- Elevance Health (Chicago, IL)
- ** Nurse Reviewer I** **Location:** **Virtual:** This role enables associates to work virtually full-time, with the exception of required inperson training ... integration, and ensures essential face-to-face onboarding and skill development. The ** Nurse Reviewer I** will be responsible for conducting preauthorization,… more
- US Tech Solutions (Chicago, IL)
- …experience with Utilization Review ? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** US Tech Solutions is a global staff ... policy, regulatory and accreditation guidelines. + Responsible for the review and evaluation of clinical information and documentation. +...3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior… 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
- Rush University Medical Center (Chicago, IL)
- …Offers may vary depending on the circumstances of each case. **Summary:** The Registered Nurse 3 is a proficient nurse possessing an in-depth knowledge of ... events and can respond with efficiency, flexibility and confidence. The Registered Nurse 3 immediately sees the whole situation while being able to discriminate… 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 ... of care for adult, geriatric, neonate, pediatric and adolescent patients. The Nurse Care Manager 1 contributes to the team's effectiveness by reviewing plans… more
- Rush University Medical Center (Chicago, IL)
- …position. Offers may vary depending on the circumstances of each case. **Summary:** The Nurse Care Manager is an Illinois licensed Registered Nurse who provides ... a diverse role as a clinician, educator, care coordinator and advocate. The Nurse is an expert in chronic disease management, prevention, health maintenance, and… more
- Elevance Health (Chicago, IL)
- …and ensures essential face-to-face onboarding and skill development. The **Medical Management Nurse ** is responsible for review of the most complex or ... **Medical Management Nurse ** **Location** : Atlanta, GA; Indianapolis, IN; Latham,...and requires a minimum of 2 years clinical, utilization review , or case management experience; or any combination of… more
- Elevance Health (Chicago, IL)
- …unless an accommodation is granted as required by law._** The **Medical Management Nurse ** is responsible for review of the most complex or challenging ... **Medical Management Nurse ** **Work schedule: M-F** **8:00am to 5:00pm EST....Make an Impact** : + Conducts precertification, continued stay review , care coordination, or discharge planning for appropriateness of… more
- R1 RCM (Chicago, IL)
- …production-driven position. **Here's what you will experience working as a Clinical Appeals Nurse :** + Conduct a detailed review of patient medical records and ... analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Appeals Nurse ** , you will help our hospital clients by serving as an… more
- BioLife Plasma Services (Chicago, IL)
- …Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. BioLife Plasma Services is a subsidiary of ... determine donor eligibility to donate plasma, management of donor adverse events, review of laboratory test results, and donor notification of unsuitable test… more
- Elevance Health (Chicago, IL)
- **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days ... opportunities for fraud and abuse prevention and control. + Review and conducts analysis of claims and medical records...Skills, Qualifications, and Experiences:** + Fraud and Abuse experienced Nurse with a CPC are highly desired. For candidates… more
- Fresenius Medical Center (Chicago, IL)
- …to the Inpatient Program Manager, appropriately credentialed physician, patient hospital primary nurse and others as indicated. + Delivers safe, effective care in a ... May be assigned to in-center patient care on an as needed basis + Review and comply with the Code of Business Conduct and all applicable company policies… more
- Rush University Medical Center (Chicago, IL)
- …established research projects. 5. Submits materials (articles, media, etc.) for peer- review . 6. Presents evidence based and/or scholarly papers locally and ... disability, veteran status, and other legally protected characteristics. **Position** Registered Nurse - Clinical Care **Location** US:IL:Chicago **Req ID** 16801 more
- Lakeshore Bone & Joint Institute (Chesterton, IN)
- …patients need to keep moving and keep enjoying their life. The Registered Nurse is responsible for providing professional nursing care for clinic patients following ... of tests and/or other orders given by the physician + Maintain and review patient records, charts, and other pertinent information + Respond to incoming patient… more
- CVS Health (Chicago Heights, IL)
- …-Through the use of care management tools and information/data review , conducts comprehensive evaluation of referred members' needs/eligibility and recommends ... goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes. - Identifies and escalates quality… more
- Fresenius Medical Center (Steger, IL)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... including efficient utilization of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and on-site state or… more
- Rising Medical Solutions (Chicago, IL)
- Rising Medical Solutions seeks a Medical Review Unit Director for our Workers Compensation based products and services. This role is ideal for a seasoned ... about improving patient care and reducing healthcare costs through effective medical review processes. The Medical Review Unit Director will oversee the… more
- Fresenius Medical Center (Chicago, IL)
- …effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with FMCNA policies procedures and training and in compliance ... well-being since their last treatment. Report any complaints or observations to the nurse supervisor. + Evaluate vascular access for patency and report any unusual… 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