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Resource Nurse Salary in Illinois, USA

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Rehabilitation Institute of Chicago, Chicago
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Influencing others and promoting professional development.Communicating with patients, families, and staff to ensure satisfaction and to prevent and resolve conflict.Applying principles of crisis management.Collaboratively partnering with other Nurse Managers and Nurse Leaders across the continuum.Maintaining social justice, cultural and generational competence.Performing all other duties that may be assigned in the best interest of the Shirley Ryan AbilityLab.Develops the leader within by: Managing personal growth and development, plans a career path, and develops plan for succession. Involvement in professional association(s). Achieving leadership certification. Engaging in reflective practice.Reporting RelationshipsReports directly to the Associate Chief Nursing OfficerKnowledge, Skills & Abilities RequiredBachelor's degree in nursing required. Master's degree preferred.Current Illinois license to practice as a Registered Nurse is required. Current CPR certification required. Professional Nursing Certification preferred.Minimum 5 years of experience in clinical nursing. Experience in rehabilitation preferred.Demonstrated ability to organize, and manage multiple tasks simultaneously.Practices in accordance with professional practice standards and the ANA Code of Ethics for Nurses and AONL competencies.Understanding of the growth and development of infant, child, adolescent, young adult, middle-aged adult and geriatric patients.Demonstrates the ability to interpret growth and development related information to assure patient needs are met.Strong analytical skills to assess, plan and implement strategies for successful unit management.Communicates using verbal, non-verbal, and written communication to provide leadership, and instruct patients, families, staff to ensure fulfillment of requirements for legal documentation and reimbursement.Possesses the specialized knowledge and clinical skills necessary to oversee the care provided for people with physical disabilities and chronic illness.Demonstrates a high level of initiative and creative problem-solving.Demonstrates critical thinking skills and makes sound judgments to monitor and respond to patient and staff needs or changes in condition.Demonstrates financial and business acumen.Demonstrates a vision for own function and acts with the broader benefit of SRAlab in mind.Able to maintain current knowledge of clinical best practices and share that knowledge and skills with staff.Prior involvement in professional advancement programs and shared governance preferred.Working ConditionsNormal office environment with little or no exposure to dust or extreme temperature.The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.Equal Employment Opportunity ShirleyRyan AbilityLab is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.
Nurse Reviewer I
Elevance Health, Chicago
Description Nurse Reviewer I Location: Within 50 miles of a pulse point in Illinois Shift: 9:30 am - 6 pm CST The Nurse Reviewer I is responsible for conducting preauthorization, out of network and appropriateness of treatment reviews for diagnostic imaging services by utilizing appropriate policies, clinical and department guidelines. Collaborates with healthcare providers, and members to promote the most appropriate, highest quality and effective use of diagnostic imaging to ensure quality member outcomes, and to optimize member benefits. Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. Partners with more senior colleagues to complete non-routine reviews. Through work experience and mentoring learns to conduct medical necessity clinical screenings of preauthorization request to assess assessing the medical necessity of diagnostic imaging procedures, out of network services, and appropriateness of treatment. How you will make an impact: Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review. Conducts initial medical necessity review of exception preauthorization requests for services requested outside of the client health plan network. Notifies ordering physician or rendering service provider office of the preauthorization determination decision. Follows-up to obtain additional clinical information. Ensures proper documentation, provider communication, and telephone service per department standards and performance metrics. Minimum Requirements: Requires AS in nursing and minimum of 3 years of clinical nursing experience in an ambulatory or hospital setting or minimum of 1 year of prior utilization management, medical management and/or quality management, and/or call center experience; or any combination of education and experience, which would provide an equivalent background. Current unrestricted RN license in applicable state(s) required. Preferred Skills, Capabilities, and Experiences: Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed health care including HMO, PO and POS plans strongly preferred. BA/BS degree preferred. Previous utilization and/or quality management and/or call center experience preferred. Ability to work 9:30 am - 6 pm PST Ability to work weekends if necessary New grads are encouraged to apply Knowledge in Microsoft Office (Word, Excel, Visio) Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] assistance.