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Registered Nurse Utilization Review Specialist-Lisle

Company: AMITA Health
Location: Lisle
Posted on: September 19, 2018

Job Description:

Additional Job Information
Title:--RN-Spclst-Utilization
ReviewCity, State: Lisle,ILLocation: NavistarDepartment: Total Quality Management
002Additional Job
Details: Full-Time,Day,--40
hours,Weekly.About Us
AMITA
Health (www.AMITAhealth.org)
is a joint operating company formed by--the Adventist
Health System in Altamonte Springs,
FL and St.Louis, MO based
Ascension. With the addition of Presence Health,
AMITA Health is now the largest health system in Illinois,
comprising 19 hospitals and more than 230 sites of care.The newly
combined health system has 900 providers in its medical groups,
more than 26,000 associates and 7,000 physician partners and now
serves over 4.3 million residents in the greater Chicagoland
area.Job
Description Job
Summary:Provides health care
services regarding admissions, case management, discharge planning
and utilization
review.Responsibilities:Reviews
admissions and service requests within assigned unit for
prospective, concurrent and retrospective medical necessity and/or
compliance with reimbursement policy criteria.Provides case
management and/or consultation for complex
cases.Assists departmental staff with issues
related to coding, medical records/documentation, precertification,
reimbursement and claim
denials/appeals.Assesses and coordinates
discharge planning needs with healthcare team
members.Prepares statistical analysis and
utilization review reports as
necessary.QualificationsLicenses/Certifications/Registration:Required
Credential(s):Licensed--Registered Nurse--credentialed from
the--Illinois Board of
Nursing--obtained prior
to hire date or job transfer
date.--Preferred
Credential(s):Certified--Case
Manager--credentialed from the--American Case Management Association
(ACMA).--Certified--Case
Manager--credentialed from the--Commission for Case Manager Certification
(CCMC).--Certification--specializing
in--Utilization
Review--credentialed from
the--American Board of Quality
Assurance and Utilization Review Physicians, Inc.
(ABQAURP).--Education:Diploma--Graduate of an
accredited school of nursing required Bachelor's of science in
nursing
preferredWork
Experience:Three or
more years of clinical experience required.One or more years of
utilization review experience in the hospital or insurance industry
preferred.How To
Apply We urge you to apply to any/all
positions that you have interest in. If you fit the
qualifications for the role, we will reach out to you. Please ensure you complete all required fields within the
application (indicated with an asterisk), as well as additional
information that is requested of you. Information that
you offer us will better assist us in understanding your
qualifications and fit for the position(s) you've applied
for.Equal Employment
Opportunity AMITA Health will provide
equal employment opportunities (EEO) to all associates and
applicants for employment regardless of race, color, religion,
national origin, gender, sexual orientation, gender identification
or expression, age, disability, marital status, amnesty, genetic
information, carrier status or any other legally protected status
or status as a covered veteran in accordance with applicable
federal, state and local laws.

Keywords: AMITA Health, Janesville , Registered Nurse Utilization Review Specialist-Lisle, Healthcare , Lisle, Wisconsin

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