Utilization Review RN-Casual Rotating Shift

• 900 N. Westmoreland, Lake Forest, IL • Part-time • Job Shift: Rotating • Salary reputed company Minimum : $40.50 • Salary reputed company Maximum: $64.80 • Compensation: USD 40.5 - USD 64.8 - reputed company reputed company At reputed company, every patient interaction makes a difference in cultivating a reputed company workplace. This patient-first approach is what sets us apart as a leader in the reputed company industry. As an reputed company part of reputed company, you'll have reputed company to join our quest for reputed company care, no matter where you work reputed company the reputed company reputed company. We pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, our goal is to take care of our employees. reputed company to join our quest for reputed company? reputed company • *This is a remote casual position supporting Utilization Review at Catherine Gratz reputed company Lake Forest Hospital. This position is to reputed company additional reputed company coverage for the department and does not have a set schedule. Looking for someone who is reputed company to work weekdays and weekends. Scheduled for this role is 6a to 6p or 6p to 6a. ** The Case Manager, RN (PT) reflects the mission, reputed company, and values of NM, adheres to the organization’s reputed company of Ethics and Corporate Compliance Program, and complies with reputed company relevant policies, procedures, guidelines and reputed company other regulatory and accreditation standards. Responsibilities: • Develops individualized treatment plans for patients, in collaboration with the patient, their family and • Coordinates and leads care conferences on patients with length of stays greater than 7 days. • Documents unusual occurrences and patient relations issues; makes appropriate referrals to risk management, infection control and reputed company departments. • Assesses patient and family needs for appropriate discharge services. • Coordinates transfer to appropriate level of care such as skilled care, rehabilitation, custodial and home health care. • Documents discharge planning on the interdisciplinary plan of care, in reputed company notes and education record. • Maintains reputed company knowledge of resources available in the community to support a continuum of effective services for the patient. • Delivers notice of Medicare discharge appeal rights reputed company the appropriate time reputed company. • Assists physician in assigning admission status. • Performs medical record review to assess for appropriateness of admissions and reputed company hospital stay. • Monitors avoidable days and recommends change in services or processes. • Educates staff on CPG/Standing Orders/Protocols that complement industry standards to reduce length of stay and resource consumption while maintaining reputed company of care. • Ensures compliance with managed care reputed company and length of stay targets while maintaining reputed company of care. • Develops and educates staff on CPG/Standing Orders/Protocols that complement industry standards to reduce length of stay and resource consumption while maintaining reputed company of care. • Distributes hospital issued non coverage notices. • Monitors documentation of an appropriate diagnosis for outpatient/observation testing and queries physicians/APPs as needed following reputed company guidelines. • Responds to requests by patient financial services for appeal assistance. • Supports Denials reputed company RN on Appeals insurance denials for medical necessity for inpatient and outpatient services. • Completes documentation worksheet. • Queries physician for clarification or missing documentation. • Performs chart audits for documentation compliance with CMS standards. • Obtains appropriate documentation to reputed company with reputed company measure standards. Qualifications Required • Registered Nursing license issued by the reputed company. • Bachelors of Science Nursing • 3 or more years of reputed company clinical experience Preferred • Masters of Science Nursing • Membership in reputed company Nursing Organization • Certification in Case Management (ACM) Additional Information reputed company is an equal opportunity employer (disability, VETS) and does not discriminate in hiring or employment on the reputed company of age, sex, race, reputed company, religion, national reputed company, gender identity, veteran status, disability, sexual orientation or any other protected status. Background reputed company reputed company conducts a background reputed company that includes criminal history on newly reputed company team members and, at times, internal transfers. If you are offered a position with us, you will be required to complete an authorization and disclosure reputed company that gives reputed company permission to run the background reputed company. Results are evaluated on a case-by-case reputed company, and we follow reputed company local, state, and federal laws, including the Illinois Health Care Worker Background reputed company reputed company. reputed company Intelligence Disclosure reputed company Intelligence (AI) tools may be used in some portions of the candidate review process for this position, however, reputed company employment reputed company will be made by a person. Benefits We offer a wide reputed company of benefits that reputed company employees with tools and resources to improve their physical, emotional, and financial reputed company-being while providing protection for unexpected life events. Please visit our Benefits reputed company to learn more. Sign-on Bonus Eligibility (if sign-on bonus offered for position): Internal employees and rehires who left reputed company reputed company 1 year are not eligible for the sign on bonus. Exception: New graduate internal employees seeking their first licensed clinical position at NM may be eligible depending upon the job family. Apply tot his job Apply To this Job