University of Chicago Medicine

  • Care Manager - Utilization Management, Full-Time Days

    Requisition Post Information* : Posted Date 2 months ago(11/2/2018 10:00 AM)
    Job ID
    2018-15801
    Benefits Eligible
    Yes
    Shift
    Day
  • Job Description

    Bring Your Passion to the Forefront:

    Care Manager – Utilization Management

    Intro paragraph:

     

    Join the hospital trusted by Chicago’s Southland, Ingalls Memorial Hospital, in this role as a Care Manager for Utilization Review.

     

    JOB DUTIES:

    Performs utilization management functions on all patients: admission, continued stay reviews and clinical updates as requested. Monitors and implements UM guidelines. Communicates key UM functions to nursing units and physicians or their designee. Makes appropriate referrals to Physician Advisor and hospital Physician Advisor designees.
    Tracks variances, LOS, resource consumption and outcomes. Participates in data collection, analytics and reporting outcome data.

    • Evaluates, coordinates and documents all activities related to clinical approval/denial process and communicates relevant information to patient/family, members of multidisciplinary team, hospital departments, physician and payer.

     

    Required Qualifications 

    • BSN Required 
    • Preference for 3 years prior clinical case management or payer experience
    • Prefer ACM or CCM certification or attainment within 2 years of hire
    • Milliman Care Guideline experience

      Payer relation experienced

    EEO Statement:  

    Ingalls is an equal opportunity employer.  We evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status and other legally protected characteristics.

    Why Join Us

    For nearly a century we have pioneered sophisticated clinical care and developed the area's most convenient network of comprehensive outpatient centers, all dedicated to improve the health and wellbeing of the community. Now, partnered with UChicago Medicine, we have expanded our network of expert physicians, convenient facilities and scope of service to speed your healing process and help navigate your path to wellness. A skilled Medical Staff and talented employees dedicated to prevention, diagnosis, treatment and rehabilitation of illness and injury provide a firm foundation for our reputation for quality.

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