- Huron Consulting Group (Chicago, IL)
- …Management is responsible for planning, organizing, developing, and directing implementation of the Utilization Review Plan and the overall operation of the ... + Staff Acquisition and Support: Leads and manages the utilization review staff and function for the...and may be implemented in the future._ **Position Level** Manager **Country** United States of America At Huron, we're… more
- CenterWell (Springfield, IL)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work… more
- Blessing Hospital (Quincy, IL)
- …processes and procedures + I CARE standards of behavior + Collaborates with the nurse manager in budget development, utilization , evaluation, and adjustment ... + 24/7 Wellness Center access + Educational assistance opportunities JOB SUMMARY The associate nurse manager in collaboration with the nurse manager … more
- Blessing Hospital (Quincy, IL)
- …processes and procedures + I CARE standards of behavior + Collaborates with the nurse manager in budget development, utilization , evaluation, and adjustment ... unit-based Pharmacist, Respiratory Therapist, Physical Therapist, and an Unit-based Educator. The associate nurse manager in collaboration with the nurse … more
- AdventHealth (Hinsdale, IL)
- …Street, Hinsdale, IL 60521 **The role you'll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses, physicians and the ... and progression through the continuum of care. The RN Care Manager ensures efficient and cost-effective care through appropriate resources monitoring, and… more
- CVS Health (Springfield, IL)
- …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
- Elevance Health (Chicago, IL)
- ** Nurse Case Manager II** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... 48 hours of receipt and meet the criteria._** The ** Nurse Case Manager II** is responsible for...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires… more
- Fresenius Medical Center (Macomb, IL)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. ... leading your business, and advanced leadership. As a Clinical Manager , you may advance your career into an Area...+ Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. +… more
- Fresenius Medical Center (Decatur, IL)
- …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
- CVS Health (Springfield, IL)
- …it is subject to change based on business needs.** The RN Case Manager is responsible for telephonically assessing, planning, implementing, and coordinating all case ... through integration. - Through the use of clinical tools and information/data review , conducts an evaluation of member's needs and benefit plan eligibility and… more