2 ED Utilization Review Nurse Jobs in Chicago, IL
Insight is Hiring an ED Utilization Review Nurse Near Chicago, IL
Seeking a fulltime candidate to work remotely overnight as a Utilization Review Nurse in the ER. Responsibilities include screening admissions, critical thinking, and being in constant communication with the ER Physicians.
These duties are to be performed in a highly confidential manner, in accordance with the mission, values and behaviors of Insight Hospital and Medical Center. Employees are further expected to provide a high quality of care, service, and kindness toward all patients, staff, physicians, volunteers and guests.
- Under the direction of the UR/CM/CDI Director, the Nurse Manager has the functional responsibility for insuring clinical profiles are sent to the payers in a timely manner and that discharge planning begins in the first 24 hours of the patient’s inpatient encounter.
- He/she is responsible for team and individual development, utilization of human, technical and material resources and quality improvement activities at the unit and organization level.
- The Nurse Manager assists the director in fiscal responsibilities.
- Responsible for evaluating and screening potential admissions to the facility when appropriate.
- Knowledgeable of criteria for Medicare, Medicaid, HMO and private insurance coverage.
- Communicate daily with admissions personnel regarding admissions and discharges to various units.
- Initiate ongoing communication with the resident and resident’s family to assess discharge needs.
- Communicate with physicians to ascertain their plans for a timely discharge.
- Document discharge planning as an ongoing review.
- Knowledgeable of resident’s financial status, diagnosis and discharge needs.
- Responsible for home care needs being met by the time of discharge, with a goal of arrangements completed 24 hours prior to discharge when date of discharge is known.
- Cooperate with insurance companies, based on information received.
- Manage and collaborate with the healthcare team on ED Hold Bed placement and complete clinical documentation as necessary.
- Assist as needed with obtaining referrals, prior authorization for Home Health Care and DME for home use by the patient.
- Educates physicians and staff regarding appropriate level of care/utilization issues.
- Develop and implement methods, policies and procedures to improve the departments’ efficiency and overall effectiveness.
- Registered Nurse
- Available to work nights
- Available to work weekends
- Experience with UR/ Case Management (Preferred)
Job Summary
Full Time
Business Services
$99k-121k (estimate)
05/13/2023
06/24/2024
insight.com
CHARLOTTE, NC
7,500 - 15,000
1988
Public
JEFF LONGO
$5B - $10B
Business Services
Related Companies
About Insight
Insight is a provider of computer hardware, software, cloud solutions and IT services to business, government, education and healthcare sectors.
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