- US Tech Solutions (Chicago, IL)
- …+ Do you have experience with Prior Authorization? + Do you have experience with Utilization Review ? + Do you have an Active Registered Nurse License? ... 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior...and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1… more
- Cognizant (Springfield, IL)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience in ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral,… 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
- Zurich NA (Schaumburg, IL)
- …medical 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… more
- Rush University Medical Center (Chicago, IL)
- …on the circumstances of each case. **Summary:** The Bone Marrow Transplant (BMT) Oncology Nurse Navigator 2 is a registered nurse (RN) who works collaboratively ... with physician practices and multi-disciplinary teams as to promote the effective utilization of services and coordination of care for patients within the Section of… more
- Blessing Hospital (Quincy, IL)
- …and procedures + I CARE standards of behavior + Collaborates with the nurse manager in budget development, utilization , evaluation, and adjustment + Maintenance ... ON RELEVANT EXPERIENCE COMPETITIVE BENEFITS Click here (https://www.blessinghealth.org/sites/default/files/users/user15/HR\_2023\_Total\_Rewards\_Guide.pdf) to review our complete Total Rewards Guide. + Retirement +… more
- Blessing Hospital (Quincy, IL)
- …and procedures + I CARE standards of behavior + Collaborates with the nurse manager in budget development, utilization , evaluation, and adjustment + Maintenance ... BASED ON RELEVANT EXPERIENCE COMPETITIVE BENEFITS Click here (https://www.blessinghealth.org/benefits) to review our complete Total Rewards Guide. + 403b + matching… more
- Rush University Medical Center (Chicago, IL)
- …may vary depending on the circumstances of each case. **Summary:** The Clinical Nurse Leader (CNL) functions as an advanced generalist providing and managing care ... The CNL provides insight regarding the microsystem for collaboration with the Clinical Nurse Specialist (CNS) on macrosystem processes and outcomes. The CNL and CNS… more
- Fresenius Medical Center (Urbana, IL)
- **PURPOSE AND SCOPE:** The Inpatient Services Charge Nurse is an additional "responsibility" assigned to the Inpatient Services RN, for a limited period of time, and ... duties, as assigned by the Program Manager. The Inpatient Services Charge Nurse ensures appropriate provision of Acute Dialysis Services and treatments within… more
- AdventHealth (Hinsdale, IL)
- …to nurses, physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge Planning and care ... 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… more
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