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Utilization Review Nurse

Health Care | Chicago, IL | Full Time

Job Description
InGenesis, Inc. is seeking a highly qualified Utilization Review Nurse to work at our client in Chicago, IL.  Hours are Monday – Friday, 40 hours per week.


QUALIFICATIONS
  • Registered Nurse (RN) with valid, current, unrestricted IL license.
  • 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.
  • Utilization management experience, preferred.
  • MCG Certification, preferred.


DUTIES
  • Perform 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.



ABOUT US
Established in 1998, InGenesis enjoys a long history of positive government and commercial relationships with healthcare industry professionals and businesses nationwide. We are the recent recipients of an Inc. 5000 award and dedicated to servicing our customers.
InGenesis is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin.