[Hiring] RN Utilization Management & Review Specialist @OSF HealthCare

Role Description

The Utilization Management and Review Specialist (UMR Specialist) evaluates patient care and activities against objective criteria in an effort to take a proactive approach in addressing appropriate admission status of each patient. In addition, the UMR Specialist will:

• Identify utilization issues involving under or over utilization of services.
• Resolve and/or refer utilization issues in accordance with established procedures.
• Review medical records to determine appropriateness and medical necessity of admission and hospital stay and use of ancillary services.

This position has the potential to be fully remote after 6 months of training and at the discretion of leadership. The nurse must live within traveling distance of an OSF facility.

Qualifications

• Education: Bachelor's Degree in Nursing must be obtained within 3 years of date of hire into role.
• Experience: 2 years of clinical experience in an acute care or managed care setting.
• Licensure/Certifications: Current state license as Registered Nurse (IL).
• Other skills/knowledge: Working knowledge of clinical EMR system.

Requirements

• Education: Bachelor's Degree in Nursing.
• Other Skills/Knowledge: Working knowledge of Microsoft Office applications.

Benefits

• Comprehensive and market-competitive total rewards package that includes benefits, compensation, recognition, and well-being offerings.
• Pay range for this position is $34.25 - $51.13/hour. Actual pay is based on years of licensure.
• This is a salaried position.

Company Description

OSF HealthCare is dedicated to providing Mission Partners with a comprehensive and market-competitive total rewards package that focuses on the whole person and engages with their current stage of life and career.