Carle Health

• Responsible for identifying prior auth requirements by insurance/payer • Processes and completes prior authorizations • Determines if services are a covered benefit • Communicates with the ordering Provider's office • Advocates for patients/providers by processing pre-auths in a time sensitive manner • Identifies challenges, trends and patterns

Role Description Responsible for the oversight, coordination, and management of the functional and financial outcomes during acute illness requiring hospitalization for patients of the Carle Foundation Hospital. Facilitates the care of patient by ensuring that admissions and continued days are medically necessary, cost-effective, and provided in the appropriate level of care to qualify for reimbursement. The UM staff RN will function within the IP Care Coordination Department to ensure that the most cost-effective and appropriate use of health care services for patients treated by Carle Foundation Hospital. - Ensures efficient patient flow and throughput - Initial assessment of all new patients for correct status (admission/observation/outpatient) based on UR medical necessity criteria - Performs concurrent reviews of all patient charts to ensure proper resource utilization as necessary to identify practice trends - Keeping LOS within patients working DRG - Send clinical documentation to insurance companies per their request - Communicate with physicians on status changes and documentation - Refers cases for secondary review when appropriate - Refers cases for escalated medical review when services do not meet medical necessity criteria and/or appropriate level of care - Documents utilization reviews/issues in appropriate locations, including but not limited to case management/utilization review software - Track Avoidable days - Educates and assists physicians in resource utilization - Participate in extended care reviews and attend meetings - Review cases for potential quality indicators and refers to UM Leadership - Works with Appeal staff to actively appeal cases concurrently and retrospectively Qualifications - College Diploma - Nursing - Registered Professional Nurse (RN) License Illinois Upon Hire - Satisfactorily complete all required continuing education regarding the care of acute stroke patients - Case Management Certification preferred - Able to establish professional relationships with all healthcare providers - Work independently and collaborate - Strong communication and organizational skills - Attention to detail Salary Range The compensation range for this position is $35.87 per hour - $58.37 per hour. This represents a good faith minimum and maximum range for the role at the time of posting by Carle Health. The actual compensation offered a candidate will be dependent on a variety of factors including, but not limited to, the candidate’s experience, qualifications, location, training, licenses, shifts worked and compensation model. Benefits Carle Health offers a comprehensive benefits package for team members and providers. To learn more visit careers.carlehealth.org/benefits .

• Support the ability to schedule all procedures performed in the department • Allow for patient prep and education of CT procedures, ultrasound biopsies, para/thoras, and IR cases • Ensure outpatient PCI patients called the day after the procedure • Resource to ensure that the pre-procedural requirements are completed • Serve as a liaison to provide support to pre-procedural patients, schedulers, proceduralists, HVI staff, outside PCP's, clinics, and proceduralists offices • Maintain knowledge of all tests, medications, and possible contraindications associated with procedure and anesthesia/moderate sedation • Completion of Pre-Procedural checklist /= 2 - 7 days prior to procedure (excluding emergent/add on cases) • Monitor and maintain pre-procedural checklist completion prior to procedure • Review and ensure up to date History and Physicals • Provide patient education and instruction regarding: procedure that is ordered, medication orders to either take or hold prior to procedure • Perform the Pre-Day calls to patients having procedures at main hospital to verify compliance with medication instructions, procedure report time, review of medications to take in the AM day of procedure and answer any questions • Reinforce diet • Reinforce the CHG bath instructions with patients at Pre-Day call if required • Serve as liaison to the proceduralist, PCP, referring provider in obtaining additional tests/forms, teaching on medication, informing patients of lab/test results prior to procedure • Perform Post Catheterization Intervention (PCI) patient phone calls to ensure adherence to medication orders

• Maintain department patient care supplies • Ensure timely flow of patients • Assist physicians and nurses to provide optimal care • Perform a variety of routine direct patient care duties

• Supports and governs assigned finance/accounting applications • Responsible for system audits and reviewing application outputs • Builds and maintains dashboards, reports, and presentations • Assists with month-end close processes and analytical reporting

• Provide utilization management services to the inpatient unit • Collaborates with the interdisciplinary team to facilitate placement of patients • Reviews all admissions immediately following the admission and no later than the next business day • Applies admission, continued stay/transfer, and discharge criteria • Maintains communication to ensure timely and comprehensive transmission of information • Assists in identifying and decreasing unnecessary ancillary services • Participates on unit council and contributes to quality improvement reviews

Role Description Carle Health is seeking an additional BE/BC Neuroradiologist to join our expanding Radiology Division at Carle Foundation Hospital in Urbana, Illinois. - 100% Remote - Daytime emergency/general radiology with neuroradiology focus – fellowship training required - $625,000 base salary with lucrative incentive package & signing bonus - Non-profit status with public service loan forgiveness eligibility - 7-on/7-off schedule: 11a-7p CST weekdays, 7a-5p CST weekends - Comprehensive Stroke Center with Level I Trauma Center and active Neurosurgical, Neurology and Otolaryngology referral bases - Affiliation with the new Carle Illinois College of Medicine with teaching and research opportunities available - State of the art equipment including a new Visage PACS, PowerScribe One Dictation, RadAI Impression Generator, Robust AI Infrastructure, EPIC EMR Qualifications - BE/BC Neuroradiologist - Fellowship training required Requirements - Experience in emergency/general radiology with a neuroradiology focus Benefits - Excellent benefit package including health/dental/life insurance - 403-B and 457 plans with employer match - LTD - Relocation signing bonus - CME allowance - Malpractice insurance with tail insurance coverage Company Description Globally connected, innovative and culturally rich, Champaign-Urbana is centrally located to Chicago, Indianapolis and St. Louis and is home to one of the world's great public research universities - the Big Ten University of Illinois. With ease of transportation, excellent schools and affordable housing options, our community features the friendliness and advantages of a smaller town while offering the dining, arts, sports, and entertainment options found in a much larger city. At Carle Health, we're committed to fostering a workplace where every team member feels valued, respected and empowered, where passion and purpose come together to positively impact the lives of our patients and our communities. - Nearly 17,000 team members and providers supporting patient care across central and southeastern Illinois - Eight award-winning hospitals and a multispecialty provider group with more than 1,500 doctors and advanced practice providers - Developing the next generation of providers and healthcare professionals through Carle Illinois College of Medicine - Magnet® designations for nursing care at several hospitals - Opportunities in several communities throughout central Illinois with potential for growth and life-long careers

Role Description Carle Health is seeking an additional BE/BC Neuroradiologist to join our expanding Radiology Division at Carle Foundation Hospital in Urbana, Illinois. - 100% Remote Neuroradiology cross-sectional position – fellowship training required - $625,000 base salary with lucrative incentive package & signing bonus - Non-profit status with public service loan forgiveness eligibility - 7-on/7-off schedule: 11a-7p CST weekdays, 7a-5p CST weekends - Comprehensive Stroke Center with Level I Trauma Center and active Neurosurgical, Neurology and Otolaryngology referral bases - Affiliation with the new, Carle Illinois College of Medicine with teaching and research opportunities available - State of the art equipment including a new Visage PACS, PowerScribe One Dictation, RadAI Impression Generator, Robust AI Infrastructure, EPIC EMR Qualifications - BE/BC Neuroradiologist - Fellowship training required Requirements - Experience in Neuroradiology - Ability to work 7-on/7-off schedule Benefits - Comprehensive benefit package including health/dental/life insurance - 403-B and 457 plans with employer match - LTD and malpractice insurance with tail insurance coverage - Relocation signing bonus - CME allowance Company Description Globally connected, innovative and culturally rich, Champaign-Urbana is centrally located to Chicago, Indianapolis and St. Louis and is home to one of the world's great public research universities - the Big Ten University of Illinois. With ease of transportation, excellent schools and affordable housing options, our community features the friendliness and advantages of a smaller town while offering the dining, arts, sports, and entertainment options found in a much larger city. At Carle Health, we're committed to fostering a workplace where every team member feels valued, respected and empowered, where passion and purpose come together to positively impact the lives of our patients and our communities. - Nearly 17,000 team members and providers support patient care across central and southeastern Illinois - Includes eight award-winning hospitals and a multispecialty provider group with more than 1,500 doctors and advanced practice providers - Developing the next generation of providers and healthcare professionals through Carle Illinois College of Medicine - Magnet® designations for nursing care at several hospitals - Opportunities in several communities throughout central Illinois with potential for growth and life-long careers

Role Description The Ambulatory RN supervisor assists with management responsibilities and oversight of multiple clinical operations within the Patient Contact Center and maintains daily oversight of the 24/7 Patient Advisory Nurse call center activities. Qualifications - Licensed Registered Professional Nurse (RN) - Ohio (OH) within 1 year - Ohio Board of Nursing (OBON) - Licensed Registered Professional Nurse (RN) - Iowa (IA) within 1 year - Iowa Board of Nursing (IBON) - Licensed Registered Professional Nurse (RN) - Indiana (IN) within 1 year - Indiana Professional Licensing Agency (IPLA) - National Nursing Certification within 3 years - Varies - Licensed Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR) - Licensed Registered Professional Nurse (RN) - Washington (WA) within 1 year - Washington State Board of Nursing (WABON) - Bachelor's Degree: Nursing (Required) - Work Experience: Nursing Requirements - Develops, manages, and maintains PAN staffing and call schedules. - Remains competent in all Patient Contact Center clinical areas and performs essential job functions of direct reports when staffing/volumes require. - Recommends and initiates various personnel actions including, but not limited to: hiring, performance appraisals, disciplinary actions, and promotions. - Makes work assignments, reviews and edits work of direct reports. - Ensures staff member's training in to required competency levels to perform all required job tasks. - Resolves work related issues or assists employees in solving work related issues. - Confers with Human Resources, experts, and other leaders to resolve more complex issues. - Participates in development, planning, and monitoring of fiscal budget(s). - Monitors and completes all edits within time keeping system for direct reports. - Assists in development and review of department policies, procedures, standing orders, and competencies. - Collects, reviews, and prepares data for leadership, using various Carle and other software systems. - Participates in development, implementation, and presentation of education to clinical team members and key stakeholders. - Supervises all direct reports and assists with other clinical departments within Patient Contact Center, as needed. - Assists with NEO for others within the Patient Contact Center associated with nursing roles and understanding of the Symptom Guide. Benefits - The compensation range for this position is $42.52 per hour - $73.13 per hour. - The actual compensation offered will be dependent on various factors including experience, qualifications, location, training, licenses, shifts worked, and compensation model. - Carle Health offers a comprehensive benefits package for team members and providers. Company Description At Carle Health, we're committed to fostering a workplace where every team member feels valued, respected, and empowered, where passion and purpose come together to positively impact the lives of our patients and our communities. - Nearly 17,000 team members and providers support patient care across central and southeastern Illinois. - Includes eight award-winning hospitals and a multispecialty provider group with more than 1,500 doctors and advanced practice providers. - Developing the next generation of providers and healthcare professionals through Carle Illinois College of Medicine and Methodist College. - Holds Magnet® designations, the nation’s highest honor for nursing care. - Opportunities in several communities throughout central Illinois with potential for growth and life-long careers.

Role Description Coordinates scheduling of HVI procedure center suites with the providers, anesthesia services, and ancillary services. This person is responsible for entering and updating data, as well as monitoring, verifying, confirming, and distributing final schedules. Validates EPIC with Lawson supplies within the Intra-OP Navigator as well as reconciles par levels from Spacetrax. Responsible for billing patient accordingly for items used during procedures. Qualifications - Certifications: - Education: - Work Experience: Healthcare Requirements - Proactively identify potential problems with cases that are missing information and discrepancies in type of procedure, surgeon, and times. - Coordinates scheduling of procedure labs, bedside procedures, and biopsies with the provider, anesthesia services, and ancillary services. - Manages administrative time for the VIR Associate Medical Director and HVI Quality Directors. - Responsible for entering and updating data, as well as monitoring, verifying, confirming, case schedules. - Validates, in EPIC and Inventory System, the supplies used from the patient record and bills the patient accordingly. - Assists with same day add-ons and case stats. - Monitors depot and procedure lists for prior authorization status and communicates outliers to medical insurance and appropriate discipline. - Adjusts procedure center schedule and communicates any changes to provider offices and others as appropriate. - Assisting in other areas as needed. Benefits - The compensation range for this position is $19.16 per hour - $31.04 per hour. - Carle Health offers a comprehensive benefits package for team members and providers. Company Description At Carle Health, we're committed to fostering a workplace where every team member feels valued, respected and empowered, where passion and purpose come together to positively impact the lives of our patients and our communities. - Nearly 17,000 team members and providers support patient care across central and southeastern Illinois. - Includes eight award-winning hospitals and a multispecialty provider group with more than 1,500 doctors and advanced practice providers. - Developing the next generation of providers and healthcare professionals through Carle Illinois College of Medicine, the world’s first engineering-based medical school, and Methodist College. - Carle BroMenn Medical Center, Carle Foundation Hospital, Carle Health Methodist Hospital, Carle Health Proctor Hospital, Carle Health Pekin Hospital, and Carle Hoopeston Regional Health Center hold Magnet® designations. - Opportunities in several communities throughout central Illinois with potential for growth and life-long careers at Carle Health.