- KPH Healthcare Services, Inc. (Hoffman Estates, IL)
- …With Us! (https://kphcareers-kphhealthcareservices.icims.com/jobs/13429/ clinical - nurse -%28hourly%29/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336031866) ... professional licensure, certification, and health requirements as well as demonstrates clinical competence. + Participates in the orientation of other nurses or… more
- Molina Healthcare (Kenosha, WI)
- …regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching strategy to provide quality and ... cost-effective member care. **ESSENTIAL JOB DUTIES:** + Facilitates clinical /medical reviews of retrospective medical claim reviews, medical claims and previously… more
- Fresenius Medical Center (Grayslake, IL)
- PURPOSE AND SCOPE: The registered professional nurse Home Therapies RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). This ... guidance from the Educator, Preceptor or in collaboration with another Registered Nurse . . Performs ongoing, systematic collection and analysis of dialysis data for… more
- BioLife Plasma Services (Mount Pleasant, WI)
- …Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. **BioLife Plasma Services is a subsidiary ... unsuitable test results. The Medical Support Specialist (Plasma Center Nurse ) works under the guidance of the Center Manager...for BioLife Medical Support Specialist Two years in a clinical or hospital setting **What Takeda can offer you:… more
- Molina Healthcare (Kenosha, WI)
- …and experience. * Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Practical Counselor ... provide quality and cost-effective member care. Essential Job Duties * Based on clinical assessment and member reported health care concerns, uses clinical … more
- Molina Healthcare (Kenosha, WI)
- For this position we are seeking a (RN) Registered Nurse who must be licensed for the state they reside This role will be doing Utilization review for our Ohio ... Medicaid population, looking for clinicians with strong inpatient clinical experience WORK SCHEDULE: Tuesday to Saturday - 8 AM to 5 PM Wednesday to Sunday - 8 AM to… more
- Molina Healthcare (Oakwood Hills, IL)
- …and experience. *Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure and/or certification required ONLY if required ... and informal ICT collaboration. * Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.… more
- Molina Healthcare (Kenosha, WI)
- For this position we are seeking a (RN) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity of high ... review, and medical coding. JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that… more
- Fresenius Medical Center (Mundelein, IL)
- …dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance ... and/or change in patient condition directly to the registered nurse or supervisor. + Observe patient and conduct machine...activities. + Enters all treatment data into the designated clinical application in an accurate and timely manner. +… more
- BioLife Plasma Services (Mount Pleasant, WI)
- …Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. _BioLife Plasma Services is a subsidiary ... unsuitable test results. The Medical Support Specialist (Plasma Center Nurse ) works under the guidance of the Center Manager...BioLife Medical Support Specialist + Two years in a clinical or hospital setting **More about us:** ** **… more
- Molina Healthcare (Kenosha, WI)
- …RN license required_** JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that ... services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes… more
- Molina Healthcare (Kenosha, WI)
- …**Job Summary** The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for verifying that services ... are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through… more
- Molina Healthcare (Kenosha, WI)
- JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members...equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in… more
- Molina Healthcare (Kenosha, WI)
- …**Job Summary** The Care Review Clinician (RN) provides support for clinical member services review assessment processes. Responsible for verifying that services ... are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through… more
- Amergis (Union Grove, WI)
- Hourly Pay: $60/hr. - $65/hr. The Long Term...a Long Term Care and/or Assisted Living Facilities. The nurse demonstrates ability to make clinical judgments ... management of patient care. Minimum Requirements: + Current Registered Nurse License for the state in which the ...Nurse License for the state in which the nurse practices + Current CPR if applicable + TB… more
- Molina Healthcare (Kenosha, WI)
- …benefits, and medical records to document relevant findings of a post pay clinical review. This position manages documents and prioritizes case load to ensure timely ... + Review of applicable policies, CPT guidelines, and provider contracts. + Devise clinical summary post review. + Communicate and participate in meetings related to… more
- Molina Healthcare (Kenosha, WI)
- …compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical ... in consistent and efficient manner. + Makes appropriate referrals to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care… more
- CVS Health (Antioch, IL)
- …and maintain positive working relationships with the Aetna members, providers, nurse case managers, agency representatives, supervisors and office staff, from ... state guidelines) **Preferred Qualifications** + 1-2 years' experience providing clinical services; experience in community/outpatient setting + Community Health… more