• 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? ... 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
    US Tech Solutions (10/18/24)
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  • Utilization Review RN for Behavioral…

    AdventHealth (Glendale Heights, IL)
    …Behavioral Health RN experience strongly preferred + Experience in utilization review strongly preferred + Registered Nurse credentialed from the Illinois ... health care services regarding admissions, case management, discharge planning and utilization review . **The value you'll bring to the team:** + Reviews… more
    AdventHealth (11/09/24)
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  • Utilization Review Author

    R1 RCM (Chicago, IL)
    …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Author** , you will help our hospital ... in this remote position. **Here's what you will experience working as a Utilization Review Author:** + Perform initial admission and continued stay reviews… more
    R1 RCM (10/26/24)
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  • Nurse Auditor - Medical Bill Review

    Rising Medical Solutions (Chicago, IL)
    …was born - and continues to thrive. Rising Medical Solutions is looking for a Nurse Auditor who wants to make their mark in the world of medical cost containment. ... team and maximize client savings by reviewing medical bills from a nurse perspective, including appropriate billing, coding and treatment, fee schedule compliance,… more
    Rising Medical Solutions (11/13/24)
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  • Registered Nurse - Accreditation…

    Veterans Affairs, Veterans Health Administration (Hines, IL)
    Summary The Accreditation and Quality Specialist (AQS) Consultant Nurse demonstrates leadership in providing continuous readiness for accreditation and regulatory ... agency review and compliance (Joint Commission, Inspector General, Long Term...Center. Responsibilities The Accreditation and Quality Specialist (AQS) Consultant Nurse serves as a Specialist within the Accreditation &… more
    Veterans Affairs, Veterans Health Administration (11/17/24)
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  • Registered Nurse - Quality Performance…

    Veterans Affairs, Veterans Health Administration (Hines, IL)
    …incumbent conducts various patient care studies based on areas assigned, including review of patient incident report reviews, utilization management reviews, ... coordinating and maintaining a comprehensive, organized, continuous readiness program to review and identify opportunities for improvement in order to achieve… more
    Veterans Affairs, Veterans Health Administration (11/16/24)
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  • Nurse Care Manager 1 ( Overnight)

    Rush University Medical Center (Chicago, IL)
    …rewards and benefits learn more at our Rush benefits page . **Summary:** The Nurse Care Manager 1 works with physician practices and inpatient teams to promote the ... effective utilization of services and coordination of care for adult,...for adult, geriatric, neonate, pediatric and adolescent patients. The Nurse Care Manager 1 contributes to the team's effectiveness… more
    Rush University Medical Center (11/08/24)
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  • Med Surg Oncology Clinical Nurse Leader

    Rush University Medical Center (Chicago, IL)
    **Job Description** Med Surg Oncology Clinical Nurse Leader **Location:** Chicago, IL **Hospital:** RUSH University Medical Center **Department:** 14 W Tower ... 1 **Work Schedule:** 8 Hr (7:00:00 AM - 3:30:00 PM) **Summary:** The Clinical Nurse Leader (CNL) functions as an advanced generalist providing and managing care for… more
    Rush University Medical Center (10/16/24)
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  • BMT Clinical Nurse Leader

    Rush University Medical Center (Chicago, IL)
    **Job Description** **BMT Clinical Nurse Leader** **Location:** Chicago, IL **Hospital:** RUSH University Medical Center **Department:** 14 E Tower (BMT/Heme ... **Work Schedule:** 8 Hr (7:00:00 AM - 3:30:00 PM) **Summary:** The Clinical Nurse Leader (CNL) functions as an advanced generalist providing and managing care for… more
    Rush University Medical Center (10/16/24)
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  • Nurse Practitioner

    ChenMed (Chicago, IL)
    …explain nurse practitioner role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... we need great people to join our team. The Nurse Practitioner (NP) acts as part of the clinical...in-depth documentation through written progress notes and summaries. The Nurse Practitioner must demonstrate the ability to function both… more
    ChenMed (10/02/24)
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  • Psychiatric Nurse Practitioner

    Symetria Recovery (Chicago, IL)
    …in the context of Evaluation/Management visits when appropriate. + Utilization of safe prescribing practices and evidence-based treatment guidelines for ... co-occurring substance use disorders. + Complete training provided on utilization and result interpretation of available diagnostic procedures (Ie Pharmacogenetic… more
    Symetria Recovery (10/27/24)
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  • Nurse Manager, Emergency Department

    Trinity Health (Melrose Park, IL)
    **Employment Type:** Full time **Shift:** Day Shift **Description:** The Nurse Manager of our Emergency Department at Gottlieb Memorial Hospital is a registered ... professional nurse , conversant with the nursing process, who has 24x7...projects and research activities (as appropriate). a) Conduct bi-annual review of all unit-specific policies/procedures to ensure compliance with… more
    Trinity Health (09/11/24)
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  • Clinical Nurse Leader, Nurse

    Trinity Health (Berwyn, IL)
    **Employment Type:** Full time **Shift:** Day Shift **Description:** **The Clinical Nurse leader is an expert nurse and role model who facilitates expected ... to provide holistic, patient-centered care using evidence-based practices.** **The Clinical Nurse Leader, LDRP Birthing Center at MacNeal Hospital, is responsible… more
    Trinity Health (11/08/24)
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  • Nurse Practitioner, Healthy House Calls

    Lumeris (Chicago, IL)
    …in the process. Additionally, we can easily send pertinent documents to you for your review . Once you create the account, you may apply to any position you feel is ... re-enter information. Thank you for your interest in Lumeris. **Position:** Nurse Practitioner, Healthy House Calls, Chicago, IL **Position Summary:** Responsible… more
    Lumeris (11/12/24)
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  • Dialysis Clinical Manager Registered Nurse

    Fresenius Medical Center (Plainfield, 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 (10/13/24)
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  • Dialysis Clinical Manager Registered Nurse

    Fresenius Medical Center (Chicago, 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
    Fresenius Medical Center (09/24/24)
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  • RN Care Manager PRN

    AdventHealth (La Grange, IL)
    …to nurses, physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge Planning and care ... (as permitted by the patient) as well as a review of the current and past inpatient and outpatient...days, and facilitates progression of care. **.** Collaborates with Utilization Management staff for collaboration on patient status changes… more
    AdventHealth (11/15/24)
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  • Associate Medical Director, Clinical Operations

    Elevance Health (Chicago, IL)
    …PulsePoint locations. **How you will make an impact:** + Perform physician-level case review , following initial nurse review , of high-tech diagnostic ... Demonstrate and maintain knowledge of relevant policies and regulations pertaining to utilization review of diagnostic imaging procedures, cardiac services and… more
    Elevance Health (10/22/24)
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  • Service Line Coordinator RN

    Rush University Medical Center (Chicago, IL)
    …response to treatment. 3. Constantly seeks process improvement opportunities regarding supple utilization and charge captures. 4. Acts as the primary liaison between ... brings topics for potential investigation to the Nursing Quality/UAC group. Coordinates peer review of nursing quality and safety issues for the service line. 11.… more
    Rush University Medical Center (10/02/24)
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  • Case Manager RN

    CVS Health (Downers Grove, IL)
    …to reside in Illinois.** **Schedule: Monday-Friday 9-5 CST.** **Position Summary** Nurse Case Manager is responsible for telephonically and/or face to face ... and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes. Fundamental… more
    CVS Health (10/06/24)
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