- US Tech Solutions (Chicago, IL)
- …and implementation of QM Work Plan Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior ... Authorization? + Do you have experience with Utilization Review ? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** US Tech… more
- Prime Healthcare (Aurora, IL)
- …licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/189384/ utilization - review - nurse ... or payer setting within the last 5 years. 2. Utilization review and denial management experience required.... and denial management experience required. 3. Current state RN licensure required. 4. Must be able to communicate… more
- Fresenius Medical Center (Chicago, IL)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Fresenius Medical Center (Chicago, IL)
- …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
- AdventHealth (Hinsdale, IL)
- …skills **.** Teamwork principles **EDUCATION AND EXPERIENCE REQUIRED:** . Associates Degree Nursing or RN Diploma degree . Registered Nurse ( RN ) . ... **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** **.** State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:**… more
- Molina Healthcare (Chicago, IL)
- …production levels are maintained + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management ... to resolve/correct them.. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ) Program and an Associate's or… more
- Rush University Medical Center (Chicago, IL)
- …**Other information:** **Required Job Qualifications:** * Current State of Illinois Registered Nurse licensure * National certification * Master's degree ... circumstances of each case. **Summary:** The Clinical Consulting Specialist is a nurse with expertise within a specialized area of nursing practice responsible for… more
- Rush University Medical Center (Chicago, IL)
- …and procedures. **Other information:** **Required Job Qualifications:** *Current license in Illinois as Registered Nurse ( RN ). *Ability to perform all job ... depending on the circumstances of each case. **Summary:** The Nurse Care Manager 1 works with physician practices and...physician practices and inpatient teams to promote the effective utilization of services and coordination of care for adult,… more
- ICW Group (Lisle, IL)
- …providing direct clinical care required. **CERTIFICATES, LICENSES, REGISTRATIONS** Current unrestricted Registered Nurse ( RN ) or Licensed Vocational ... regulatory standards. + Interfaces with external agencies in relation to the utilization review process including, Third-Party Payers, Insurance Companies and… 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
- Rush University Medical Center (Chicago, IL)
- …**Other information:** **Required Job Qualifications:** * Current State of Illinois Professional Registered Nurse licensure * Graduate degree in nursing * o ... may vary depending on the circumstances of each case. **Summary:** The Clinical Nurse Leader (CNL) functions as an advanced generalist providing and managing care… more
- Trinity Health (Melrose Park, IL)
- …preferred. + Managerial Experience: 1-2 years + Basic Life Support (CPR) + Current Registered Nurse license State of Illinois Other: Specialty certification in a ... Nurse Manager of our Emergency Department at Gottlieb Memorial Hospital is a registered professional nurse , conversant with the nursing process, who has 24x7… 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 Copley Medical Center (Aurora, IL)
- **Position Summary:** The registered nurse is responsible for the assessment, planning, implementation, and evaluation of the patients' status, plan of care, and ... and is in accordance with policies and procedures. The registered nurse is expected to uphold the...patient admission and level of care. + Provides continuous review of medical necessity and SI/IS criteria. Notifies physician… more
- Prime Healthcare (Chicago, IL)
- …the Clinical Manager. Qualifications EDUCATION, EXPERIENCE, TRAINING 1. Current and valid state Registered Nurse license. 2. Five (5) years of experience in ... the direction and supervision of the Clinical Manager, the RN Assessment Coordinator is responsible for conducting and coordinating...acute hospital setting in a Utilization Review , Case Management, business office or… more
- Rush University Medical Center (Chicago, IL)
- …**Other information:** **Required Job Qualifications:** Current State of Illinois Registered Nurse licensure required **Preferred Job Qualifications:** ... response to treatment. 3. Constantly seeks process improvement opportunities regarding supple utilization and charge captures. 4. Acts as the primary liaison between… more