Utilization Review Nurse
Company: Union Health Service
Location: Chicago
Posted on: May 9, 2025
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Job Description:
*Job description**Position: Utilization Review Nurse
(UR)**Status: Full-time **Location Polk Street Center - 1634 West
Polk Street, Chicago, IL 60612**Who we are:*Union Health Service
(UHS) is an AAAHC (Accreditation Association for Ambulatory
HealthCare) accredited non-profit multi-specialty managed care plan
covering approximately 48,000 Chicago area union members and their
dependents since 1955. UHS has approximately 50 primary care
physicians, over 70 specialist physicians and a tremendous clinical
and support staff at 6 different medical facilities.UHS is proud to
be an employer that has a diverse workforce boasting multi-language
skills across the organization, merging different cultures and
heritage a proven strategy that comes with a long history of people
who have stayed in the company for many years. We have an average
length of service of over 12 years, above industry standard
employee benefits, and eighty percent of our employees are union
members.*Job Description:*Reporting to the Director of Medical
Management, the UR Nurse implements care management review
processes that are consistent with established industry and
corporate standards and are within the care managers professional
discipline.*Responsibilities:* Function in accordance with
applicable state, federal laws and regulatory compliance. Implement
all care management reviews according to accepted and established
criteria, as well as other approved guidelines and medical
policies. Promote quality and efficiency in the delivery of care
management services. Respect the members right to privacy, sharing
only information relevant to the members care and within the
framework of applicable laws. Practice within the scope of ethical
principles. Identify and refer members whose healthcare outcomes
might be enhanced by Health Coaching/case management interventions.
Employ collaborative interventions, which focus, facilitate, and
maximize the members health care outcomes. Is familiar with the
various care options and provider resources available to the
member. Educate professional and facility providers and vendors for
the purpose of streamlining and improving processes, while
developing network rapport and relationships. Develop and sustain
positive working relationships with internal and external
customers. Utilize outcomes data to improve ongoing care management
services. Other duties as assigned or requested.*QUALIFICATIONS *
Active IL RN (Registered Nurse) license / Active LPN (License
Practical Nurse) 3 - 5 years of related, progressive clinical
experience in the area of specialization Experience in a clinical
setting Preferred Experience in UM/CM/QA/Managed CareJob Type:
Full-timePay: $31.41 - $54.85 per hourExpected hours: 37.50 per
weekBenefits:* Dental insurance* Disability insurance* Employee
discount* Free parking* Health insurance* Life insurance* Paid time
off* Parental leave* Retirement plan* Tuition
reimbursementSchedule:* Day shift* Monday to FridayExperience:*
Case management: 1 year (Preferred)License/Certification:*
Certified Case Manager (Preferred)* Nursing License (Preferred)Work
Location: In personby Jobble
Keywords: Union Health Service, Chicago , Utilization Review Nurse, Healthcare , Chicago, Illinois
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