• Clinical Review Nurse…

    Centene Corporation (Springfield, IL)
    …InterQual knowledge, and discharge planning knowledge. **Additional Details:** Department: Concurrent Review MCD** Business Unit: Corporate** Schedule: Mon-Fri ... needed to discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member… more
    Centene Corporation (10/31/25)
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  • Field Nurse Case Manager Hospice

    Prime Healthcare (Mount Prospect, IL)
    …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... accredited school of nursing and a current state Registered Nurse license 2. Grandfathered prior to April 1, 2015....of an accredited school Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred. 3.… more
    Prime Healthcare (08/14/25)
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  • Utilization Review Clinician - Behavioral…

    Centene Corporation (Springfield, IL)
    …with 1 hour lunch; plus weekend and holiday rotations **Position Purpose:** Performs a clinical review and assesses care related to mental health and substance ... medical appropriateness in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine… more
    Centene Corporation (10/31/25)
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  • HIM Clin Doc Integrity Specialist NE - CFH

    Carle Health (Champaign, IL)
    …Work Experience: Clinical bedside; CDI Responsibilities Conducts the initial concurrent review process for all selected admissions. Clarifies documentation ... Overview Performs inpatient chart review to determine appropriate DRG assignment and assures...and assures appropriate documentation in the chart to support clinical care provided, including severity of illness and risk… more
    Carle Health (09/18/25)
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  • Manager, Health Information Management, Coding

    Carle Health (Urbana, IL)
    …and changes related to coding. + Ensures proper coordination between Concurrent Clinical Documentation Specialists, inpatient coders, outpatient coders, ... (COC) or + Certified Inpatient Coder (CIC) or + Licensed Registered Professional Nurse (RN) or + Certified Coding Specialist - Physician-Based (CCS-P) or +… more
    Carle Health (09/18/25)
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  • Hospice RN Case Manager 12 Hr - Phil-HH/PC Hospice…

    Prime Healthcare (Mount Prospect, IL)
    …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... accredited school of nursing and a current state Registered Nurse license 2. Grandfathered prior to April 1, 2015....of an accredited school Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred. 3.… more
    Prime Healthcare (10/29/25)
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  • Case Manager RN

    Prime Healthcare (Evanston, IL)
    …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... accredited school of nursing and a current state Registered Nurse license 2. Grandfathered prior to April 1, 2015....of an accredited school Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred. 3.… more
    Prime Healthcare (10/25/25)
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