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Title:  UM Qual/Educ Coord

Req #:  154846
Facility:  Shared Revenue Cycle
Department:  Quality/Safety/Risk
City:  Oak Brook
Posting Budget Status:  Day
Shift Type:  Full Time - Permanent
Posting FTE:  1

Advocate Health Care, the largest health system in Illinois and one of the largest health care providers in the Midwest. Our Corporate Support & Operations Services are equally committed to advancing Advocate's goal of building lifelong relationships with patients by delivering the best health outcomes and highest level of service through an integrated approach to care and wellness.

We help people Live Well

UM Quality / Educator Coordinator

In the Full- time Utilization Management (UM) Quality/Educator Coordinator position based in Oakbrook you will work with our UM Leadership Team to be deeply involved in creating workflow documents and policy that assist the expanding UM team to function as a cohesive group. Additional responsibilities include supporting new team members and developing education and training workflows for the UM team. Ability to have crucial conversations and coach and support the team to meet our established quality and productivity goals. Must have strong computer skills with Microsoft and excel and excellent communication skills. A strong knowledge base of UM  processes and workflows is required. Some weekend call is required to assist with leadership issues on a rotational basis every 3-4 weeks and some holidays may be required.

 

 

Position Requirements:
BS or BSN
3 yrs of hospital nursing, hospital case management, insurance case management, or utilization management experience required
Knowledge of clinical practice norms.
Excellent communication skills.

Critical thinking skills
Organization, planning, and time management skills.

Proficient computer and Microsoft Office skills
Current nursing license in State of Illinois

MCG Certification required within one year of hire.
Ability to be flexible and work in the changing health care/payer environment

Ability to prioritize independently and respond to multiple
simultaneous requests

May require carrying approximately 8 pound laptop


Purpose:
Monitors and audits the quality of the daily work produced by UM RNs and UMAs to identify and investigate any issues preventing the optimal and compliant application of the UM principles. Ensures the team members' compliance with pre~established UM workflows and expectations of daily performance, timeliness, and accuracy of work through the provision of ongoing education, training, direction, and support. Maintains intimate working knowledge of all UM workflows and processes and ensures the timely completion of any needed updates to written guidelines, job aids, manuals, and SRGs.



Accountabilities:
Provide education and training sessions for the UM RNs and UMAs.
Perform ongoing quality audit reviews of the work produced by the UM RNs and UMAs.
Prepare department QA/Activity/Productivity reports
Provide support with routine Payer Portal maintenance
Other responsibilities as assigned

About Advocate Health Care

 

Advocate Health Care, named among the nation’s Top 5 large health systems based on quality by Truven Analytics, is the largest health system in Illinois and one of the largest health care providers in the Midwest. Advocate operates more than 250 sites of care, including 12 hospitals that encompass 11 acute care hospitals, the state’s largest integrated children’s network, the state’s largest emergency and Level I trauma network, one of the area’s largest home health care companies, and the region’s largest medical group. Advocate Health Care has 4 teaching hospitals and is a not-for-profit, mission-based health system affiliated with the Evangelical Lutheran Church in America and the United Church of Christ.


Nearest Major Market: Chicago