- ProgenyHealth (Elk Grove Village, IL)
- …medical record. + May include evening and/or weekend on call. Qualifications + Registered Nurse (RN) with a current, unrestricted license is required + ... ProgenyHealth is a leading provider of care management solutions for premature and medically complex newborns. Our program promotes appropriate utilization ,… more
- AdventHealth (Hinsdale, IL)
- …documents avoidable days, and facilitates progression of care. **.** Collaborates with Utilization Management staff for collaboration on patient status changes ... . Associates Degree Nursing or RN Diploma degree . Registered Nurse (RN) . Two (2) years.... Health-related Master's degree or MSN . Prior Care Management / Utilization Management experience **LICENSURE, CERTIFICATION… more
- AdventHealth (Hinsdale, IL)
- …documents avoidable days, and facilitates progression of care. . Collaborates with Utilization Management staff for collaboration on patient status changes and ... . Associates Degree Nursing or RN Diploma degree . Registered Nurse (RN) . Two (2) years.... Health-related Master's degree or MSN . Prior Care Management / Utilization Management experience **LICENSURE, CERTIFICATION… more
- Humana (Springfield, IL)
- …+ Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Experience compiling NCQA File Review Universes and timeliness ... Qualifications** + Expertise on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health. + Detailed working knowledge… more
- R1 RCM (Chicago, IL)
- …as needed to support service delivery **Required Qualifications:** + Must have a current Registered Nurse license in your state of residence + At least 2 ... of the evidence-based criteria. The successful candidate will have hospital-based Utilization Review or Case Management experience. **Responsibilities:** +… more
- Fresenius Medical Center (Chicago, IL)
- …for you! We offer industry-leading technology and exceptional training offers for your nurse and dialysis tech staff. **About this role:** As a Clinical Manager with ... Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. +… more
- Trinity Health (Maywood, IL)
- …preauthorization requests utilizing defined criteria. Collects, analyzes and communicates relevant utilization management information to insurers and third party ... IPA or MCO. Leadership experience is preferred. **Licensure/Certifications:** **Required:** Current Registered Nurse License State of Illinois **Our Commitment… more
- Fresenius Medical Center (Chicago Heights, IL)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Rush University Medical Center (Chicago, IL)
- …AM - 5:30:00 PM) **Summary:** The Oncology Nurse Navigator 2 is a registered nurse (RN) who works with physician practices and multi-disciplinary teams to ... promote the effective utilization of services and coordination of care for patients...The Oncology Nurse Navigator 2 is a registered nurse (RN) who works with physician… more
- Rush University Medical Center (Chicago, IL)
- …workshops. **Other information:** **Required Job Qualifications:** *Current license in Illinois as Registered Nurse (RN). *Ability to perform all job components ... **Location:** Chicago, IL **Hospital:** RUSH University Medical Center **Department:** Care Management **Work Type:** Full Time (Total FTE between 0.9 and 1.0)… more
- CVS Health (Springfield, IL)
- …5+ years of clinical experience required - 2+ years of experience as a Registered Nurse - Must have active current and unrestricted RN licensure in ... 8:00am - 5:00pm in time zone of residence Preferred Qualifications - Utilization Management review- Managed Care experience- Client processing experience… 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 ... Hr (7:00:00 AM - 5:00:00 PM) **Summary:** The Clinical Nurse Leader (CNL) functions as an advanced generalist providing...improvement of patient care outcomes, and resource in the management of clinically complex patients. The CNL provides insight… more
- Trinity Health (Berwyn, IL)
- …1-2 years of previous job-related experience required. Licensure/Certifications: Current Registered Nurse License State of Illinois required. Certification ... **Employment Type:** Full time **Shift:** Day Shift **Description:** The Perioperative Clinical Nurse Leader (CNL) at MacNeal Hospital is an expert nurse and… more
- Marriott (Springfield, IL)
- …Information** Nurse CARE Manager (CARE - Coordinated Action and Response) Registered Nurse license required **Job Number** 24069165 **Job Category** Finance ... Claims Services + Collaborate with Claims department regarding case management . + Collaborate with UNM on utilization ...informed **Education or Certification** + Must be a licensed registered nurse + Certification as an occupational… more
- Carle (Urbana, IL)
- …team members and the medical staff. + Collaborates with the System Director Utilization Management and Clinical Denial Management . + Collaborates with ... Director - Regional Care Management East/South + Department: IP Clinical Case Mgmt...Nursing or Healthcare Administration. CERTIFICATION & LICENSURE REQUIREMENTS + Registered Professional Nurse (RN) License Illinois upon… more
- Rush University Medical Center (Chicago, IL)
- …the clinic. **Other information:** **Required Job Qualifications:** * Current State of Illinois Registered Nurse licensure. State of IN RN licensure required for ... Certificate, ONS Chemotherapy Biotherapy: Fundamentals of Administration provider card, or Certified Registered Nurse of Infusion (CRNI) OR obtain the ONS/ONCC… more
- Carle (Urbana, IL)
- …agencies and payers to plan and execute a safe discharge* Collaborates with Utilization Management team on continued stay review. + Discharge Planning* ... the individual and their support systems. Qualifications: CERTIFICATION & LICENSURE REQUIREMENTS Registered Professional Nurse (RN) License in state of Illinois… more
- Fresenius Medical Center (Springfield, IL)
- …of prescriptions for FKC patients. + Under the supervision of Registered Nurse , assists FKC clinic staff with medication management tasks such as benefit ... in a timely manner. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** + Under the guidance of registered nurse , takes the appropriate actions to ensure the accuracy of… more
- Carle (Urbana, IL)
- … Professional Nurse (RN) License Current licensure in good standing as a Registered Nurse in the State of Illinois. EXPERIENCE REQUIREMENTS Three years of ... This role will focus on nursing process, physician communication, case management and resource utilization . Qualifications: EDUCATIONAL REQUIREMENTS College… more
- Rush University Medical Center (Chicago, IL)
- …from an ARC-PA (or predecessor) accredited PA Program. * Current State of Illinois Registered Nurse (RN) and Advanced Practice Nurse (APN) Licensure. * ... Donor Care Unit with the goal of maximizing organ utilization . They demonstrate a high degree of clinical expertise...The APP - Organ Donation will provide both donor management care as well as intraoperative care to the… more