- Highmark Health (Springfield, IL)
- …+ 5 years in Clinical, Direct Patient care (hospital, outpatient, or private practice) ** Preferred ** + 1 year in Medical Management in a Health Insurance Plan; ... standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical...Preferred ** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral & Written… more
- Rush University Medical Center (Chicago, IL)
- …care. Applies criteria, performs concurrent review process. Works with physicians and Medical Director regarding Case issues and concurrent denials as indicated. ... **Job Description** Location: Chicago, Illinois Business Unit: Rush Medical Center Hospital: Rush University Medical ...Offers may vary depending on the circumstances of each case . **Summary:** The Social Work Care Mgr (CM) works… more
- Rush University Medical Center (Chicago, IL)
- … medical records * Demonstrated knowledge and/or experience with case management-related service functions such as: patient interviews, discharge planning/social ... Offers may vary depending on the circumstances of each case . **Summary:** The Care Management Navigator II is part...area of focus such as social work, psychology or medical terminology) preferred . * QBS Certification … more
- Rush University Medical Center (Chicago, IL)
- …adherence to all regulations. ** Preferred Job Qualifications:** * National certification preferred . * Two years of medical /surgical experience preferred . ... **Job Description** Location: Chicago, Illinois Business Unit: Rush Medical Center Hospital: Rush University Medical ...Offers may vary depending on the circumstances of each case . **Summary:** The Transplant Coordinator RN 2 is responsible… more
- Humana (Springfield, IL)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... or data requires an in-depth evaluation of variable factors. Candidate must have valid Florida Medical license and must be able to start with 30-60 days of hire. The… more
- Datavant (Springfield, IL)
- …for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to ... ICD-9-CM, ICD-10-CM, and ICD-10-PCS codes + Accurately sequence and abstract medical codes from patient records, ensuring precision and adherence to documentation… more
- Rush University Medical Center (Chicago, IL)
- **Job Description** Location: Chicago, Illinois Business Unit: Rush Medical Center Hospital: Rush University Medical Center Department: Rush Simulation Center ... be offered for the position. Offers may vary depending on the circumstances of each case . **Summary:** A standardized patient is a person trained in a case … more
- Humana (Springfield, IL)
- …our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. The ... Behavioral Health Medical Director work assignments involve moderately complex to complex...participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post-acute… more
- Humana (Springfield, IL)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... situations or data requires an in-depth evaluation of variable factors. The Medical Director provides medical interpretation and decisions about the… more
- Rush University Medical Center (Chicago, IL)
- **Job Description** Location: Chicago, Illinois Business Unit: Rush Medical Group Hospital: Rush University Medical Center Department: RUCC Ortho Oncology - ... Type:** Full Time **Orthopedic Oncology - Advanced Practice Provider** **Rush University Medical Center** **Chicago, IL** **Rush University System for Health** , a… more