Utilization Review Nurse/ Appeals RN - Chicago

The RN Clinical Appeals Nurse provides support for internal appeals clinical processes ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements Molina policies and procedures and medically appropriate clinical guideline ...

This role supports the end to end appeals process to ensure timely accurate and compliant resolution of member and provider appeals. You will collaborate across multiple operational teams uphold regulatory and accreditation standards and contribute to continuous improvement initi ...

This position reviews initial clinical denials, document appeals for clinical inpatient denials, conducts appeals as appropriate. · ...

ALIYA Healthcare is seeking an experienced Reimbursement Consultant to support and optimize reimbursement across our skilled nursing operations. This role is responsible for ensuring accurate reimbursement, regulatory compliance, and revenue integrity through analysis, reporting, ...

· Job Description · Dermatology Nurse Practitioner / Physician Assistant Job in the Chicago Area · Job-8198 · You've put in the time, built real dermatology experience and you know what a solid practice feels like. You're confident in clinic, comfortable with patient flow and re ...

Pearl Healthcareis seeking a dedicated Medicaid Specialist with strong knowledge of Illinois Medicaid eligibility and processes' to join our team. · The ideal candidate will be detail oriented, communicative and experienced in supporting long term residents in our facilities. The ...

The Utilization Management Manager plays a vital role in ensuring patients have timely access to care by managing both front-end prior authorizations and in-house concurrent review authorizations. · This position blends strong relationship-building skills with clinical knowledge ...

+ 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 ...

+Lead and oversee luxury operations at Next Health. · +Manage staff including physicians nurses administrative staff. · E nsure patient care services meet regulatory standards · +Benefits + OUTSTANDING compensation package available + A supportive inclusive work environment Mea ...

We are seeking a Litigation Paralegal to join our team in Chicago, IL. As part of our dedicated legal team, you will play a vital role in assisting attorneys with all aspects of litigation cases. · ...

Doctor of Medicine | Radiology - General/Other · Location: · Mount Vernon, IL · Employer: · Wellhart, LLC · Pay: · Competitive weekly pay (inquire for details) · Contract Duration: · 36 Days · Start Date: · ASAP · About the Position · LocumJobsOnline is working with Wellhart, LLC ...

WearelookingforanIntakeCoordinator(jointeam)tojoinourteamAreyousomeonethtthrivesinfastpacedenvironmentwhereyour timemanagementattention-todetailandcommunicationskillspu... · ...

· Company Description · At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportun ...

The Patient Access Liaison (PAL) is a regional, field-based position that provides clinical disease state education and product education to patients and their families for our rare disease portfolio of products, · oftentimes in the patient's home. · ...

· About Us: · Step into Next Health, where innovation meets longevity. Established over 9 years ago, we have flourished into the leader source of functional medicine and wellness throughout the United States, fueled by an unstoppable mission to advance health optimization and lo ...

Nurse manager responsible for planning and directing implementation of utilization review plan. · Staff acquisition and support: leads utilization review staff function. · Team guidance and leadership: determines policies and procedures. · Performance tracking and improvement: pr ...

We are currently searching for experienced professionals to join our team as a Patient Access Manager for the West Region. · Immedica has had remarkable growth over the past years. · ...

We are seeking an Inpatient Coder II to join our team at Northwestern Medicine. As an integral part of our team, you'll have the opportunity to join our quest for better health care. · Utilizes technical coding expertise to assign appropriate ICD-10-CM and ICD-10-PCS codes. · Rev ...

· Company Description · At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportun ...

We are seeking a Commercial Litigation Attorney with dual licensure in Illinois and California to join our prestigious legal team. Handle a diverse portfolio of commercial litigation matters including professional liability cases, nursing home defense, condominium disputes, elder ...