Utilization Mgmt Nurse Rev Cycle

Schedule Details/Additional Information:

• Position is remote.

  Full time -80 hours a pay period.

  Monday- Friday-8:30-5pm-Every 5th weekend required. One summer and one winter holiday required.

Strongly prefer candidates with current Utilization Review or Care Management experience

This is a remote position.

• Utilization Management Registered Nurse

  The ideal candidate will have a BSN and a background in Utilization Review

  Be able to do 25-28 reviews a day for 9 of the Advocate Aurora hospitals.

  Strong communication skills required to communicate with providers

  Familiarity with Milliman Care Guidelines a plus

  Position Requirements:

  Level of Education: Bachelor`s Degree in Nursing

  Years of Experience: 3+ Years of experience in clinical nursing Utilization Review case and/or quality management. Working knowledge in the use of Microsoft Office (Excel Outlook PowerPoint and Word) or similar products. Knowledge of the components of quality and acute care patient care needs specifically related to the area/function in which care management will be performed.

  Demonstrated working knowledge and accurate application of evidence based nationally recognized Utilization Review criteria as evidenced by achieving 80 percent or greater on the annual Inter Rater Reliability (IRR) competency exam. Critical thinking skills to analyze and synthesize clinical scenarios as it relates to application of medical necessity criteria. Excellent analytical and interpersonal communication skills necessary to interact with colleagues physicians and third~ party payers. Ability to foster and maintain effective professional relationships with physicians and other professionals in a direct and positive manner. Ability to manage conflict appropriately and communicating with others in a manner that aligns with Advocate Aurora`s Behaviors of Excellence

  initiatives. Ability to be flexible and function well in the everchanging fast~ paced heavily regulated health care/payer environment and to comply to expectation of strict adherence to predetermined process

• Schedule Details/Additional InformationSchedule Details/Additional Information

  Position is remote. May have to go into the office for some meetings-Oakbrook, Illinois.

  Full time -80 hours a pay period.

  Monday- Friday-8:30-5pm-Every 5th weekend required. One summer and one winter holiday required.

Attachments

Pay Range

Our Commitment to You:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
• Premium pay such as shift, on call, and more based on a teammate's job
• Incentive pay for select positions
• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

About Advocate Health

Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.