Utilization Review RN for Behavioral Health

*Job Overview*We are seeking a dedicated and detail-oriented Utilization Review Nurse with a Behavioral Health background to join our team!*All the benefits and perks you need for you and your family:** Benefits from Day One* Paid Time Off from Day One* Student Loan Repayment Program* Career Development* Whole Person Wellbeing Resources* Mental Health Resources and Support* Paid Parental Leave* Debt-free Education (Certifications and Degrees without out-of-pocket tuition expense*Location:* UChicago Medicine I AdventHealth GlenOaks Hospital 701 Winthrop Ave, Glendale Heights, IL*Schedule:* Full-Time 36 hours/week, 11am - 7pm (hours may change based on business need, No weekends/holidays*The role you'll contribute:*Provides health care services regarding admissions, case management, discharge planning and utilization review.*The value you'll bring to the team:** Reviews admissions and service requests within assigned unit for prospective, concurrent and retrospective medical necessity and/or compliance with reimbursement policy criteria. Provides case management and/or consultation for complex cases.* Assists departmental staff with issues related to coding, medical records/documentation, precertification, reimbursement and claim denials/appeals.* Assesses and coordinates discharge planning needs with healthcare team members.* May prepare statistical analysis and utilization review reports as necessary.* Oversees and coordinates compliance to federally mandated and third-party payer utilization management rules and regulations.Qualifications*The expertise and experiences you'll need to succeed:** Diploma from an accredited school/college of nursing required.* Behavioral Health RN experience strongly preferred* Experience in utilization review strongly preferred* Registered Nurse credentialed from the Illinois Board of Nursing obtained prior to hire date or job transfer date.This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.Job Type: Full-timePay: $36.00 - $50.40 per hourExpected hours: 36 per weekBenefits:* Dental insurance* Health insurance* Health savings account* Life insurance* Paid time off* Parental leave* Referral program* Retirement plan* Tuition reimbursement* Vision insuranceSchedule:* 8 hour shift* Day shift* No weekendsExperience:* Utilization review: 1 year (Required)* Behavioral health: 1 year (Required)License/Certification:* RN (Required)Ability to Commute:* Glendale Heights, IL 60139 (Required)Ability to Relocate:* Glendale Heights, IL 60139: Relocate before starting work (Required)Work Location: In person

Created: 2025-02-03