- 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
- 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 ... 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 (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
- Elevance Health (Chicago, IL)
- ** Nurse Reviewer I** **Location:** This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum ... Monday - Friday (9:30 AM -6:00 PM Centeral) The ** Nurse Reviewer I** is responsible for conducting preauthorization, out...that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or… 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
- Trinity Health (Berwyn, IL)
- …time **Shift:** **Description:** This position is for our Intensive Care Unit. The Clinical Nurse Leader works in tandem with the Nurse Manager to achieve and ... in our shared governance. Position responsibilities: + The Clinical Nurse Leader (CNL) is an expert nurse ...team's effectiveness by identifying barriers to effective and efficient utilization of resources and evaluating patients' needs. + They… 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
- 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 ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's… 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
- Health Care Service Corporation (Chicago, IL)
- …and decision-making skills. *PC and database experience. **PREFERRED JOB REQUIREMENTS:** * Utilization review experience. *MUST be licensed to practice at the ... Summary** This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity including assisting members… 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