Rush University Medical Center  Nurse Certification Coord RN in Chicago, Illinois

Job Title: Nurse Certification Coord RN

Department: Utilization Mgt

Shift: 1st

Full/Part: Active Regular FT (72 to 80 hours per pay period)

Specialty: Case Management

Job Number: 2018-2533

Job Description:

Nurse Certification Coordinator

We are seeking an experienced and highly motivated Nurse Certification Coordinator focused on Utilization Review to join our Case Management team at Rush University Medical Center!

Position Highlights :

  • The Nurse Certification Coordinator assists in maintaining patient insurance certification, denial avoidance, and/or working post discharge level of care work queues.

  • Monday-Friday Days

Responsibilities:

  • Review cases for commercial and governmental payers, apply criteria and the concurrent/post discharge review process to maintain certification at the appropriate level of care.

  • Function as an expert clinical practitioner and resource within the Certification/Level of Care team regarding admission and ongoing stay reviews Manage complex caseload

  • Support process improvement and problem resolution.

  • Utilize the CM information system and appropriate technologies.

  • Assist with training, and orientation for staff and new employees as needed.

  • Provide team and department support. Promote customer satisfaction among patients, families, physicians, external case managers, payers, vendors, Care Managers, Patient Access, and Collections/Billing staff.

Qualifications:

  • Current IL RN license.

  • Bachelor’s degree from an accredited university required (except current Rush employees working as RN before May, 2016).

  • Three or more years of experience as a health care provider for the Psychiatric, neonate, pediatric, adolescent, adult and/or geriatric patients required.

  • Utilization review experience preferred

  • Certification in criteria application or Care Management is required (or a commitment to obtain with. 2.5 years).

  • Prior training /experience with nationally accepted clinical criteria, willingness to complete criteria training and meet InterQual Interrater Reliability expectations.

  • Excellent Customer service skills required.

  • Ability to perform tasks independently, prioritize workload, and interpret data is required.

  • Experience or ability to master information systems and windows technology and competency within the CM Information System(s).

  • Team building skills are required.

Company Highlights:

  • Ranked among the top academic medical centers in the country, Rush University Medical Center is an outstanding place to enhance your career. Everything we do centers on one goal: improving patient care.

  • Rush University Medical Center is a four-time Magnet® facility, the highest recognition given for nursing excellence. Rush was also the first hospital in Illinois serving adults and children to receive Magnet status.

  • Rush was ranked Best Hospital in Illinois for Nurses in 2017 by Nurse.org.

  • Ranked among the top 20 best places to work in healthcare by Indeed.

  • Rush offers a competitive salary, and valuable healthy living benefits including: health, dental and vision to help you maintain and improve your health. Rush also offers several ways to invest in your future.

Rush is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.