- Huron Consulting Group (Chicago, IL)
- …Management is responsible for planning, organizing, developing, and directing implementation of the Utilization Review Plan and the overall operation of the ... + Staff Acquisition and Support: Leads and manages the utilization review staff and function for the...and may be implemented in the future._ **Position Level** Manager **Country** United States of America At Huron, we're… more
- CenterWell (Springfield, IL)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work… more
- Blessing Hospital (Quincy, IL)
- …processes and procedures + I CARE standards of behavior + Collaborates with the nurse manager in budget development, utilization , evaluation, and adjustment ... + 24/7 Wellness Center access + Educational assistance opportunities JOB SUMMARY The associate nurse manager in collaboration with the nurse manager … more
- Blessing Hospital (Quincy, IL)
- …processes and procedures + I CARE standards of behavior + Collaborates with the nurse manager in budget development, utilization , evaluation, and adjustment ... unit-based Pharmacist, Respiratory Therapist, Physical Therapist, and an Unit-based Educator. The associate nurse manager in collaboration with the nurse … more
- Fresenius Medical Center (Macomb, IL)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. ... leading your business, and advanced leadership. As a Clinical Manager , you may advance your career into an Area...+ Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. +… more
- Fresenius Medical Center (Decatur, 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
- Fresenius Medical Center (Urbana, IL)
- …of time, and for specific additional duties, as assigned by the Program Manager . The Inpatient Services Charge Nurse ensures appropriate provision of Acute ... **PURPOSE AND SCOPE:** The Inpatient Services Charge Nurse is an additional "responsibility" assigned to the...their direct supervision and submit results to the Program Manager for review . + Ensure all Acute… more
- Rush University Medical Center (Chicago, IL)
- …may vary depending on the circumstances of each case. **Summary:** The Clinical Nurse Leader (CNL) functions as an advanced generalist providing and managing care ... microsystem. The CNL is a point of care expert clinician, outcomes manager , client advocate, educator, information manager , system analyst/risk anticipator, team… more
- CenterWell (Joliet, IL)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... delivery, and documentation requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance … more
- Highmark Health (Springfield, IL)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management,… more
- BJC HealthCare (Belleville, IL)
- …nursery, medical and surgical services plus critical care. Care Management includes Utilization Management ( Utilization Review ), Discharge Planning, Social ... Services, Clinical Outcomes (Care Managers), Discharge Transition Coaches, Nurse Practitioners, and Clinical Documentation Improvement. **Preferred Qualifications** **Role… more
- Carle Health (Urbana, IL)
- Overview The Nurse Manager , OR Intraoperative has leadership accountability for planning, facilitating and monitoring the day-to-day activities and functions of ... Operating Room. Responsible for planning, organizing, delegating, coordinating staff utilization , budgeting, and marketing OR services. Directly supervises nursing… more
- Carle Health (Champaign, IL)
- …patient care outcomes. The incumbent will have a deep understanding of utilization review and case management principles, case management best practices, ... experience 2+ years Responsibilities Maintain current knowledge of case management and utilization review trends including the entire continuum of care within… more
- Trinity Health (Berwyn, IL)
- …looking for an experienced Authorization Referral Coordinator. Reporting to the Manager of Utilization Management and working under general supervision, ... under the supervision of the clinical team per protocol. Refers requests to the nurse reviewer or medical director if criteria or guidelines not met. This position… more
- Carle Health (Urbana, IL)
- … issues in appropriate locations, including but not limited to: case management/ utilization review software and the multidisciplinary plan of care document ... timely planning and collaboration. Qualifications Certifications: Licensed Registered Professional Nurse (RN) - Illinois Department of Financial and Professional… more
- Prime Healthcare (Chicago, IL)
- …license. + Five (5) years of experience in acute hospital setting in a Utilization Review , Case Management, business office or related department. Experience in ... IL Responsibilities Under the direction and supervision of the Clinical Manager , the RN Assessment Coordinator is responsible for conducting and coordinating… more
- ChenMed (Berwyn, IL)
- …explain nurse practitioner role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... State of practice. + Other duties as assigned and modified at manager 's discretion. KNOWLEDGE, SKILLS AND ABILITIES: + Demonstrated record of consistently achieving… more
- Deloitte (Chicago, IL)
- …Experience as clinical registered nurse , physician, physician assistant, case manager , clinical documentation specialist, utilization review , informatics ... in nursing, medical degree, or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical Documentation Specialist - CCDS… more