RN Admissions Coordinator - Utilization Management
Not Disclosed•Full-TimeOn-site
location_on249, West Burton Street, Eureka, Woodford County, Illinois, 61530, United States
About Carle Health
At Carle Health, we are committed to fostering a workplace where every team member feels valued, respected, and empowered. Our nearly 17,000 team members and providers work together to support patient care across central and southeastern Illinois. We operate eight award-winning hospitals and a multispecialty provider group with more than 1,500 doctors and advanced practice providers. Our commitment to excellence is recognized through Magnet® designations held by Carle BroMenn Medical Center, Carle Foundation Hospital, Carle Health Methodist Hospital, Carle Health Proctor Hospital, Carle Health Pekin Hospital, and Carle Hoopeston Regional Health Center.
We are developing the next generation of healthcare professionals through the Carle Illinois College of Medicine, the world's first engineering-based medical school, and Methodist College. We offer opportunities in several communities throughout central Illinois with potential for growth and lifelong careers.
About the Role
This position serves as a vital liaison between the hospital, external payers, and the interdisciplinary team to ensure optimal patient care outcomes on a 24-hour basis. You will be accountable for the proactive coordination and timely transition of patients to the most appropriate level of care along the continuum, specifically focusing on the Eureka Swing Bed program and acute care patients.
In this role, you will facilitate the coordination of patient care by conducting interdisciplinary rounds and discharge planning. You will screen all referrals for the Eureka Swing Bed, performing pre-authorization and concurrent utilization management (UM) for Carle Eureka Swing Bed patients. A key part of your day involves acting as the bridge between the hospital and external payers to ensure reimbursement for acute rehab and Eureka Swing Bed admissions. You will also assist in identifying appropriate admission diagnoses, managing length of stay relative to the patient's Case Mix Group (CMG), and proactively investigating coverage for post-hospital needs to present options to patients, families, and providers.
The role requires a flexible work model, primarily based on-site at Eureka from Monday through Friday, with 2 to 3 afternoons on-site at BroMenn pending census and operational needs.
Equal Opportunity Employer
Carle Health is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, basis of disability, or any other federal, state, or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.
