Nursing Jobs in Tuscola, IL
$66,768 - $103,500.80 / year
Internal Employees: Please ensure that you are logged into Workday and applying through the Jobs Hub before proceeding. RN (Utilization Review) Job Description Utilization Review RN conducts medical certification review for medical necessity for acute care facility and services Uses nationally recognized, evidence-based guidelines approved by medical staff to recommend level of care to the physician and serve as a resource to the medical staff on issues related to admission qualifications, resource utilization, national and local coverage determinations and documentation improvement opportunities. Relays information as requested to the payer sources. Assures the highest quality, most cost effective patient care in the most appropriate setting. Responsibilities Assessment - Collects pertinent data and information relative to the patient's health or the situation. Recognizes normal and abnormal findings when gathering data., Assumes responsibility for remaining current on all regulatory and reimbursement rules and regulations., Concurrently reviews medical necessity, bed status, length of stay and quality of care indicators on all assigned patients. Serves as coordinator for communication with payors and providers to determine the appropriateness of hospital level of care., Confers with attending physician and physician advisor if medically unnecessary inpatient treatment is contemplated., Consults with medical staff, care team, and case managers as necessary to resolve immediate progression-of-care barriers through appropriate administrative and medical channels., Coordinates Medicare appeals with the discharge planner, Director of Utilization Management, Physician Advisor and the QIO., Coordination of Care - Plans and evaluates care in collaboration with appropriate disciplines., Diagnosis - Analyzes assessment data to determine actual or potential diagnosis, problems, and issues., Evaluation - Evaluates progress toward attainment of goals and outcomes. Reports data and outcomes to others as appropriate., Implementation - Implements care or work plan in alignment with the plan and approved safety, infection control, and department/organization standards., Knowledge - In collaboration with leaders, actively pursues required knowledge and skills through orientation activities specific to the position, reading current literature and seeking new learning opportunities., Outcomes Identification - Identifies expected outcomes for a plan individualized to the patient or situations., Planning - Develops a plan that prescribes strategies to attain expected, measurable outcomes., Recognizes and responds appropriately to patient safety/risk factors., Refers all denials, as appropriate, to the Director of Utilization Management and/or Physician Advisor., Relationships - Establishes effective working relationships with peers, physicians, and other members of the health care / work team. Identifies and confers with appropriate resources regarding patient / work decisions., Reviews operating room (OR) schedule 48 hours in advance of scheduled procedures to confirm that all eligible Medicare and Medicaid admissions were identified and the coded procedure is or is not on the Medicare inpatient-only list. Confirms that physician’s admission orders accurately reflect status., Serves as a resource person to physicians, case managers, physician offices, and billing office for coverage and compliance issues., Serves as coordinator for third party payer reviews, certifications and authorizations., Teaching - Employs teaching strategies to promote health and a safe environment., Works closely with physician advisor to review resource utilization data and trends to identify outliers who may benefit from real-time coaching to improve outcomes. Requirements ADN (Required)RN-Registered Nurse - Illinois Department of Financial and Professional Regulation Compensation Estimated Compensation Range $66,768.00 - $103,500.80 Pay based on experience 
$125,000 - $155,000 / year
Certified Nurse Practitioner (NP)– Post-Acute Care | Salary up to $155K Location: Sullivan, Illinois Compensation: $125,000 - $155,000 per year + Uncapped Bonus Potential Job Type: Full-time Launch or Grow Your Career in Post-Acute Care! Are you a Certified Nurse Practitioner (NP) looking for a rewarding and high-paying career with work-life balance? Whether you're an experienced provider or a recent graduate eager to learn , we provide the training, mentorship, and support you need to succeed in post-acute and skilled nursing care. ✅ New Graduates Welcome – Training & Support Provided! ✅ Flexible Scheduling – Achieve Work-Life Balance ✅ Competitive Pay + Bonus Potential At Altea Healthcare , we offer a collaborative team environment, cutting-edge technology, and ongoing education to ensure you thrive in your career. What You’ll Do: As a Certified NP, you will be a key clinical provider in a skilled nursing facility, diagnosing, treating, and guiding patients to better health. No two days are the same! Your daily responsibilities include: Performing physical exams and reviewing medical histories. Ordering and interpreting diagnostic tests (labs, imaging, etc.). Diagnosing and managing acute and chronic conditions. Prescribing medications and creating treatment plans. Collaborating with physicians, nurses, and facility staff. Educating patients and families on health conditions and preventive care. Documenting patient care accurately and efficiently. Who Should Apply? We welcome both experienced providers and motivated new graduates! ✅ NP License (or eligibility to obtain) ✅ All Experience Levels Welcome – Training & Mentorship Available! ✅ Passion for geriatrics, internal medicine, or primary care ✅ Strong team player with excellent communication skills ✅ Self-motivated with a patient-first approach What We Offer: Highly Competitive Pay ($125K - $155K Base Salary) + Uncapped Performance Bonuses Flexible Scheduling – Achieve the Work-Life Balance You Want Career Growth & Leadership Opportunities – Fast-Track Your Success Paid Time Off (PTO) – Because You Deserve It Full Benefits Package – Medical, Dental, Vision, Life Insurance & More 401(k) With Company Match – Invest in Your Future Ongoing Training & Mentorship – Support for New Grads & Experienced Providers Take the Next Step in Your Career! Don’t miss this opportunity to join a top-tier healthcare team, receive excellent pay, and make a lasting impact in post-acute care. Apply Today & Secure Your Spot! 