Utilization Review RN

Kelly Services is seeking qualified candidates for a Utilization Management Coordinator RN! This is a direct hire opportunity working for a large healthcare corporation in Chicago, IL.

 

BASIC FUNCTION

This position is responsible performing initial, concurrent review activities; discharge care coordination for determining efficiency, effectiveness and quality of medical/surgical services and serving as liaison between providers and Medical and Network Management Divisions. This position reviews service requests, collects clinical and non-clinical data, verifies eligibility, determines benefit levels in accordance to contract guidelines, prepares reports on quality of care, identifies and reports cases, and provides information regarding utilization management requirements and operational procedures to members, providers and facilities. 

 

JOB REQUIREMENTS

* Registered Nurse (RN) with valid, current, unrestricted license in the state of operations.

* 3 years of clinical experience in a physician office, hospital/surgical setting or health care insurance company. 

* Knowledge of medical terminology and procedures.

* Verbal and written communication skills.

* Willingness and ability to travel

 

PREFERRED JOB REQUIREMENTS

*Utilization Management or Case Management experience, highly desired

*In-patient experience, highly desired

*Specialty - O/R, Cardio, etc.

*MCG Certification.

Why Kelly®?

As a worker today, it’s up to you to take charge of your career and look for opportunities to learn, grow, and achieve your potential. Helping you find what’s next is what we’re all about. We know what’s going on in the evolving world of work—just ask the nearly 500,000 people we employ each year. Connecting with us means getting the support, guidance, and opportunities needed to take your career where you may have never imagined.

About Kelly®

At Kelly, we’re always thinking about what’s next and advising job seekers on new ways of working to reach their full potential. In fact, we’re a leading advocate for temporary/nontraditional workstyles, because we believe they allow flexibility and tremendous growth opportunities that enable a better way to work and live. Connecting great people with great companies is what we do best, and our employment opportunities span a wide variety of workstyles, skill levels, and industries around the world.

Kelly is an equal opportunity employer committed to employing a diverse workforce, including, but not limited to, minorities, females, individuals with disabilities, protected veterans, sexual orientation, gender identity. Equal Employment Opportunity is The Law.

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