• Field Nurse Case Manager Hospice

    Prime Healthcare (Mount Prospect, IL)
    …effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service ... accredited school Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred. 3. Five years acute care nursing experience preferred. At… more
    Prime Healthcare (11/13/25)
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  • Case Manager RN

    Prime Healthcare (Evanston, IL)
    …effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service ... accredited school Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred. 3. Five years acute care nursing experience preferred. At… more
    Prime Healthcare (10/25/25)
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  • Social Work Case Manager

    AdventHealth (Hinsdale, IL)
    …patient and involved care givers (as permitted by the patient) as well as a review of the current and past inpatient and outpatient medical record in the Initial ... and updates, as needed. Actively participates in daily Multidisciplinary Rounds to review progression of care and discharge plan for all assigned patients… more
    AdventHealth (11/06/25)
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  • Claim Specialist Major Case Unit - West

    The Hartford (Naperville, IL)
    …and counsel, inclusive of litigation planning and execution, budgeting and bill review ; + Attending trials and mediations as necessary; + Contributing to broader ... comprehensive reports and delivering presentations to senior claim leadership on case developments, policy issues, industry trends, etc.; + Providing support to… more
    The Hartford (11/11/25)
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  • RN Registered Nurse Case Manager

    AdventHealth (Hinsdale, IL)
    …patient and involved care givers (as permitted by the patient) as well as a review of the current and past inpatient and outpatient medical record in the Initial ... each position may vary based on geographical location. **Category:** Case Management **Organization:** UChicago Medicine AdventHealth Hinsdale **Schedule:** Full-time… more
    AdventHealth (09/09/25)
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  • Medical Bill Review Senior Nurse

    Zurich NA (Schaumburg, IL)
    …terminology Preferred Qualifications: + 2 or more years' experience in Utilization Review , Case Management, Workers Compensation, or medical bill reviews + ... Medical Bill Review Senior Nurse 127127 Zurich Insurance is currently looking for a **Medical Bill Review Senior Nurse** to work from our Schaumburg, IL office.… more
    Zurich NA (11/26/25)
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  • Field Medical Director, Interventional Cardiology…

    Evolent (Springfield, IL)
    …for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a meaningful impact ... interventional cardiology to help ensure the delivery of high-value, evidence-based case reviews. Enjoy improved work-life balance while contributing to better… more
    Evolent (10/29/25)
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  • Associate Manager, Clinical Health Services…

    CVS Health (Springfield, IL)
    …within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical ... consists of working intensely as a telephonic Associate Manager, Case Management with staff and clients for fully and/or...a potential quality of care issue to a physician reviewer . - Identify and address quality issues and participates… more
    CVS Health (11/27/25)
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  • Quality Assurance Manager-Healthcare

    BrightSpring Health Services (Danville, IL)
    …reviews, including, but not limited to Site Reviews, Record Reviews and review of other quality monitoring and improvement activities. + Completes documentation of ... operational review activities thoroughly and timely. + Prepares detailed summary...+ Maintains certification for company signature programs (YSIS, Site Reviewer , QIDP, etc.) + Supervises entry level QA position,… more
    BrightSpring Health Services (11/11/25)
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  • Discharge Planner - Social Work Services

    Prime Healthcare (Evanston, IL)
    …Responsible for the coordination of the various activities of the Case Management Department including utilization management, social services and performance ... improvement. + Assists with development of discharge plans. + Assists with case management referrals and authorizations. + Maintains and coordinates Medi-Cal (TARS)… more
    Prime Healthcare (10/25/25)
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