- Molina Healthcare (IL)
- …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Molina Healthcare (Downers Grove, IL)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... medical clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. To all… more
- Rush University Medical Center (Oak Park, IL)
- …origin, disability, veteran status, and other legally protected characteristics. **Position** Registered Nurse 2 Operating Room **Location** US:IL:Oak Park **Req ... the circumstances of each case. **Summary:** The RNIII is a proficient nurse possessing in-depth knowledge of patient management; can accommodate unplanned events… more
- Centene Corporation (Springfield, IL)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... preferred. Experience working with providers and healthcare teams to review care services related to mental health... only: LMSW, LCSW, LMHC, LPC, LMFT, LMHP or RN required Pay Range: $26.50 - $47.59 per hour… more
- Highmark Health (Springfield, IL)
- …of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** + ... and the proper action to complete the retrospective claim review with the goal of proper and timely payment...outcomes. Will monitor and analyze the delivery of health care services in accordance with claims submitted, and analyzes… more
- Datavant (Springfield, IL)
- …with clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... government agencies, and those who deliver and pay for care . By joining Datavant today, you're stepping onto a...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
- Rush University Medical Center (Chicago, IL)
- …**Other information:** **Required Job Qualifications:** * Current State of Illinois Registered Nurse licensure * National certification * Master's degree ... organization's strategic plans, regulatory agency requirements, guidelines, and standards of care . * Uses effective strategies for changing clinician behavior… more
- Rush University Medical Center (Chicago, IL)
- …**Other information:** **Required Job Qualifications:** * Current State of Illinois Professional Registered Nurse licensure * Graduate degree in nursing * o ... families, and communities in the microsystem. The CNL is a point of care expert clinician , outcomes manager, client advocate, educator, information manager,… more
- Aveanna Healthcare (Peoria, IL)
- …remain at the forefront of everything we do and receive the best care possible! Clinical Supervisor ( RN ) (Nursing Supervisor) Aveanna Healthcareis a leading ... patient intake and discharge to home, our start of care process and nurse competency validation. The...the Nursing Supervisor: + Must have good standing license ( RN ) in the state in which the clinician… more
- US Tech Solutions (Chicago, IL)
- …and implementation of QM Work Plan Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior ... **Responsibilities:** + Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations.... Review ? + Do you have an Active Registered Nurse License? **About US Tech Solutions:**… more
- Kestra Medical Technologies, Inc (Peoria, IL)
- …+ Knowledge of MS Office, Excel, PowerPoint, MS Teams + Direct cardiac patient care experience - RN , RT, CVIS, Paramedic, CRM WORK ENVIRONMENT + Variable ... comfort and dignity. Innovating versatile new ways to deliver care , Kestra is helping patients and their care...the patient to determine the correct garment size + Review and transmit essential paperwork with the patient to… more
- Elevance Health (Chicago, IL)
- …employment, unless an accommodation is granted as required by law. The **Medical Management Nurse ** is responsible for review of the most complex or challenging ... **Medical Management Nurse ** **Hours: 8am-6pm flexible start time** **Location** :...not be receiving appropriate type, level, or quality of care , eg, if services are not in line with… more