- 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
- Veterans Affairs, Veterans Health Administration (Hines, IL)
- …The Utilization Management (UM) Consultant is a registered professional nurse , qualified by education and experience to work directly with physicians, residents, ... nurses, nurse managers, ward clerks, admission clerks, social services, administrative...and can retrieve information from multiple sources/packages for case review (ie, CPRS, VistA, Outlook, NUMI, etc.) The responsibilities… 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
- 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
- Fresenius Medical Center (Chicago, 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
- 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
- CenterWell (Chicago, IL)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... about what CenterWell Home Health can do for your Nurse Career! The **Clinical Manager** coordinates and oversees all...requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking… 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
- Trinity Health (Maywood, IL)
- …ED, hospital and post-acute system resources are used appropriately and effectively. They review utilization and quality data to monitor performance of care ... Physician Partners. The Manager provides oversight and daily management of the Nurse Care Coordinators, Community Health Workers, Social Workers and other population… 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), ... Customer comments. + Collaborate with Project Controls to have monthly rhythm to review workload vs capacity and work with department managers on their respective… more
- Trinity Health (Maywood, IL)
- …**Description:** The Lead Case Manager Position reports to the Manager of Nurse Care Management. The specific duties include: Recruiting, interviewing, hiring, and ... Assists in compilation of physician profile data and regarding LOS, resource utilization , denied days, costs, case mix index, patient satisfaction and quality… more
- Fresenius Medical Center (Downers Grove, IL)
- …barriers to quality improvement. This includes promoting the adoption and utilization of Medical Advisory Board Recommended Algorithms and Standing Orders, clinical ... quality improvement tools and electronic applications. + Performs desk review of facility Quality Assessment and Performance Improvement (QAPI) documentation… more