- Elevance Health (Chicago, IL)
- **Clinical Operations Medical Director** ** Utilization Management of Medical Oncology Benefits** **Carelon Benefits Management ** **$20,000 Sign On Bonus** ... members and providers. **Job Summary:** + Perform physician-level case review , following initial nurse review ,...maintain knowledge of relevant policies and regulations pertaining to utilization review of oncology care. + Participate… more
- Elevance Health (Chicago, IL)
- ** Utilization Management Representative II** **Location** : This position will work remotely. The ideal candidate will live within 50 miles of one of the ... Atlanta, GA; Chicago, IL; Indianapolis, IN; Louisville, KY; The ** Utilization Management Representative II** is responsible for...the provider on referrals given. Refers cases requiring clinical review to a nurse reviewer; and handles… more
- Rush University Medical Center (Chicago, IL)
- …**Location:** Chicago, IL **Hospital:** RUSH University Medical Center **Department:** Care Management **Work Type:** Full Time (Total FTE between 0.9 and 1.0) ... **Shift:** **Shift 1** **Work Schedule:** 8 Hr **Summary:** The Nurse Care Manager 1 works with physician practices and...physician practices and inpatient teams to promote the effective utilization of services and coordination of care for adult,… more
- Elevance Health (Chicago, IL)
- …**How you will make an impact:** + Develops, maintains and enhances the claims review process. + Assists management with developing unit goals, policies and ... ** Nurse Audit Lead** **Supports the Carelon Payment Integrity...responsible for identifying, monitoring, and analyzing aberrant patterns of utilization and/or fraudulent activities by health care providers through… more
- AdventHealth (Hinsdale, IL)
- …documents avoidable days, and facilitates progression of care. **.** Collaborates with Utilization Management staff for collaboration on patient status changes ... (as permitted by the patient) as well as a review of the current and past inpatient and outpatient.... Health-related Master's degree or MSN . Prior Care Management / Utilization Management experience **LICENSURE, CERTIFICATION… more
- Rush University Medical Center (Chicago, IL)
- …**Work Schedule:** 8 Hr (7:00:00 AM - 5:00:00 PM) **Summary:** The Clinical Nurse Leader (CNL) functions as an advanced generalist providing and managing care for ... for the improvement of patient care outcomes, and resource in the management of clinically complex patients. The CNL provides insight regarding the microsystem… more
- Rush University Medical Center (Chicago, IL)
- …Schedule:** 10 Hr (7:00:00 AM - 5:30:00 PM) **Summary:** The Ambulatory Clinical Nurse Leader functions as an advanced generalist providing and managing care for ... anticipator, team lead, professional, and lifelong learner. The Ambulatory Clinical Nurse Leader collaborates with nursing leadership and the healthcare team, and… more
- Trinity Health (Berwyn, IL)
- …the inter-professional team and actively participates in interdisciplinary rounds, complex case review and management of patient throughput. The CNL evaluates, ... **Employment Type:** Full time **Shift:** Day Shift **Description:** The Perioperative Clinical Nurse Leader (CNL) at MacNeal Hospital is an expert nurse and… more
- Fresenius Medical Center (Chicago, IL)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… 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
- AdventHealth (Hinsdale, IL)
- …documents avoidable days, and facilitates progression of care. . Collaborates with Utilization Management staff for collaboration on patient status changes and ... (as permitted by the patient) as well as a review of the current and past inpatient and outpatient.... Health-related Master's degree or MSN . Prior Care Management / Utilization Management experience **LICENSURE, CERTIFICATION… more
- Rush University Medical Center (Chicago, IL)
- …(7:00:00 AM - 3:30:00 PM) **Summary:** The Clinical Consulting Specialist is a nurse with expertise within a specialized area of nursing practice responsible for ... team and demonstrates advanced knowledge and skills in education, organizational management and forging partnerships. Gaining cooperative efforts to promote a safe… more
- Trinity Health (Maywood, IL)
- …for regional and hospital nursing operations, including regionalized services for Utilization Review /Case Management , Centralized Telemetry, Nursing ... analytics and predictive modeling. Participates with the governing body, management , medical staff, and clinical leaders in the organization's decision-making… more
- Vyaire Medical (Chicago, IL)
- …within and across functional groups. Communicate information related to quality management system efficiency. + Directly support the timely and quality sale, ... of new products and services; make recommendations to drive client acceptance and utilization of new medical devices. Facilitate UPE's for new products. + Develop,… more