• Director of Medical Mgmt, Post Acute

    Elevance Health (Chicago, IL)
    …operations managers who will perform clinical reviews for a set of Post Acute Care Utilization Management solutions and complex cases such as home ... or a UM/benefits management firm - Utilization management or clinical experience with post - acute care, especially wound care -Certified Wound care… more
    Elevance Health (04/17/24)
    - Save Job - Related Jobs - Block Source
  • Cardiologist

    ChenMed (Chicago, IL)
    …Coordinates as needed with the transitional care team, hospital, skilled nursing facility, post - acute , utilization management , and home-based services ... PCP requests for external cardiology referrals and participates in delegated utilization authorizations; determines level of urgency of follow-up, referral /… more
    ChenMed (04/27/24)
    - Save Job - Related Jobs - Block Source
  • National Solution Medical Director - Post

    Elevance Health (Chicago, IL)
    …with Managed Care, Utilization Management , Prior Auth, and Benefits Management decision support in the Post - Acute Domain, DME, Home Health, ... as part of consideration for employment. **National Solution Medical Director - Post Acute Services** + Job Family: MED > Licensed Physician/Doctor/Dentist… more
    Elevance Health (04/30/24)
    - Save Job - Related Jobs - Block Source
  • Licensed Clinical Social Worker or Licensed Social…

    AdventHealth (Glendale Heights, IL)
    …documents avoidable days, and facilitates progression of care. **.** Collaborates with Utilization Management staff for collaboration on patient status changes ... AND EXPERIENCE PREFERRED:** . Current working knowledge of discharge planning, utilization management , care management , performance improvement and… more
    AdventHealth (03/08/24)
    - Save Job - Related Jobs - Block Source
  • RN - Clinical Transition Specialist

    Carle (Urbana, IL)
    …and management of the functional and financial outcomes during acute illness requiring hospitalization for patients of the Carle Foundation Hospital. Ensures ... post - hospital providers to ensure responsive and appropriate care is provided post -discharge. + Documents plan of care and utilization issues in appropriate… more
    Carle (03/27/24)
    - Save Job - Related Jobs - Block Source
  • Medical Director - North Central Region - Medicaid

    Humana (Springfield, IL)
    …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post - acute services such ... time to the Indiana Pathways program to assist the Utilization Management , Care Management , and.... The clinical scenarios predominantly arise from inpatient or post - acute care environments. Has discussions with external… more
    Humana (04/25/24)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse RN Care Manager

    AdventHealth (Hinsdale, IL)
    …documents avoidable days, and facilitates progression of care. . Collaborates with Utilization Management staff for collaboration on patient status changes and ... . BSN . Health-related Master's degree or MSN . Prior Care Management / Utilization Management experience **LICENSURE, CERTIFICATION OR REGISTRATION… more
    AdventHealth (04/26/24)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse RN Care ManagerPRN

    AdventHealth (Hinsdale, IL)
    …documents avoidable days, and facilitates progression of care. **.** Collaborates with Utilization Management staff for collaboration on patient status changes ... . BSN . Health-related Master's degree or MSN . Prior Care Management / Utilization Management experience **LICENSURE, CERTIFICATION OR REGISTRATION… more
    AdventHealth (04/25/24)
    - Save Job - Related Jobs - Block Source
  • Medical Director - Florida

    Humana (Springfield, IL)
    …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post acute services such ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (04/18/24)
    - Save Job - Related Jobs - Block Source
  • RN Case Manager

    Carle (Urbana, IL)
    …agencies and payers to plan and execute a safe discharge* Collaborates with Utilization Management team on continued stay review. + Discharge Planning* ... and payers to plan and execute a safe discharge* Identifies and facilitate post - acute resource needs: Home Care, Community based Referrals, Diagnostic testing,… more
    Carle (03/20/24)
    - Save Job - Related Jobs - Block Source
  • Medical Director - Mid West Region

    Humana (Springfield, IL)
    …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post acute services such ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (04/12/24)
    - Save Job - Related Jobs - Block Source
  • Behavioral Health Medical Director - N. Central…

    Humana (Springfield, IL)
    …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post acute services such ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
    Humana (04/09/24)
    - Save Job - Related Jobs - Block Source
  • Wound Care UM RN

    Elevance Health (Springfield, IL)
    …pm CST. A proud member of the Elevance Health family of companies, Carelon Post Acute Solutions, formerly myNEXUS, is the leader in health resource optimization, ... and Experiences:** + Home health experience preferred. + 1 year of Utilization Management experience preferred. + Multi-State/Compact Nursing License strongly… more
    Elevance Health (04/30/24)
    - Save Job - Related Jobs - Block Source
  • Physician Office Liaison Intermediate

    AdventHealth (Hinsdale, IL)
    …Electronic Medical Record functionality, has expertise in web-based applications for post - acute settings, and other key applications for physician office ... for application installs for office devices. Competent in the utilization of remote control tools to assist in analyzing...interruption of service. + Provides go live support and post go live optimization at local sites and for… more
    AdventHealth (04/24/24)
    - Save Job - Related Jobs - Block Source
  • Consulting Manager - Healthcare, Supply Chain…

    Huron Consulting Group (Chicago, IL)
    …building talent, training, supervising, coaching/mentoring, and providing feedback through performance management + Employees are required to follow utilization ... required] + Expertise managing cost structures and improving operational workflows within post - acute settings (eg, SNF, long-term care, home health, rehab) [not… more
    Huron Consulting Group (04/24/24)
    - Save Job - Related Jobs - Block Source
  • Clinical RD - Comprehensive Care (Part-Time)

    Sharecare, Inc. (Springfield, IL)
    …of the care enhancement program by providing telephonic care and resource utilization for members in an appropriate, efficient, and cost-effective manner while ... the health care team to support appropriate total healthcare management . RD colleague is supervised by an Operations Manager....in the orientation and to take the pre and post -test to review competency during orientation. Yearly competency test… more
    Sharecare, Inc. (04/23/24)
    - Save Job - Related Jobs - Block Source
  • RN - Pre-op (Procedural)

    Carle (Urbana, IL)
    …a designated time frame and provides care to these patients via the utilization of the nursing process, nursing trends, technology, financial and human resources ... complete all required continuing education regarding the care of acute stroke patients. + Continuing education requirements for this...Performs bladder scans if patient is unable to void post op + Proficient in: + Arterial and central… more
    Carle (04/11/24)
    - Save Job - Related Jobs - Block Source