What are the responsibilities and job description for the Utilization Management & Review Specialist position at OSF HealthCare?
Pay range for this position is $33.36 - $50.34/hour. Actual pay is based on years of licensure.
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.
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
- 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.
Salary : $33 - $50
