- 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 127127 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)
- …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
- 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
- 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
- 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)
- …years clinical experience with direct clinical care to the consumer. + 2 years utilization review / managed care experience. + Leadership skills. + Knowledge of ... staff involved in a variety of clinical operations such as Utilization Management, Case Management and/or Disease Management. Responsible for hiring, training,… more
- Prime Healthcare (Chicago, IL)
- …license. 2. Five (5) years of experience in acute hospital setting in a Utilization Review , Case Management, business office or related department. Experience in ... Set (MDS), and for tracking, and transmitting all data including the Resource Utilization Groups (RUGs) to the Department of Health and Human Services. The process… more