at University of Illinois at Chicago in Chicago, Illinois, United States
Job Description
Health Care Utilization Review Coordinator
Health Care Utilization Review Coordinator
Hiring Department: Health Care Utilization Review Coordinator
Location: Chicago, IL USA
Requisition ID: 1026708
Posting Close Date: 08/23/2024
FTE: 1.0
Shift: Days
About the University of Illinois Chicago
UIC is among the nation's preeminent urban public research universities, a Carnegie RU/VH research institution, and the largest university in Chicago. UIC serves over 34,000 students, comprising one of the most diverse student bodies in the nation and is designated as a Minority Serving Institution (MSI), an Asian American and Native American Pacific Islander Serving Institution (AANAPSI) and a Hispanic Serving Institution (HSI). Through its 16 colleges, UIC produces nationally and internationally recognized multidisciplinary academic programs in concert with civic, corporate and community partners worldwide, including a full complement of health sciences colleges. By emphasizing cutting-edge and transformational research along with a commitment to the success of all students, UIC embodies the dynamic, vibrant and engaged urban university. Recent "Best Colleges" rankings published by U.S. News & World Report, found UIC climbed up in its rankings among top public schools in the nation and among all national universities. UIC has over 300,000 alumni, and is one of the largest employers in the city of Chicago.
Description:
Position Summary
a. Facilitates coordination of patient services in assigned patient care unit, or department.
b. Collaborates with patient, family, physician(s), RN(s), and multidisciplinary team to ensure appropriate safe, cost effective, timely and efficient services. Utilize critical and social work experts as needed to ensure delivery of comprehensive patient services.
c. Collaborates and communicates with all staff in developing and implementing the Admission planning process including appropriate Clinical Level of Care (CLOC), continued stay and patient assessment (for appropriate CLOC), planning, Implementation, interdisciplinary collaboration and ongoing evaluation.
d. Identifies variations in the utilization of benefits with payers to fund the continuing or alternative care plan where possible,
e. Documents risk assessment and pre-certification information in the electronic medical record according to department standards.
f. Communicates key UM information to units and attending physicians o
Duties & Responsibilities
a. Facilitates coordination of patient services in assigned patient care unit, or department.
b. Collaborates with patient, family, physician(s), RN(s), and multidisciplinary team to ensure appropriate safe, cost effective, timely and efficient services. Utilize critical and social work experts as needed to ensure delivery of comprehensive patient services.
c. Collaborates and communicates with all staff in developing and implementing the Admission planning process including appropriate Clinical Level of Care (CLOC), continued stay and patient assessment (for appropriate CLOC), planning, Implementation, interdisciplinary collaboration and ongoing evaluation.
d. Identifies variations in the utilization of benefits with payers to fund the continuing or alternative care plan where possible,
e. Documents risk assessment and pre-certification information in the electronic medical record according to department standards.
f. Communicates key UM information to units and attending physicians or their representatives and managed care companies as it relates to pre-certifications.
g. Applies approved utilization acuity criteria to monitor appropriateness of CLOC and documents findings based on department standards.
h. Inputs and maintains UM data into electronic medical record.
i. Maintains expertise through participation in continuing education program. Serves as experienced resource and patient services facilitation reference for care team members.
j. Participates in internally and externally driven quality improvement programs
Perform other related duties and participate in special projects as assigned.
Qualifications:
Minimum Qualifications
1. Graduation from an accredited professional nursing program
2. Current licensure as a Registered Professional Nurse with the Illinois Department of Financial and Professional Regulation, Division of... For full info follow application link.
The University of Illinois may conduct background checks on all job candidates upon acceptance of a contingent offer. Background checks will be performed in compliance with the Fair Credit Reporting Act.
The University of Illinois Chicago is an affirmative action, equal opportunity
institution/employer and does not discriminate on the basis of race, color, national origin, sex, religion, age, sexual orientation, gender identity, veteran or disability status, height, weight, or marital status in employment or the provision of services.
