Quality Utilization Specialist, Emergency Department, Full-time, Days

3 weeks ago


Chicago, Illinois, United States Northwestern Medicine Full time
Job Summary

We are seeking a highly skilled Quality Utilization Specialist to join our team at Northwestern Medicine. This role will play a critical part in ensuring the highest quality patient care and optimal resource utilization in our Emergency Department.

Key Responsibilities
  • Apply medical necessity criteria and level of care guidelines to ensure appropriate hospital status orders
  • Partner with medical staff to ensure accurate and timely status orders
  • Monitor bed request orders and recommend changes as needed
  • Complete admission reviews and follow-up reviews in a timely manner
  • Effectively communicate with third-party review companies and payors
  • Collaborate with hospital teams to coordinate bed placement and optimize patient flow
  • Develop and implement quality utilization tools and processes
  • Participate in departmental and hospital committees and taskforces
Requirements
  • Registered Nurse in the State of Illinois
  • Bachelor's degree in nursing
  • 2 years of experience in Quality Utilization Specialist or related role
  • Mastery of utilization management and level of care guidelines
  • Proven leadership skills and analytical skills
Preferred Qualifications
  • 5+ years of relevant experience
  • Master's degree in Nursing
About Northwestern Medicine

Northwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.



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