- R1 RCM (Chicago, IL)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Nurse ** , you will help our hospital ... you must have experience in a clinical inpatient environment and hospital-based utilization or case management experience. Proficiency in basic computer skills… more
- ChenMed (Chicago, IL)
- …I, Care Line is responsible for diagnostic patient care primarily through virtual, remote consultation via video conference or telephone. The incumbent in this role ... trends in patient conditions and develops, documents and implements a patient management plan based on interpretation of findings. Aids in the development of… more
- Elevance Health (Chicago, IL)
- ** Nurse Audit Lead** **Supports the Carelon Payment Integrity line of business** _Location: This position will work a hybrid model ( remote and office). The ideal ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Nurse Audit Lead** is responsible for leading a team of clinicians… more
- Sharecare, Inc. (Chicago, IL)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... the Family Health Advocate is an exciting and innovative remote role newly created to provide meaningful support to...+ Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex… more
- ChenMed (Chicago, IL)
- …expanding and we need great people to join our team. The Registered Nurse 1, Care Line, is responsible for providing telephonic triage directional patient care ... client counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families. Providing on-call coverage, the… more
- Centene Corporation (Burr Ridge, IL)
- …5+ years of leadership experience. Master's degree preferred. **License/Certification:** Registered Nurse . Certified Case Management (CCM). **For Illinois Plan ... Must reside in Illinois. Will direct all activities pertaining to Case Management and Care Coordination activities and monitor utilization of Enrollees'… more
- Teleflex (Chicago, IL)
- …territory. The incumbent is responsible for the growth of overall product utilization within their accounts including, but not limited to, selling the designated ... time in the field. * Facilitate sales growth by conducting physician, nurse , and technologist training and account in-servicing of dialysis access products. *… more