RN Case Manager

General Summary:

Under general supervision and according to established procedures, collects pertinent information relating to the admission of patients to the hospital, their continued stay and the appropriate use of hospital resources and facilities. Reviews concurrently the information using guidelines developed and approved by the Utilization Review Committee. Acts as liaison with insurance and third party payer for review. Age specific and using principles specific to pediatrics, adolescents, adult and elderly patients.

Qualifications:

1. Mustbe RN or LPN, licensed in Illinois, BSN or MSN preferred

2. Must be knowledgeable and supportive of all aspects of the utilization review program

3. Min 3 years experience working with patients in a clinical setting

4. Must possess strong oral and written communication skills

5. Must possess analytical ability in order to objectively collect and evaluate data to define trends in patterns of utilization

6.Should demonstrate a high degree of clinical nursing skills with the ability to make objective professional judgements