Utilization Management and Review Specialist RN
US-IL-URBANA
External Apply Portal
Req #: 98445
Type: Full Time
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Overview: POSITION SUMMARY: 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, resolves and/or refers utilization issues in accordance with established procedures. Reviews medical records to determine appropriateness and medical necessity of admission and hospital stay and use of ancillary services. Qualifications: REQUIRED 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 Other skills/knowledge: Working knowledge of clinical EMR system PREFERRED QUALIFICATIONS: Education: Bachelor's Degree in Nursing Other Skills/Knowledge: Working knowledge of Microsoft Office applications OSF HealthCare is an Equal Opportunity Employer.
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