- 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? ... 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior...and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1… more
- 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 ... in Annapolis, MD + Staff Acquisition and Support: Leads and manages the utilization review staff and function for the system, reporting to the Director of … more
- Ascension Health (St. Charles, IL)
- **Details** + **Department:** Utilization Review + **Schedule:** Part-Time, Partially Remote, Monday - Friday; 9am - 1pm. + **Hospital:** Ascension Saint Joseph ... Provide health care services regarding admissions, case management, discharge planning, and utilization review . + Review admissions and service requests… more
- Health Care Service Corporation (Chicago, IL)
- …decision making skills.** **PC and database experience.** **PREFERRED JOB REQUIREMENTS:** ** Utilization review experience.** **3 years clinical experience in ... Summary** This position is responsible for ensuring accurate and timely clinical review of behavioral health cases (Applied Behavior Analysis (ABA)) for medical… more
- Zurich NA (Schaumburg, IL)
- …medical terminology Preferred Qualifications: + 2 or more years' experience in Utilization Review , Case Management, Workers Compensation, or medical bill reviews ... Medical Bill Review Senior Nurse 127127 Zurich Insurance is currently looking for a **Medical Bill Review Senior Nurse ** to work from our Schaumburg, IL… more
- Rush University Medical Center (Chicago, IL)
- …on the circumstances of each case. **Summary:** The Bone Marrow Transplant (BMT) Oncology Nurse Navigator 2 is a registered nurse (RN) who works collaboratively ... with physician practices and multi-disciplinary teams as to promote the effective utilization of services and coordination of care for patients within the Section of… 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
- 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 ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… 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, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
- Trinity Health (Berwyn, IL)
- …an experienced Authorization Referral Coordinator. Reporting to the Manager of Utilization Management and working under general supervision, manages Utilization ... 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
- 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 ... information:** **Required Job Qualifications:** * Current State of Illinois Registered Nurse licensure * National certification * Master's degree in Nursing from… 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 ... Set (MDS), and for tracking, and transmitting all data including the Resource Utilization Groups (RUGs) to the Department of Health and Human Services. The process… more
- Trinity Health (Maywood, IL)
- …through a thorough understanding of Milliman and InterQual criteria, conducts concurrent utilization review . Interacts with insurers, third party payors, and ... your career and make a lasting impact. Full Time - 8-5pm (days), Registered Nurse (RN) and 3 - 5 years of experience required Position Responsibilities: Using… more
- Deloitte (Chicago, IL)
- …nurse , physician, physician assistant, case manager, clinical documentation specialist, utilization review , informatics RN, Quality, DRG Validation and health ... in nursing, medical degree, or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical Documentation Specialist - CCDS… more
- ChenMed (Berwyn, IL)
- …explain nurse practitioner role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... CRITERIA: + ARNP or similar advanced degree in Nursing required + Current Nurse Practitioner Certification in the State of practice required + Board certification by… more
- ChenMed (Berwyn, IL)
- …PCPs, Dialysis units and vascular or inpatient care facilities. + Ability to review patient charts, provide assessments and recommendations for care plan. + Enhances ... home dialysis utilization for patients with emphasis on increasing de-novo start...**EDUCATION AND EXPERIENCE CRITERIA:** + Licensed Physician Assistant or Nurse Practitioner with 5+ years of nephrology experience +… more