- Elevance Health (Chicago, IL)
- ** Nurse Reviewer I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... rotating weekends.** **New Grads are encouraged to apply!** The ** Nurse Reviewer I** will be responsible for...that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or… more
- 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
- Huron Consulting Group (Chicago, IL)
- …for planning, organizing, developing, and directing implementation of the Utilization Review Plan and the overall operation of the Utilization Management Department ... Annapolis, MD + Staff Acquisition and Support: Leads and manages the utilization review staff and function for the system, reporting to the Director of Utilization… 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)
- …on the circumstances of each case. **Summary:** The Bone Marrow Transplant (BMT) Oncology Nurse Navigator 2 is a registered nurse (RN) who works collaboratively ... Cellular Therapy within the Cancer Center service line. The BMT Oncology Nurse Navigator 2 assesses patients' psychosocial, financial, and clinical needs throughout… more
- BioLife Plasma Services (Chicago, 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 of ... determine donor eligibility to donate plasma, management of donor adverse events, review of laboratory test results, and donor notification of unsuitable test… more
- Sunrise Senior Living (Palos Park, IL)
- …services by administering medication and treatments in a safe organized manner. + Review , read, notate, and initial the electronic health record to document and ... + Receive medication updates from Resident Care Director (RCD) or Wellness Nurse . + Administer, assist with, and observe medications and treatments for each… more
- Elevance Health (Chicago, IL)
- ** Nurse Case Manager II** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... complete the assessment within 48 hours of receipt and meet the criteria._** The ** Nurse Case Manager II** is responsible for care management within the scope of… more
- Elevance Health (Chicago, IL)
- **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days ... opportunities for fraud and abuse prevention and control. + Review and conducts analysis of claims and medical records...Skills, Qualifications, and Experiences:** + Fraud and Abuse experienced Nurse with a CPC are highly desired. For candidates… more
- Rush University Medical Center (Oak Park, IL)
- …the circumstances of each case. **Summary:** The RNIII is a proficient nurse possessing in-depth knowledge of patient management; can accommodate unplanned events ... management of complex patient situations. * Provides coaching for reflection and review of complex patient situations in order to identify practical solutions.… more
- Ascension Health (Chicago, IL)
- …issues prior to patient's discharge. + Maintain accurate records of review activities, ensuring reports and outcomes of clinical documentation improvement (CDI) ... improvement activities. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Illinois Board of Nursing obtained prior… more
- AdventHealth (Hinsdale, 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 ... CERTIFICATION OR REGISTRATION REQUIRED:** . State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:** . ACM/CCM… 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
- Molina Healthcare (Chicago, IL)
- …meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital or medical ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing (RN) license in good standing. To all current Molina employees: If you are interested in applying for this position, please apply through the… more
- Trinity Health (Berwyn, IL)
- …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 ... medical necessity criteria, and network availability. **Key Responsibilities:** + Review , process, and approve pre-certification requests under clinical supervision.… 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
- ChenMed (Berwyn, IL)
- …patient visits, once patient has completed their episode of care management the register nurse (RN) will review patient chart for discharge and conduct final ... our team. The Community Care team is a multidisciplinary service including Registered Nurse (RN) Community Care nurses, Licensed Practical Nurse (LPN) Community… more
- Amergis (Chicago, IL)
- Amergis Healthcare Staffing is seeking a Medical/Surgical Registered Nurse to assume responsibility and accountability for the application of the nursing process and ... the delivery of patient care. The nurse demonstrates ability to make clinical judgments in an...any unit issues Blocked Scheduling? N/A Position Details Please review all details: Run daily unit huddles, assure BSSR… more
- Rush University Medical Center (Chicago, IL)
- …as clinical resource for staff through consultation, formal and informal education, review of literature, and participation in seminars and conferences. Ensures that ... a licensed physician assistant (PA) or advanced practice registered nurse (APRN) who functions as a member of the...care for everyone who comes to Rush. **Position Requirements:** ** Nurse Practitioner:** * Current licensure from the State of… 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