- Morris Hospital (Morris, IL)
- …using evidenced-based clinical guidelines. Performs duties in accordance with the Utilization Review Plan. Demonstrates thorough knowledge of performance measure ... in acute hospital setting. + Strong clinical expertise. + Prior experience in utilization management or case management preferred. + Ability to maintain… more
- Prime Healthcare (Aurora, IL)
- …Qualifications EDUCATION, EXPERIENCE, TRAINING 1. Two (2) years clinical experience as a Case Manager in an acute care, post-acute, or payer setting within ... status and continued stay reviews. Communicates all medical necessity review outcomes and denials to case management...the last 5 years. 2. Utilization review and denial management experience required.… more
- Rush Copley Medical Center (Aurora, IL)
- …appropriateness of patient admission and level of care. + Provides continuous review of medical necessity and SI/IS criteria. Notifies physician and collaborates ... necessity, appropriateness, and quality of care. Applies criteria, performs concurrent review process. Works with physicians and Medical Director regarding Case… more