- Evolent (Springfield, IL)
- …scheduled. + Determines medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all review ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks… more
- Centene Corporation (Springfield, IL)
- …be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... knowledge, and discharge planning knowledge. **Additional Details:** Department: Concurrent Review MCD** Business Unit: Corporate** Schedule: Mon-Fri 8am - 5pm… more
- Rush University Medical Center (Chicago, IL)
- …Offers may vary depending on the circumstances of each case. **Summary:** The Clinical Nurse Leader (CNL) functions as an advanced generalist providing and ... The CNL provides insight regarding the microsystem for collaboration with the Clinical Nurse Specialist (CNS) on macrosystem processes and outcomes. The… more
- Rush University Medical Center (Chicago, IL)
- …ethnically diverse educational environment. 6. Supports the college, university and medical center wide interdisciplinary programs. Clinical Practice. Research ... disability, veteran status, and other legally protected characteristics. **Position** Registered Nurse , Clinical Care - Newark, NJ **Location** US:IL:Chicago… more
- Fresenius Medical Center (Cicero, IL)
- …or federal surveys. + Participates in the completion of the FMS Administrative Clinical Review . **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical ... requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory… more
- Veterans Affairs, Veterans Health Administration (Chicago, IL)
- …CC Coordinator possesses intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical ... Summary The Community Care EHRM Clinical Care Coordinator acts as subject matter expert...throughout the consult process. The CC Coordinator supports the medical center's mission to improve timely access to care,… more
- Cognizant (Springfield, IL)
- …necessity determinations to the Health Plan/ Medical Director based on the review of clinical documentation in accordance with Medicare, Medicaid, and ... as well as timely filing deadlines and processes. . Review clinical denials including but not limited...thinking skills to interpret guidelines of internal policies for clinical determination. . Medical Necessity Reviews can… more
- Fresenius Medical Center (Chicago Heights, IL)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture...a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in… more
- Fresenius Medical Center (Spring Valley, IL)
- **PURPOSE AND SCOPE:** The professional registered nurse Outpatient RN CAP 2 may be an entry level designation into the Clinical Advancement Program (CAP) for ... functions under the direction of the Supervisor and with guidance from the Clinical Educator, Preceptor or in collaboration with other Registered Nurses. + Performs… more
- BioLife Plasma Services (Villa Park, IL)
- …You will report to the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. BioLife ... of laboratory test results, and donor notification of unsuitable test results. The Medical Support Specialist (Plasma Center Nurse ) works under the guidance of… more
- Gentiva (Peoria, IL)
- …(LCD) criteria per hospice policy and regulatory requirements. + Communicate clinical findings, review treatment plans, lab results, diagnostics, and ... Transform Hospice Care.** We are seeking a dedicated per diem Hospice Nurse Practitioner to perform Face-to-Face (F2F) encounters essential for hospice eligibility… 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 ... The RN 3 assumes a leadership role in the clinical practice area, using clinical experience to...* Work requires the ability to walk throughout the medical center and to be standing and walking most… more
- Blessing Hospital (Quincy, IL)
- …BASED ON RELEVANT EXPERIENCE COMPETITIVE BENEFITS Click here (https://www.blessinghealth.org/benefits) to review our complete Total Rewards Guide. + 403b + matching ... who are above 17 years of age who require medical /surgical nursing care. The primary population served is surgical...Therapist, Physical Therapist, and an Unit-based Educator. The associate nurse manager in collaboration with the nurse … more
- Blessing Hospital (Quincy, IL)
- …BASED ON RELEVANT EXPERIENCE COMPETITIVE BENEFITS Click here (https://www.blessinghealth.org/benefits) to review our complete Total Rewards Guide. + 403b + matching ... SUMMARY We are a 30 bed unit serving many medical patient populations. Our focus is oncology (from new...we serve with high quality, compassionate care. The associate nurse manager in collaboration with the nurse … more
- Fresenius Medical Center (Waukegan, IL)
- …Functions as part of the hemodialysis health care team as a Staff Registered Nurse to ensure provision of quality patient care on a daily basis in accordance ... + Reviews, transcribes, and enters physician lab orders accurately into the Medical Information System. + Ensures appropriate preparation of lab requisitions for… more
- AccentCare, Inc. (Rosemont, IL)
- …a Palliative Care Nurse Practitioner, you will: + Develop and implement clinical plans of care for patients with chronic and terminal illnesses + Perform patient ... Overview Nurse Practitioner / NP, Palliative Care Location: Rosemont,...and maintain valid CPR certification while employed in a clinical role, preferred + Must be a licensed driver… more
- Fresenius Medical Center (Chicago, IL)
- …to the Inpatient Program Manager, appropriately credentialed physician, patient hospital primary nurse and others as indicated. + Delivers safe, effective care in a ... May be assigned to in-center patient care on an as needed basis + Review and comply with the Code of Business Conduct and all applicable company policies… more
- Sunrise Senior Living (Prospect Heights, IL)
- …Sunrise of Prospect Heights **Job ID** 2025-230959 **JOB OVERVIEW** The Wellness Nurse is responsible for monitoring the health and well-being of our residents ... administration, communication with resident support services and families, and maintaining clinical quality assurance while leading and demonstrating the Mission for… more
- CVS Health (Springfield, IL)
- …benefit overall claim management. + Using a holistic approach, consults with clinical colleagues, supervisors, Medical Directors and/or other programs to ... in the US with virtual training.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993,… more
- Veterans Affairs, Veterans Health Administration (North Chicago, IL)
- …report and record relevant] patient information. Completed work [should need] only a general review by a registered nurse [(RN) or physician (MD/DO)] for [ ] ... limited to: Makes observations and thoroughly documents care in the electronic medical record (EMR) the patient's response. Promptly recognizes urgent or emergent… more