- Prime Therapeutics (Springfield, IL)
- …Registered Nurse (RN). + 5 years of post-degree clinical experience. + Experience in managed care , specialty drugs, care management and utilization review. + ... financial and clinical considerations with members who are considering care at a higher cost treatment site, researches available...for drug services. + Will actively maintain a required case load and the activities to reach overall goals… more
- Humana (Springfield, IL)
- …state inquiries, concerns, or problems associated with claims payment to adhere to Managed Care contract requirements and to optimize provider experience and ... LTSS EVV (Electronic Visit Verification) technologies + Thorough understanding of managed care contracts, including provider contract language and reimbursement… more
- Rush University Medical Center (Chicago, IL)
- …* Experience within a hospital or clinic environment, a health insurance company, managed care organization or other health care financial service ... Medicaid, Social Security Disability, Champus, Supplemental Security Income Disability, etc., managed care contracts and coordination of benefits is highly… more
- AdventHealth (Hinsdale, IL)
- …as a clinical leader to the hospital's medical staff providing guidance in case management, appropriate levels of care for patients, efficient utilization of ... medical staff members and lower cost. Direct reports include + Med Staff Manager PRINCIPAL DUTIES AND JOB RESPONSIBILITIES: + Leads in the continuing adoption of… more
- Rush University Medical Center (Chicago, IL)
- …**Other information:** **Preferred Experience:** *Knowledge of EPIC applications *Knowledge of managed care contracts *Knowledge of Healthcare Finance Revenue ... for the position. Offers may vary depending on the circumstances of each case . **Summary:** The Cash Poster Financial Services Representative 2 works within the… more
- Prime Healthcare (Chicago, IL)
- … Case Management, business office or related department. Experience in a Managed Care environment will be accepted for partial qualifications. 3. Current ... excellence. Responsibilities Under the direction and supervision of the Clinical Manager , the RN Assessment Coordinator is responsible for conducting and… more
- Trinity Health (Westchester, IL)
- …position requires collaboration with other hospital departments such as Patient Access, Coding, Case Management, and Managed Care to gather necessary ... Medicine, a member of Trinity Health, is a nationally ranked academic, quaternary care system based in Chicago's western suburbs. With its main campus at Loyola… more
- Rush University Medical Center (Chicago, IL)
- …with strong time management skills. **Responsibilities:** 1. Writes standard appeal letters to Managed Care payers and submit charts when needed with these ... for the position. Offers may vary depending on the circumstances of each case . **Summary:** Responsible for assisting the Denial Management team with various duties… more