Health Care Utilization Review Coordinator (Behavorial Health) II - Continuum of Care

Details

Posted: 18-Mar-24

Location: Chicago, Illinois

Type: Full-time

Salary: Open

Categories:

Academic/Faculty
Healthcare Administration

Internal Number: 5108250

Health Care Utilization Review Coordinator (Behavorial Health) II - Continuum of Care
Health Care Utilization Review Coordinator (Behavorial Health) II - Continuum of Care
Hiring Department: Continuum of Care
Location: Chicago, IL USA
Requisition ID: 1020635
FTE : 1.0
Work Schedule - M-F 8:30 to 4:30pm
Shift : Days
# of Position: 1
Posting Date: 1/26/2024
This position requires Illinois residency within 180 days of the hire date.
About the University of Illinois Chicago
UIC is among the nation's preeminent urban public research universities, a Carnegie RU/VH research institution, and the largest university in Chicago. UIC serves over 34,000 students, comprising one of the most diverse student bodies in the nation and is designated as a Minority Serving Institution (MSI), an Asian American and Native American Pacific Islander Serving Institution (AANAPSI) and a Hispanic Serving Institution (HSI). Through its 16 colleges, UIC produces nationally and internationally recognized multidisciplinary academic programs in concert with civic, corporate and community partners worldwide, including a full complement of health sciences colleges. By emphasizing cutting-edge and transformational research along with a commitment to the success of all students, UIC embodies the dynamic, vibrant and engaged urban university. Recent 'Best Colleges' rankings published by U.S. News & World Report, found UIC climbed up in its rankings among top public schools in the nation and among all national universities. UIC has nearly 260,000 alumni, and is one of the largest employers in the city of Chicago.
Description:
Position Summary
Health Care Utilization Review Coordinator (HURC) is accountable for coordinating and facilitating patient services across the various levels of the continuum utilizing Relationship-Based Care model as the framework. The HURC takes initiative to improve patient outcomes by integrating Shared Leadership, Evidence Based Practice and Magnet's Five Models of Care into clinical practice. Through therapeutic relationships with patients, families, self and colleagues, the HURC functions as an interdisciplinary team member who assist patients and their families in navigating through the healthcare system based on individual and patient population needs. In addition to the care facilitation, the HURC will perform related duties including utilization management, discharge planning and referral to other levels of care and fulfills unit and organizational goals
Duties & Responsibilities

Facilitates coordination of patient services in assigned patient care unit, or department

Collaborates with the patient, family, physicians, RNs, and multidisciplinary team to assure_x000d_ appropriate safe, cost effective, timely and efficient services

Identifies variations in the utilization of benefits with payors to fund the continuing or alternative care_x000d_ plan, where possible_x000d_

Provides utilization management functions for patients: pre-certification (primarily a function of the_x000d_ Admissions Department), continued stay reviews and retro-reviews. Assist physicians with determining_x000d_ CLOC and medical necessity. Facilitates appropriate clinical level of care determination and_x000d_ conversion, if necessary. Responsible for notification to the Admissions Department of CLOC_x000d_ conversions. Monitors internal and external UR guidelines for patients in assigned units or department. Communicates key UM information to units and attending physicians or their _x000d_ representative and managed care companies _x000d_

Applies approved utilization acuity criteria to monitor appropriateness of CLOC and continued stays_x000d_ and documents finding based on department standards

Inputs and maintains utilization management data into computer system

Participates in gathering and reporting data, such as variances, LOS, cost and outcomes

Qualifications:
Minimum Qualifications

Graduation from an accredited professional nursing program

Current licensure as a Registered Professional Nurse with the Illinois Department of Financial and Professional Regulation, Division of Professional Regulation.

Five years (60 months) of RN experience.

Current AHA BLS/CPR and other required unit specific certifications

Effective communication skills (oral and written) that facilitate therapeutic relationships between patients, family, and health care providers

Intermediate computer skills with the ability to become proficient in the Electronic Health Record (EHR) with on-the-job training

Excellent attendance, interpersonal skills and work history required.

Candidate must have 3-5 years experience in Behavior Health

Preferred Qualifications
BSN preferred
ACMA or CCM certified
Behavior Health Utilization Review expericence
The University of Illinois System is an equal opportunity employer, including but not limited to disability and/or veteran status, and complies with all applicable state and federal employment mandates. Please visit Required Employment Notices and Posters to view our non-discrimination statement and find additional information about required background checks, sexual harassment/misconduct disclosures, COVID-19 vaccination requirement, and employment eligibility review through E-Verify.
The university provides accommodations to applicants and employees. Request an Accommodation
Looking for more University of Illinois positions?
We invite you to search for positions at each of the University of Illinois locations, the University of Illinois System Office and the University of Illinois Foundation. The University of Illinois System Office supports the primary missions of teaching, research, public service, and economic development for all of the Universities and offers positions in all locations. The University of Illinois Foundation is the official fundraising and private gift-receiving agency for the University of Illinois and also offers position in all locations. Click the links below to search for other University of Illinois positions.
University of Illinois Urbana-Champaign
University of Illinois Springfield
University of Illinois System Office
University of Illinois Foundation
The University of Illinois System is an equal opportunity employer, including but not limited to disability and/or veteran status, and complies with all applicable state and federal employment mandates. Please visit Required Employment Notices and Posters to view our non-discrimination statement and find additional information about required background checks, sexual harassment/misconduct disclosures, and employment eligibility review through E-Verify.
To apply, visit https://uic.csod.com/ux/ats/careersite/1/home/requisition/8400?c=uic
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About University of Illinois - Chicago
The University of Illinois Chicago is the city’s largest university and its only public Carnegie Research 1 institution. Its 16 academic colleges serve close to 34,000 undergraduate, graduate and professional students. UIC is recognized as one of the best public universities and one of the most ethnically rich and culturally diverse campuses in the nation, located in the heart of Chicago, it is an integral part of the city's educational, technological and cultural fabric.
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