- Elevance Health (Chicago, IL)
- …Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. + Partners ... information presented meets medical necessity criteria or requires additional medical necessity review . + Conducts initial medical necessity review of exception… more
- US Tech Solutions (Chicago, IL)
- …experience with Utilization Review ? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** US Tech Solutions is a global staff ... policy, regulatory and accreditation guidelines. + Responsible for the review and evaluation of clinical information and documentation. +...3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior… more
- Molina Healthcare (Kenosha, WI)
- …DESCRIPTION** **Job Summary** Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level ... quality of care issues. + Assists with Complex Claim review including DRG Validation, Itemized Bill Review ,...Claim review including DRG Validation, Itemized Bill Review , Appropriate Level of Care, Inpatient Readmission, and any… more
- Froedtert South (Kenosha, WI)
- Physician Assistant/ Nurse Practitioner a€" Shepler Froedtert South Kenosha, WI (Onsite) Full-Time Apply Now Job Details Physician Assistant or Nurse Practitioner ... has an exciting opportunity for a Physician Assistant or Nurse Practitioner to join Neil Shepler, MD as a...and clinic setting, handle all aspects of treatment plans, review and evaluate test results, complete medical documentation, and… more
- Froedtert South (Kenosha, WI)
- Nurse Practitioner a€" Family Medicine (Gauthier) Froedtert South Kenosha, WI (Onsite) Full-Time Apply Now Job Details Nurse Practitioner - Family Medicine ... Froedtert South Medical Group Froedtert South has an exciting opportunity for a Nurse Practitioner to a busy family practitioner. The Nurse Practitioner will… more
- Froedtert South (Kenosha, WI)
- Physician Assistant or Nurse Practitioner a€" Cardiothoracic Froedtert South Kenosha, WI (Onsite) Full-Time Apply Now Job Details Physician Assistant or Nurse ... has an exciting opportunity for a Physician Assistant or Nurse Practitioner to join Stephen Laga, MD The ideal...and clinic setting, handle all aspects of treatment plans, review and evaluate test results and complete medical documentation… more
- Veterans Affairs, Veterans Health Administration (Chicago, IL)
- …and record relevant patient information. Completed work should need only a general review by a registered nurse (RN) or physician (MD/DO) for appropriateness ... Summary This Licensed Practical Nurse position is located in the Nursing Service...completed work may require routine or detailed higher level review depending upon the complexity of the duties involved.… more
- Actalent (Grayslake, IL)
- Job Title: Clinical Research Nurse Job Description This part-time role involves working Monday to Friday, 7 AM to 12 Noon. The main responsibility of the Clinical ... Research Nurse is to screen and enroll patients in clinical...and assessments of healthy volunteers and/or patients. Responsibilities + Review protocols and informed consent forms for scheduled studies,… 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 ... The CNL provides insight regarding the microsystem for collaboration with the Clinical Nurse Specialist (CNS) on macrosystem processes and outcomes. The CNL and CNS… more
- Rush University Medical Center (Chicago, IL)
- …Offers may very depending on the circumstances of each case. **Summary:** The Nurse Care Manager 1 works with physician practices and inpatient teams to promote ... of care for adult, geriatric, neonate, pediatric and adolescent patients. The Nurse Care Manager 1 contributes to the team's effectiveness by reviewing plans… more
- R1 RCM (Chicago, IL)
- …analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Coding Appeals Nurse ** , you will help review and interpret medical records ... **Here's what you will experience working as a Clinical Coding Appeals Nurse :** + Review and interpret medical records to appeal denied and underpaid claims. +… more
- Veterans Affairs, Veterans Health Administration (Chicago, IL)
- …and record relevant patient information. Completed work should need only a general review by a registered nurse (RN) or physician (MD/DO) for appropriateness ... Summary This Licensed Practical Nurse position is located in the Nursing Service at the Auburn Gresham CBOC which is located at 7731 South Halsted Street, Chicago,… more
- Rush University Medical Center (Chicago, IL)
- …position. Offers may vary depending on the circumstances of each case. **Summary:** The Nurse Care Manager is an Illinois licensed Registered Nurse who provides ... a diverse role as a clinician, educator, care coordinator and advocate. The Nurse is an expert in chronic disease management, prevention, health maintenance, and… more
- KPH Healthcare Services, Inc. (Des Plaines, IL)
- …**Job Summary:** Provides services to clients in accordance with the State Nurse Practice Act, Agency policy, and accepted professional standards of practice. The ... Registered Nurse provides nursing services utilizing a comprehensive base of...accidents and promote + Notifies supervisor of need for review and/or training related to equipment, procedures, or safety/infection… more
- US Tech Solutions (North Chicago, IL)
- …Training will be on the same schedule **Purpose** + The Clinical Research Nurse is a specialized research professional working with and under the direction of ... subjects. + The primary role is to function as a licensed registered nurse engaged in the practice of care/assessments of the healthy volunteers and/or patient.… more
- BioLife Plasma Services (Chicago, IL)
- …Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. _BioLife Plasma Services is a subsidiary ... determine donor eligibility to donate plasma, management of donor adverse events, review of laboratory test results, and donor notification of unsuitable test… more
- Elevance Health (Chicago, IL)
- **Diagnosis Related Group Clinical Validation Auditor-** **Registered Nurse ** **Location:** This position will work a hybrid model (remote and office). Ideal ... documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims. **How you will make… more
- Elevance Health (Chicago, IL)
- ** Nurse and CPC - Clinical Fraud Investigator II - SIU Fraud & Abuse** **Location:** This position will work a hybrid model (remote and office). The ideal candidate ... opportunities for fraud and abuse prevention and control. + Review and conducts analysis of claims and medical records...Skills, Qualifications, and Experiences:** + Fraud and Abuse experienced Nurse with a CPC are highly desired. For candidates… more
- Rush University Medical Center (Chicago, IL)
- …Offers may vary depending on the circumstances of each case. **Summary:** Expert research nurse who leads the provision of clinical care within the context of a ... publications. 16. May act as a nursing representative on the Protocol Review and Monitoring Committee, Data Safety Monitoring Board and other relevant committees.… more
- Fresenius Medical Center (Waukegan, IL)
- …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... surveys. + Participates in the completion of the FMS Administrative Clinical Review . **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical demands and work… more