomas within the application.

Please note that once you have submitted your application you will not be able to make any changes. In order to revise your application you must withdraw and reapply. You will not be able to reapply after the posting close date. Please ensure the application is fully completed and all supporting documents have been uploaded before the posting close date.

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.

The university provides accommodations to applicants and employees. Request an Accommodation

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.