Utilization Management Nurse Jobs in Racine, WI (NOW HIRING)

M-F 08:00-16:30. Occasional weekends, one holiday/year.

Pay Range:

Registered Nurse (RN) - RN Inpatient Case Manager inpatient St Luke's

1.0 FTE

Where You Will Work:

Milwaukee, WI, United States Centrally located in the south side of Milwaukee
Help patients transition safely through their hospital stay. Partner with patients, families, and the care team to assess needs, coordinate services, plan discharges, and support utilization management.

We're Looking For:

License/Registration/Certification: Registered Nurse License issued by the state in which the Team Member practices.
Level of Education: Bachelor's Degree in Nursing
Years of Experience: 2 years of clinical nursing experience

What You'll Do:

• Conduct comprehensive assessments and create timely care plans & interventions

• Collaborate and negotiate with patients/families and the multidisciplinary team to meet goals and preferences

• Provide continuity of care and discharge planning aligned with regulatory standards

• Coordinate smooth transfers and handoffs across units and settings

• Deliver case management services (healthcare access, finances, housing, family dynamics, illness adjustment) using community resources

• Initiate internal/external referrals; document discharge planning and UM activities accurately and on time

• Perform concurrent/retrospective reviews using approved criteria

• Partner closely with Social Work and support staff to implement safe, effective plans of care

• Identify and remove barriers to discharge; expedite care delivery and report care coordination/UM outcomes

• Collaborate with managers, physicians, medical directors, and physician advisors on status, progression of care, and regulatory compliance

• Complete UM activities (payer updates, data collection, denials coordination, avoidable delay management); deliver CMS notices within required timeframes

• Build relationships with community agencies; collaborate with Ambulatory Care Management/Continuing Health

• Educate staff on admission status, acute care criteria, UM, care coordination, discharge planning, and regulatory requirements

• Provide age-appropriate care per departmental standards

About This Location:

Aurora St. Luke's Medical Center is a 938-bed, quaternary acute care
community hospital that provides advanced health care expertise.
The organization offers leading edge oncology, cardiovascular and
neurology therapies for primarily adult patients. Nursing professional
governance is a particular organizational strength, with over 40 years
of experience in clinical nurse shared decision making. Aurora St.
Luke's has been recognized for Nursing Excellence by the American
Nurses Credentialing Center Magnet Recognition Program since
2001, most recently celebrating our 6th consecutive designation in
February 2024.

Be the Nurse Who Redefines Care.
At Advocate Health, being a nurse means more than delivering exceptional clinical care-it means leading with purpose, compassion, and boldness. As part of our One Advocate Nurse community, you'll join a unified team committed to lifting others up, embracing innovation, and creating inclusive spaces where everyone can thrive. You'll be empowered to think boldly, collaborate with humility, and drive change through fearless curiosity. Whether you're at the bedside, in the community, or advancing care through research and education, you'll help shape the future of health-because here, we're redefining care for you, for us, for all.
Your feedback matters. Every nurse's voice is vital in shaping our culture and improving care. We value your insights and experiences because they help us grow stronger together.

Ready to Take the Next Step:
Apply Now!

Our CommitmenttoYou:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training

• Premium pay such as shift, on call, and more based on a teammate's job

• Incentive pay for select positions

• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs

• Health and welfare benefits such as medical, dental, vision, life, andShort- and Long-Term Disability

• Flexible Spending Accounts for eligible health care and dependent care expenses

• Family benefits such as adoption assistance and paid parental leave

• Defined contribution retirement plans with employer match and other financial wellness programs

• Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.