- Molina Healthcare (Chicago, IL)
- …one within 30 days of hire. + MCO experience preferred. + UM experience preferred- prior auth, inpatient review , concurrent review and prior experience ... team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for… more
- Molina Healthcare (Kenosha, WI)
- **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States who has a compact, multi-state license. This team reviews the prior ... requests for transplants; the ideal candidate will have experience either in utilization review or case management for transplants. Preference will be given to those… more
- Molina Healthcare (Kenosha, WI)
- …Experience** Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care ,… more
- Molina Healthcare (Kenosha, WI)
- …team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for ... staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of… more
- US Tech Solutions (Chicago, IL)
- …objectives **Responsibilities:** + Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations. + ... clinical policy, regulatory and accreditation guidelines. + Responsible for the review and evaluation of clinical information and documentation. + Reviews… more
- CVS Health (Mundelein, IL)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... limited to: hospital setting, outpatient clinic, PCP office, or member's residence. The Clinical Care Manager - BH is responsible for care coordination and case… more
- Prime Healthcare (Chicago, IL)
- …severity of illness. Qualifications EDUCATION, EXPERIENCE, TRAINING Required qualifications: + Licensed clinician in your state. + Grandfathered prior to April ... case managers, social workers, case management coordinators/discharge planners, utilization review coordinators and utilization review technicians. Assesses… more