RN Case Manager/Utilization Review - Chicago, IL

This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity. · ...

Now Hiring: Utilization Review (UR) Case Manager – Full Time Permanent | Chicago, IL · Facility: Insight Hospital and Medical Center · Location: 2525 S Michigan Ave, Chicago, Illinois 60616 · Employment Type: Full-Time | Permanent · Shift: Days · ━━━━━━━━━━━━━━━━━━ · Salary Pac ...

This position is responsible for ensuring compliance of the Utilization Management (UM) and Quality Review (QR) functions performed by the Medical Groups/IPAs participating in the networks of client's HMOs. · 3 years clinical experience with 2 years' experience in utilization rev ...

+ Utilization Review Specialists bridge between a Utilization Review Nurse and Pre-Clinical Coordinator + Facilitate and schedule appointments as needed + Maintain appropriate electronic and paper files + Interface with inter-disciplinary providers + Basic invoicing at completion ...

Utilization Review Nurse · A remote position for a contract period of approximately 9 months requires candidates to reside in Texas or Illinois. · Perform accurate and timely medical review of claims suspended for medical necessity using medically accepted criteria. · Interpret c ...

· WE ARE INSIGHT · At Insight Hospital and Medical Center Chicago, we believe there is a better way to provide quality healthcare while achieving health equity. Our Chicago location looks forward to working closely with our neighbors and residents, to build a full-service commun ...

This position is responsible for ensuring compliance of the Utilization Management (UM) and Quality Review (QR) functions performed by the Medical Groups/IPAs participating in the networks of client's HMOs. · ...

We're looking for a Utilization Review Coordinator who truly understands the substance use disorder treatment world and how payors work. · In this role, you'll be a key bridge between our clinical team and payors, making sure our clients get – and keep – the right level of care a ...

We are seeking a Clinical Care Manager who is passionate about advancing high‑quality compliant patient‑centered care through precise timely Utilization Review. · ...

We are looking for a Utilization Review Specialist to join our team The Utilization Review Specialist bridges between a Utilization Review Nurse and Pre-Clinical Coordinator providing coverage for both teams. · The full UR function can be performed in applicable jurisdictions. UR ...

This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity including assisting members on the telephone reviewing medical records reviewing cases which involve contract interpretation of behavioral health diagnos ...

We are looking for a Utilization Review Specialist to join our team The Utilization Review Specialist bridges between a Utilization Review Nurse and Pre-Clinical Coordinator providing coverage for both teams. · Initiate and maintain appropriate verbal and/or written contacts with ...

+The Medical Director is responsible for the overall quality, effectiveness and coordination of medical review services. · +Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies. · Renderecoverage determinations. · ...

We are seeking a Clinical Care Manager who is passionate about advancing high-quality, compliant, patient-centered care through precise and timely Utilization Review. · Complete timely review of healthcare services using appropriate medical criteria to support determinations. · D ...

We are Insight Hospital and Medical Center Chicago. We believe there is a better way to provide quality healthcare while achieving health equity. · The ED Utilization Review/Case Manager is responsible for facilitating the appropriate use of hospital resources by ensuring that th ...

· As our Utilization Review Nurse, you will coordinate and perform all aspects of Worker's Compensation, auto, and general liability claims for medical management activity (IME/Peer Review, UR) to ensure optimum medical care service delivery, utilization of resources, and cost-e ...

+ Detailed analytical role contributing integrity care management operations member experience · + Collaborative environment solving healthcare challenges · +Comprehensive benefits package including medical dental vision plans life disability insurance EAP time off parental leav ...

As our Utilization Review Nurse, you will coordinate and perform all aspects of Worker's Compensation, auto, and general liability claims for medical management activity (IME/Peer Review, UR) to ensure optimum medical care service delivery, utilization of resources, and cost-effe ...

We are seeking a Clinical Care Manager who is passionate about advancing high-quality compliant patient-centered care through precise timely Utilization Review In this role you will apply clinical expertise regulatory knowledge to evaluate healthcare services ensure medically nec ...

Coordinate and perform all aspects of Worker's Compensation, auto, and general liability claims for medical management activity (IME/Peer Review, UR) to ensure optimum medical care service delivery. · ...