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Utilization Review Registered Nurse - St. Louis Children's Hospital in Brooklyn, IL

Job Description

Additional Information About the Role This is a great opportunity for a local remote position!Benefits eligibleMonday - Friday; days; 6:30am-3:00pm40 hours per weekSaturday rotation (approximately 4 per year)No nights, no holidays, no callOnsite orientation/training requirements: Onsite orientation for at least the first 2 weeksVarious onsite trainings throughout the yearAdditional Preferred RequirementsAt least 2 years of recent hospital-based RN experienceAt least 1 year of Utilization Review/Utilization Management experienceMust live within one hour of St. Louis Children's Hospital (One Children's Place, St. Louis, MO 63110)EPIC experience Overview St. Louis Children’s Hospital is dedicated to improving the health and lives of children. As one of the top-ranked children’s hospitals in the country, St. Louis Children’s provides care in more than 50 specialty areas through a dedicated team of physicians, nurses, staff and volunteers. Along with inpatient and outpatient medical care, the hospital offers education, wellness and injury-prevention programs to fulfill its mission to “do what’s right for kids.” Providing comprehensive, high-quality care and serving as an advocate for children has been St. Louis Children’s commitment since its inception in 1879. Today, the hospital serves patients and families across a 300-mile service area, and has seen patients from all 50 states and more than 80 countries. St. Louis Children’s consistently ranks among America’s Best Children’s Hospitals by U.S.News & World Report in all surveyed categories. In 2021, St. Louis Children’s was one of eight children’s hospitals to rank in the top 25 of all 10 specialties. The hospital’s academic and physician partner, Washington University School of Medicine, is one of the top-ranked medical schools in the United States. Since 2005, St. Louis Children’s has been designated as a Magnet® hospital for nursing excellence from the American Nurses Credentialing Center® (ANCC). Preferred Qualifications Role PurposeEnsure that the administration of hospital resources are appropriate, efficient and fall within the parameters of the patient's payment structure while providing safe and quality care. Evaluate the cost and quality of medical services provided by the medical team. Ensure appropriate utilization, which includes the evaluation of potential under and over-utilization according to patient's presentation and documentation. Education of medical providers and other health care professionals on the appropriate and cost-effective use of health care resources. ResponsibilitiesUses clinical and analytical skills to review and interpret diagnostic test results to determine appropriateness of patient's level of care.Uses Interqual Criteria to determine level of care for all elective inpatient hospitalizations to assure services are provided in the appropriate setting.Minimum RequirementsEducationNursing Diploma/Associate's - NursingExperience2-5 yearsSupervisor ExperienceNo ExperienceLicenses & CertificationsRNPreferred RequirementsEducationBachelor's Degree - Nursing Benefits and Legal Statement BJC Total RewardsAt BJC we’re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire dateDisability insurance* paid for by BJCAnnual 4% BJC Automatic Retirement Contribution401(k) plan with BJC matchTuition Assistance available on first dayBJC Institute for Learning and DevelopmentHealth Care and Dependent Care Flexible Spending AccountsPaid Time Off benefit combines vacation, sick days, holidays and personal timeAdoption assistanceTo learn more, go to our .*Not all benefits apply to all jobsThe above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer
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Posted 3 days ago

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Job Details

Employment Type

Full-time

Required License

RN (Registered Nurse)

Work Setting

HospitalChildren's hospital

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About BJC Medical Group

BJC Medical Group is a physician-led company providing exceptional medical care through its network of over 600 doctors and specialists across more than 120 locations in the greater St. Louis, mid-Missouri, and southern Illinois region. Backed by BJC HealthCare, one of the top healthcare organizations in the country, they leverage research and technology resources to foster long-term, healing relationships and offer exceptional patient experiences.