- 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
- Elevance Health (Chicago, IL)
- ** Nurse Audit Sr** **Location:** This position will work virtual. Ideal candidates will live within 50 miles of one of our Pulse Point locations. Carelon Payment ... determined to recover, eliminate and prevent unnecessary medical-expense spending." The ** Nurse Audit Sr** is responsible for identifying, monitoring, and analyzing… 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 vary 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 (Manteno, IL)
- …and record relevant patient information. Completed work should need only a general review by a registered nurse or physician for appropriateness and conformity ... and Store and Forward Telehealth technologies. Responsibilities The Telehealth Licensed Practical Nurse (TCT-LPN) serves in a generalist role to support and manage… more
- Elevance Health (Chicago, IL)
- …the Elevance Health major office (PulsePoint) location listed above. The **Medical Management Nurse ** is responsible for review of the most complex or ... **Medical Management Nurse ** **Office Location** : Atlanta, GA; Indianapolis, IN;...and requires a minimum of 2 years clinical, utilization review , or case management experience; or any combination of… more
- R1 RCM (Chicago, IL)
- …production-driven position. **Here's what you will experience working as a Clinical Appeals Nurse :** + Conduct a detailed review of patient medical records and ... analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Appeals Nurse ** , you will help our hospital clients by serving as an… more
- Reliance Home Health Caregivers (Bolingbrook, IL)
- …to live in the community, in the private residence of their own. The RN Nurse Trainer will evaluate and provide the medical, health, and safety needs of the clients ... residencies. Will provide training and authorization for non-licensed staff. The RN Nurse Trainer will be responsible for: + Documenting client specific medical… more
- AdventHealth (La Grange, IL)
- …patient and involved care givers (as permitted by the patient) as well as a review of the current and past inpatient and outpatient medical record in the Initial ... needed. **.** Actively participates in daily Multidisciplinary Rounds to review progression of care and discharge plan for all...Associates Degree Nursing or RN Diploma degree . Registered Nurse (RN) . Two (2) years of medical/hospital nursing… 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
- BioLife Plasma Services (Joliet, 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
- Fresenius Medical Center (Olympia Fields, IL)
- …to the Inpatient Program Manager, appropriately credentialed physician, patient hospital primary nurse and others as indicated. + Delivers safe, effective care in a ... May be assigned to in-center patient care on an as needed basis + Review and comply with the Code of Business Conduct and all applicable company policies… more
- Rush University Medical Center (Chicago, IL)
- …established research projects. 5. Submits materials (articles, media, etc.) for peer- review . 6. Presents evidence based and/or scholarly papers locally and ... disability, veteran status, and other legally protected characteristics. **Position** Registered Nurse - Clinical Care **Location** US:IL:Chicago **Req ID** 16801 more
- Fresenius Medical Center (South Holland, 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
- 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 ... including efficient utilization of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and on-site state or… more
- CVS Health (Chicago, IL)
- …through integration. + Through the use of clinical tools and information/data review , conducts comprehensive assessments of member's needs and recommends an approach ... to case resolution by meeting needs in alignment with their benefit plan and available internal and external programs and services. + Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and address complex clinical and… more
- Prime Healthcare (Chicago, IL)
- …status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and use sound judgment. ... Medical Graduate, PA, or Nursing (MSN) Graduate required. 2. Three years of Utilization Review experience as a Medical Review Coordinator - I required. 3.… 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 ... Summary** Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for… more
- Fresenius Medical Center (Cicero, IL)
- …dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with FMCNA policies, procedures, and training and in compliance ... well-being since their last treatment. Report any complaints or observations to the nurse supervisor. + Evaluate vascular access for patency and report any unusual… more