- US Tech Solutions (Chicago, IL)
- …+ Do you have experience with Prior Authorization? + Do you have experience with Utilization Review ? + Do you have an Active Registered Nurse License? ... 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior...and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1… more
- Insight Global (Skokie, IL)
- …https://insightglobal.com/workforce-privacy-policy/ . Skills and Requirements 3+ years experience as a utilization review nurse Experience reviewing and ... a Clinical Denials Specialist you will be working with the denials team to review and analyze denials from a clinical perspective. This person will be responsible… more
- Rush University Medical Center (Chicago, IL)
- …0.9 and 1.0) **Shift:** **Shift 1** **Work Schedule:** 8 Hr **Summary:** The Nurse Care Manager 1 works with physician practices and inpatient teams to promote ... the effective utilization of services and coordination of care for adult,...for adult, geriatric, neonate, pediatric and adolescent patients. The Nurse Care Manager 1 contributes to the team's effectiveness… more
- Elevance Health (Chicago, IL)
- …clinicians and business leaders passionate about transforming American healthcare delivery. ** Nurse Reviewer I** **Location:** **Illinois. This is a remote position ... of our Elevance Health PulsePoint location in** **Chicago, Illinois** **.** The ** Nurse Reviewer I** is responsible for conducting preauthorization, out of network… more
- Rush University Medical Center (Chicago, IL)
- **Job Description** Med Surg Oncology Clinical Nurse Leader **Location:** Chicago, IL **Hospital:** RUSH University Medical Center **Department:** 14 W Tower ... 1 **Work Schedule:** 8 Hr (7:00:00 AM - 3:30:00 PM) **Summary:** The Clinical Nurse Leader (CNL) functions as an advanced generalist providing and managing care for… more
- Rush University Medical Center (Chicago, IL)
- **Job Description** **BMT Clinical Nurse Leader** **Location:** Chicago, IL **Hospital:** RUSH University Medical Center **Department:** 14 E Tower (BMT/Heme ... **Work Schedule:** 8 Hr (7:00:00 AM - 3:30:00 PM) **Summary:** The Clinical Nurse Leader (CNL) functions as an advanced generalist providing and managing care for… more
- Trinity Health (Melrose Park, IL)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** The Nurse Manager of our Emergency Department at Gottlieb Memorial Hospital is a registered ... professional nurse , conversant with the nursing process, who has 24x7...projects and research activities (as appropriate). a) Conduct bi-annual review of all unit-specific policies/procedures to ensure compliance with… more
- Amergis (Chicago, IL)
- $50 / hour Position: Care Management Nurse Location: Chicago, IL Pay Rate (set rate): $50/hour Schedule: + Full-time + 8:00am - 4:30pm Monday to Friday Weekend ... with extension based on performance Requirements: + Licensed as Registered Professional Nurse in the State of Illinois + Bachelor's Degree from accredited college… more
- Prime Healthcare (Chicago, IL)
- …and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and ... PA, or Nursing Graduate required. 2. Three years of Utilization Review experience as a Medical ...interpersonal skills to build effective partnering relationships with physicians, nurse staff, coding staff and hospital management staff. 6.… more
- CenterWell (Oak Brook, IL)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's… more
- AdventHealth (Hinsdale, IL)
- …committees.** **The value you'll bring to the team:** + **Facilitates clinical teams to review utilization and options for product selection for our Great Lakes ... provides leadership and consultation to company facilities in the clinical review , evaluation and procurement of products and leads multi-disciplinary teams to… more
- AdventHealth (La Grange, IL)
- …to nurses, physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge Planning and care ... (as permitted by the patient) as well as a review of the current and past inpatient and outpatient...days, and facilitates progression of care. **.** Collaborates with Utilization Management staff for collaboration on patient status changes… more
- Elevance Health (Chicago, IL)
- …PulsePoint locations. **How you will make an impact:** + Perform physician-level case review , following initial nurse review , of high-tech diagnostic ... Demonstrate and maintain knowledge of relevant policies and regulations pertaining to utilization review of diagnostic imaging procedures, cardiac services and… more
- Rush University Medical Center (Chicago, IL)
- …our Rush benefits page . **Summary:** The Clinical Consulting Specialist is a nurse with expertise within a specialized area of nursing practice responsible for ... information:** **Required Job Qualifications:** * Current State of Illinois Registered Nurse licensure * National certification * Master's degree in Nursing from… more
- Rush University Medical Center (Chicago, IL)
- …**Required Job Qualifications:** Current State of Illinois Registered Nurse licensure required **Preferred Job Qualifications:** Baccalaureate degree in ... response to treatment. 3. Constantly seeks process improvement opportunities regarding supple utilization and charge captures. 4. Acts as the primary liaison between… more
- Prime Healthcare (Chicago, IL)
- …license. 2. Five (5) years of experience in acute hospital setting in a Utilization Review , Case Management, business office or related department. Experience in ... Set (MDS), and for tracking, and transmitting all data including the Resource Utilization Groups (RUGs) to the Department of Health and Human Services. The process… more