Utilization Management RN: Denials & Care Optimization

Carle Health is seeking a skilled staff RN to oversee and coordinate care for hospitalized patients within the IP Care Coordination Department. You will ensure medical necessity, optimize LOS, and support efficient admissions and ongoing reviews.

Responsibilities include concurrent chart reviews, communication with physicians and payers, and escalation when medical necessity criteria or appropriate level of care are not met. Strong data skills and Epic experience are essential.