• Utilization Review Nurse

    US Tech Solutions (Chicago, IL)
    …+ Do you have experience with Prior Authorization? + Do you have experience with Utilization Review ? + Do you have an Active Registered Nurse License? ... more
    US Tech Solutions (01/17/25)
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  • Clinical Denials Specialist

    Insight Global (Skokie, IL)
    …https://insightglobal.com/workforce-privacy-policy/ . Skills and Requirements 3+ years experience as a utilization review nurse Experience reviewing and ... more
    Insight Global (01/03/25)
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  • Utilization Review Author (Weekend)

    R1 RCM (Chicago, IL)
    …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Author** , you will help our hospital ... more
    R1 RCM (02/15/25)
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  • Analyst- Utilization Review

    Ascension Health (Hoffman Estates, IL)
    …Heart Association or American Red Cross accepted. + Practical/Vocational Nurse credentialed from the Illinois Department of Financial and ProfessionalRegulation ... more
    Ascension Health (02/05/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Kenosha, WI)
    …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... more
    Molina Healthcare (01/25/25)
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  • Nurse Care Manager 1

    Rush University Medical Center (Chicago, IL)
    …Offers may vary depending on the circumstances of each case. **Summary:** The Nurse Care Manager 1 works with physician practices and inpatient teams to promote ... more
    Rush University Medical Center (02/13/25)
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  • Clinical Appeals Nurse (RN): Texas and New…

    Molina Healthcare (Kenosha, WI)
    …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... more
    Molina Healthcare (02/09/25)
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  • BMT Clinical Nurse Leader

    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 ... more
    Rush University Medical Center (01/15/25)
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  • Registered Nurse (RN) Care Coordinator

    Froedtert South (Pleasant Prairie, WI)
    …implications of options with patients and families, utilizing the appropriate resources from Utilization Review and other areas. + Participates in and leads, as ... more
    Froedtert South (02/21/25)
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  • Dialysis Clinical Manager Registered Nurse

    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, ... more
    Fresenius Medical Center (02/11/25)
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  • Dialysis Clinical Manager Registered Nurse

    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 ... more
    Fresenius Medical Center (02/25/25)
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  • Medical Review Coordinator II

    Prime Healthcare (Evanston, IL)
    …and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and ... more
    Prime Healthcare (02/14/25)
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  • Care Review Clinician, Inpatient…

    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 ... more
    Molina Healthcare (02/05/25)
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  • Medical Director (Marketplace)

    Molina Healthcare (Kenosha, WI)
    …the Chief Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the ... more
    Molina Healthcare (02/06/25)
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  • Manager, Healthcare Services (Remote)

    Molina Healthcare (Kenosha, WI)
    …performing one or more of the following activities: care review / utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), ... more
    Molina Healthcare (02/09/25)
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  • RN Clinical Manager, Home Health

    CenterWell (Buffalo Grove, IL)
    review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... more
    CenterWell (01/25/25)
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  • Clinical Consulting Specialist RN

    Rush University Medical Center (Chicago, IL)
    …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 (12/10/24)
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  • Interventional Capital Sales Representative-…

    Teleflex (Chicago, IL)
    …territory. The incumbent is responsible for the growth of overall product utilization within their accounts; including, but not limited to, selling the designated ... more
    Teleflex (02/14/25)
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