Case Manager Utilization Review

Case Manager Utilization Review

Case Management

Position type: Full Time
Pay/Salary: Open
Shift: 1st

Hammond-Henry Hospital, located in Geneseo, Illinios, is a critical access hospital with Family Medicine and Urgent Care Clinics proudly serving our communities and surrounding areas. We nurture an environment of encouragement, professional development, and respect. Hammond-Henry provides exceptional patient care and our employees have made us an award-winning hospital. We invite you to review the job listing below and join our award-winning team.

Incentives and Benefits at Hammond-Henry:

• Medical, Dental and Vision Insurance (FT)
• Up to $900 deposited in your Central Bank HSA for health care expenses.
• IMRF pension provides retirement income to vested employees for the rest of their lives
• Secondary 457(b) retirement option through Edward Jones
• PTO (FT/PT) – generous accrual of paid time off
• Employee Assistance Program, Tuition Scholarship and Assistance, Bi-Annual PTO Buyback.
• Long Term Sick and Short-Term Disability (PT/FT)

80 hours per pay period - benefits depend on hours worked.

Job Description

Candidate will:

• Interact with all reporting department/services and Medical Staff to enhance the quality of patient care, as well as assuring compliance with legal and regulatory agency requirements.
• Perform Utilization Reviews by communications with third party payors and documents all interactions during review process.
• Perform data collection and assist with coordination of activities with the Professional Review Organization (PRO) and regulatory or review bodies
• Perform data collection, data entry, analysis and report generation.

Access to protected health information is limited to the minimum necessary to perform the duties of the job.

Qualifications

• Graduate from an accredited school of nursing, licensed by the state of Illinois.
• Case management experience preferred.
• Knowledge of Quality Improvement goals and functions, utilization review, and risk management desired.
• Able to work independently and self-directed.