- 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
- Zurich NA (Schaumburg, IL)
- …medical terminology Preferred Qualifications: + 2 or more years' experience in Utilization Review , Case Management, Workers Compensation, or medical bill reviews ... Medical Bill Review Senior Nurse 123154 Zurich Insurance is currently looking for a **Medical Bill Review Senior Nurse ** to work from our Schaumburg, IL… 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
- Elevance Health (Chicago, IL)
- …an expanding set of clinical domains, including radiology, cardiology and oncology._ ** Nurse Reviewer I** **Location:** This is a virtual position open to Pacific, ... position and conducted in CDT, regardless of your individual time zone. The ** Nurse Reviewer I** is responsible for conducting preauthorization, out of network and… 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
- AdventHealth (Hinsdale, 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
- 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
- CVS Health (Chicago, IL)
- …through integration. + Through the use of clinical tools and information/data review , conducts comprehensive assessments of member's needs and recommends an approach ... that impact functionality and the member's restrictions/limitations. + Analyzes utilization , self-report and clinical data available to consolidate information and… 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
- GE Vernova (Oakbrook Terrace, IL)
- …+ Hold operating rhythm, pacing calls on Resource/workload management, Engineering utilization , Budget Deviation, On Time Delivery (OTD), Say Do Ratio (SDR), ... + Collaborate with Engineering & Project Controls to have monthly rhythm to review workload vs capacity and work with department managers on their respective ramp… more
- Prime Healthcare (Des Plaines, IL)
- Overview * Department: Utilization Management * Schedule: Days, 8am-4:30pm * Facility:Prime Holy Family Medical Center * Location: Des Plaines, 60016 Company is an ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...accredited school of nursing and a current state Registered Nurse license 2. Grandfathered prior to April 1, 2015.… more