Job Information

AdventHealth Registered Nurse - Utilization Review in Hinsdale, Illinois

Description

YOU ARE REQUIRED TO UPLOAD RESUME, LICENSURE/CERTIFICATION WITH YOUR APPLICATION!

All the benefits and perks you need for you and your family:

  • Benefits from Day One for FT/PT positions

  • Paid Days Off from Day One for FT/PT positions

  • Student Loan Repayment Program for FT/PT positions

  • Career Development

  • Whole Person Wellbeing Resources

  • Mental Health Resources and Support

  • Debt-free Education (Certifications and Degrees without out-of-pocket tuition expense)

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Schedule: Full Time

Shift : Day

Location: AdventHealth Hinsdale

The role you’ll contribute:

Provides health care services regarding admissions, case management, discharge planning and utilization review.

The value you’ll bring to the team:

• 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.

• May prepare statistical analysis and utilization review reports as necessary.

• Oversees and coordinates compliance to federally mandated and third party payer utilization management rules and regulations.

Qualifications

The expertise and experiences you’ll need to succeed

  • Diploma from an accredited school/college of nursing required; BSN strongly preferred or currently enrolled in BSN Program; must be willing to obtain BSN within 3 years from date of hire.

  • Registered Nurse credentialed from the Illinois Board of Nursing obtained prior to hire date or job transfer date.

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Category: Case Management

Organization: AH Great Lakes Region

Schedule: 1 - Day

Shift: GLR Region Support

Req ID: 22028313

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.