- 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
- AdventHealth (La Grange, 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
- 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
- CVS Health (Chicago, IL)
- …we do it all with heart, each and every day. **Position Summary** The RN Case Manager is responsible for coordinating all case management activities with members to ... through integration. + Through the use of clinical tools and information/data review , conducts comprehensive assessments of member's needs and recommends an approach… more
- Molina Healthcare (Chicago, IL)
- REGISTERED NURSE must be licensed for the state of Illinois and must be willing to work CENTRAL daytime business hours 9AM to 6PM.** **JOB DESCRIPTION** **Job ... acute care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must… more
- CenterWell (Chicago, 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...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… 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
- Elevance Health (Chicago, IL)
- …fraud and over- utilization by performing medical reviews via prepayment claims review and post payment auditing. + Correlates review findings with ... ** Nurse Audit Sr** **Location:** This position will work...responsible for identifying, monitoring, and analyzing aberrant patterns of utilization and/or fraudulent activities by health care providers through… more
- Elevance Health (Chicago, IL)
- …4 years managed care experience and requires a minimum of 2 years clinical, utilization review , or case management experience; or any combination of education ... major office (PulsePoint) location listed above. The **Medical Management Nurse ** is responsible for review of the...an equivalent background. + Current active, valid and unrestricted RN license and/or certification to practice as a health… more