- Prime Healthcare (Aurora, IL)
- …licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/189384/ utilization - review - nurse ... or payer setting within the last 5 years. 2. Utilization review and denial management experience required.... and denial management experience required. 3. Current state RN licensure required. 4. Must be able to communicate… more
- 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
- Morris Hospital (Morris, IL)
- …using evidenced-based clinical guidelines. Performs duties in accordance with the Utilization Review Plan. Demonstrates thorough knowledge of performance measure ... and federal regulatory requirements and payer/reimbursement methodologies. + Licensure as Registered Nurse in Illinois. + DCFS Mandated Reporter Certificate… more
- ICW Group (Lisle, IL)
- …providing direct clinical care required. **CERTIFICATES, LICENSES, REGISTRATIONS** Current unrestricted Registered Nurse ( RN ) or Licensed Vocational ... regulatory standards. + Interfaces with external agencies in relation to the utilization review process including, Third-Party Payers, Insurance Companies and… more
- Rush Copley Medical Center (Aurora, IL)
- **Position Summary:** The registered nurse is responsible for the assessment, planning, implementation, and evaluation of the patients' status, plan of care, and ... and is in accordance with policies and procedures. The registered nurse is expected to uphold the...patient admission and level of care. + Provides continuous review of medical necessity and SI/IS criteria. Notifies physician… more