- Huron Consulting Group (Chicago, IL)
- …Management is responsible for planning, organizing, developing, and directing implementation of the Utilization Review Plan and the overall operation of the ... + Staff Acquisition and Support: Leads and manages the utilization review staff and function for the...and may be implemented in the future._ **Position Level** Manager **Country** United States of America At Huron, we're… more
- Blessing Hospital (Quincy, IL)
- …processes and procedures + I CARE standards of behavior + Collaborates with the nurse manager in budget development, utilization , evaluation, and adjustment ... great teamwork to provide those we serve with high quality, compassionate care. The associate nurse manager in collaboration with the nurse manager leads… more
- Blessing Hospital (Quincy, IL)
- …processes and procedures + I CARE standards of behavior + Collaborates with the nurse manager in budget development, utilization , evaluation, and adjustment ... unit-based Pharmacist, Respiratory Therapist, Physical Therapist, and an Unit-based Educator. The associate nurse manager in collaboration with the nurse … more
- Rush University Medical Center (Chicago, IL)
- …position. 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 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… more
- CVS Health (Springfield, IL)
- …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
- Elevance Health (Chicago, IL)
- ** Nurse Case Manager II** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... 48 hours of receipt and meet the criteria._** The ** Nurse Case Manager II** is responsible for...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires… more
- Fresenius Medical Center (Chicago, IL)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. ... leading your business, and advanced leadership. As a Clinical Manager , you may advance your career into an Area...+ Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. +… more
- Fresenius Medical Center (Zion, 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
- US Tech Solutions (Springfield, IL)
- …+ Kane + Winnebago + Rock Island **Job Overview** The **Field-Based Case Manager ** is responsible for coordinating and managing care for elderly members and ... Conduct comprehensive, in-person and telephonic assessments using clinical tools, data review , and member interviews + Evaluate member eligibility, benefit plans,… more
- Elevance Health (Chicago, IL)
- …the client health plan network. + Mentors and coaches new employees in the nurse review process. + Notifies ordering physician or rendering service provider ... ** Nurse Reviewer II** **Location:** This role enables associates...meets medical necessity criteria or requires additional medical necessity review . + Conducts initial medical necessity review … more
- Highmark Health (Springfield, IL)
- …**Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides ... to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, corporate, state, and… more
- CVS Health (Springfield, IL)
- …advocates for members who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current case management and ... medications. + Utilizes weekly and daily reporting to identify utilization for the purpose of reducing Emergency Department ...+ Candidate must have an active and unrestricted Registered Nurse (RN) License in Illinois + 3+ years of… more
- Trinity Health (Berwyn, IL)
- …Intensive Care Unit. The Clinical Nurse Leader works in tandem with the Nurse Manager to achieve and maintain the quality initiatives of the nursing unit. ... in our shared governance. Position responsibilities: + The Clinical Nurse Leader (CNL) is an expert nurse ...team's effectiveness by identifying barriers to effective and efficient utilization of resources and evaluating patients' needs. + They… more
- ChenMed (Chicago, IL)
- …We're rapidly expanding and we need great people to join our team. The Nurse Case Manager 1 (RN) is responsible for achieving positive patient outcomes ... post-acute facilities, as well as, their home environments. The Nurse Case Manager 1 (RN) role also...with patient and family. + Facilitates patient/family conferences to review treatment goals and optimize resource utilization ;… more
- Carle Health (Urbana, IL)
- Overview The Nurse Manager , OR Intraoperative has leadership accountability for planning, facilitating and monitoring the day-to-day activities and functions of ... Operating Room. Responsible for planning, organizing, delegating, coordinating staff utilization , budgeting, and marketing OR services. Directly supervises nursing… more
- Carle Health (Champaign, IL)
- …patient care outcomes. The incumbent will have a deep understanding of utilization review and case management principles, case management best practices, ... experience 2+ years Responsibilities Maintain current knowledge of case management and utilization review trends including the entire continuum of care within… more
- ChenMed (Berwyn, IL)
- …explain nurse practitioner role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... State of practice. + Other duties as assigned and modified at manager 's discretion. KNOWLEDGE, SKILLS AND ABILITIES: + Demonstrated record of consistently achieving… more
- Deloitte (Chicago, IL)
- …Experience as clinical registered nurse , physician, physician assistant, case manager , clinical documentation specialist, utilization review , informatics ... in nursing, medical degree, or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical Documentation Specialist - CCDS… more