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 several of our facilities, representing the nation's highest honor for nursing care.
We are developing the next generation of healthcare professionals through the Carle Illinois College of Medicine and Methodist College. Whether you are looking for opportunities in Eureka, BroMenn, or other communities throughout central Illinois, we offer potential for growth and lifelong careers where passion and purpose come together to positively impact the lives of our patients and communities.
About the Role
This position serves as a vital link in the continuum of care, ensuring appropriate admission decisions and facilitating the coordination of patient care on a 24-hour basis. You will act as a proactive liaison between the hospital, external payers, and the interdisciplinary team to optimize patient outcomes and manage the transition of care from acute settings to appropriate levels of care, such as the Eureka Swing Bed program.
In this role, you will oversee the functional and financial outcomes for patients requiring hospitalization, conducting initial assessments, ongoing evaluations, and discharge planning. Your day-to-day involves collaborating with physicians, charge nurses, and families to determine the next level of care, manage length of stay, and ensure safe transitions. You will perform pre-authorization and concurrent utilization management, ensuring compliance with Medicare regulations and reimbursement standards while advocating for the patient's needs throughout their journey.
Work Environment
This role operates primarily on-site at Eureka, Monday through Friday. Depending on census and operational needs, you will also work 2 to 3 afternoons on-site at BroMenn. The position requires flexibility to support the dynamic needs of the acute and swing bed programs.
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, or basis of disability. We are committed to building a diverse and inclusive workforce that reflects the communities we serve.
Work location
Work model: On-site
Similar Job Opportunities
Skills, education and keywords
Skills: Case Management, Basic Life Support, BLS, National Nursing Certification, Registered Professional Nurse, RN, Emr, Utilization Management, Um, Medicare.
Education: Bachelor's Degree in Nursing required.
Frequently asked questions about RN Admissions Coordinator - Utilization Management at Carle Health
What does a RN Admissions Coordinator - Utilization Management at Carle Health do?expand_more
In this RN Admissions Coordinator - Utilization Management at Carle Health role, you will coordinate patient admissions and transitions across the continuum of care; conduct preauthorization and concurrent utilization management reviews; perform clinical assessments to determine appropriate level of care; and serve as liaison between hospital and external payers for reimbursement.
What are the requirements for this RN Admissions Coordinator - Utilization Management role?expand_more
To qualify for the RN Admissions Coordinator - Utilization Management at Carle Health position, applicants should have: Licensed Registered Professional Nurse (RN) - Illinois; Bachelor's Degree in Nursing; National Nursing Certification within 3 years; Basic Life Support (BLS) within 30 days; 2+ years Nursing RN experience; and Case management experience preferred.
Where is the RN Admissions Coordinator - Utilization Management role at Carle Health located?expand_more
RN Admissions Coordinator - Utilization Management at Carle Health is based in 249, West Burton Street, Eureka, Woodford County, Illinois, 61530, United States. This is a on-site role.