- Humana (Chicago, IL)
- …community and help us put health first** Humana Healthy Horizons is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
- Trinity Health (Maywood, IL)
- …is Loyola campus. Position is hybrid, must reside in Illinois. The Regional Utilization Review Documentation Specialist nurse works with the ... **Employment Type:** Full time **Shift:** Day Shift **Description:** Utilization Review - RN Reviewer- Regional Coverage for Loyola, Gottlieb and MacNeal… more
- ProgenyHealth (Elk Grove Village, IL)
- …for premature and medically complex newborns. Our program promotes appropriate utilization , improves access, educates family members and reduces costs. Our team ... coordinate overall member care, from pre-admission, continued stay (concurrent review ) and any outpatient services utilizing a pro-active, evidence-based… more
- Elevance Health (Chicago, IL)
- …medical decisions to members and providers. **Job Summary:** + Perform physician-level case review , following initial nurse review , of Medical Oncology ... regimens and supportive care. + Perform physician-level case review , following initial nurse review ,...maintain knowledge of relevant policies and regulations pertaining to utilization review of oncology care. + Participate… more
- Trinity Health (Maywood, IL)
- …at the Westmont office Join our small but mighty team to guide and manage Utilization Review and Management for the Loyola Physician Partners LPP) Health Plan, a ... the Director/Manager oversees the daily caseloads of the UR/UM teams. This includes utilization review of inpatient medical and behavioral health services to… more
- Rush University Medical Center (Chicago, IL)
- …0.9 and 1.0) **Shift:** **Shift 1** **Work Schedule:** 8 Hr **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
- Elevance Health (Chicago, IL)
- ** Nurse Reviewer I** **Location:** Within 50 miles of a pulse point **Shift** : Sunday - Thursday and/or Tuesday - Saturday from 8:30 am - 5 pm **CST** The ** ... Nurse Reviewer I** is responsible for conducting preauthorization, out...that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or… 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
- 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 (Evergreen Park, IL)
- …of adjustment, along with increased risk of hospitalization and mortality. As a TCU nurse , you will help patients feel better and make more informed decisions about ... Park clinic._ _Monday-Friday, day hours._ **PURPOSE AND SCOPE:** The professional registered nurse Home Therapies RN CAP 2 may be an entry level designation… more
- Rush University Medical Center (Chicago, IL)
- …**Work Schedule:** 8 Hr (7:00:00 AM - 5:00:00 PM) **Summary:** The Clinical Nurse Leader (CNL) functions as an advanced generalist providing and managing care for ... 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
- Trinity Health (Berwyn, IL)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** The Perioperative Clinical Nurse Leader (CNL) at MacNeal Hospital is an expert nurse and ... healthcare team's effectiveness by identifying barriers to effective and efficient utilization of resources and evaluating patients' needs. The CNL facilitates… 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 Heights, 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
- Rush University Medical Center (Chicago, IL)
- …(7:00:00 AM - 3:30:00 PM) **Summary:** The Clinical Consulting Specialist is a nurse with expertise within a specialized area of nursing practice responsible for ... readiness to learn. * Selects and promotes optimal, cost effective resource utilization and interventions. Nursing Practice * Provides formal and informal education… more
- Sunrise Senior Living (Buffalo Grove, IL)
- …in order to maintain the highest quality standards for well-being. + Ensures proper utilization of the Resident Care Plan by all team members. + Ensures proper ... and service delivery as measured in the Quality Services Review (QSR) process and institutes with follow up measures...+ Maintains a current state license as a Registered Nurse per state regulations. + A minimum of two… more
- Trinity Health (Maywood, IL)
- …regional and hospital nursing operations, including regionalized services for Utilization Review /Case Management, Centralized Telemetry, Nursing Professional ... care setting, preferably in a large hospital or health system. Current Registered Nurse License. **Our Commitment to Diversity and Inclusion:** Trinity Health is one… more