RN Utilization Management & Review Specialist

Total Rewards "Your life - our Mission" OSF HealthCare is dedicated to provide Mission Partners with a comprehensive and market-competitive total rewards package that includes benefits, compensation, recognition and well-being offerings that focus on the whole person and engage with their current stage of life and career. Click here to learn more about benefits and the total rewards at OSF. Pay range for this position is $34.25 - $51.13/hour . Actual pay is based on years of licensure. This is a Salaried position. Overview POSITION SUMMARY: The Utilization Management and Review Specialist (UMR Specialist) evaluates patient care and activities against objective criteria in an effort to take a proactive approach in addressing appropriate admission status of each patient. In addition the UMR Specialist will identify utilization issues involving under or over utilization of services, resolves and/or refers utilization issues in accordance with established procedures. Reviews medical records to determine appropriateness and medical necessity of admission and hospital stay and use of ancillary services. Remote: This has the potential to be a fully remote-working position after 6 months of training and at the discretion of leadership. This nurse must live within traveling distance of an OSF facility. Qualifications REQUIRED QUALIFICATIONS: Education: Bachelor's Degree in Nursing must be obtained within 3 years of date of hire into role. Experience: 2 years of clinical experience in an acute care or managed care setting Licensure/Certifications: Current state license as Registered Nurse (IL) Other skills/knowledge: Working knowledge of clinical EMR system PREFERRED QUALIFICATIONS: Education: Bachelor's Degree in Nursing Other Skills/Knowledge: Working knowledge of Microsoft Office applications OSF HealthCare is an Equal Opportunity Employer. REQUIRED QUALIFICATIONS: Education: Bachelor's Degree in Nursing must be obtained within 3 years of date of hire into role. Experience: 2 years of clinical experience in an acute care or managed care setting Licensure/Certifications: Current state license as Registered Nurse (IL) Other skills/knowledge: Working knowledge of clinical EMR system PREFERRED QUALIFICATIONS: Education: Bachelor's Degree in Nursing Other Skills/Knowledge: Working knowledge of Microsoft Office applications OSF HealthCare is an Equal Opportunity Employer.