Utilization Review Nurse

ESSENTIAL FUNCTIONS: * Act as liaison between managed care organizations and the facility professional clinical staff. * Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements. * Monitor patient length of stay...

Responsible for performing specific tasks required for an efficient and effective hospital utilization review program for Behavioral Health (Psychiatric or Addiction) Services. The incumbent is responsible for carrying out activities that meet the objectives of the hospital utilization review program. The hospital Utilization Review Plan describes the...

Job DescriptionJob DescriptionAt A Beautiful Mind, Inc., our employees are driven by a deep sense of service, high standards of professionalism and a responsibility to better the public good. We are currently seeking an Utilization Reviewer/Trainer who has a passion for providing the highest quality care in an institutional, secure setting. Come join a team...

We are seeking a Utilization Review Supervisor to lead a team of specialists in obtaining appropriate insurance authorization for our patients to receive Behavioral Health treatment at high levels of care. In addition to overseeing and providing direction to the team, the UR Supervisor must possess exemplary organizational skills, and have a clear passion in...

Role Description: This full-time role is responsible for provisioning accurate and timely coverage determinations for inpatient and outpatient services by applying utilization management (UM) criteria, clinical judgment, and internal policies and procedures. Regardless of the final determination, the Physician Reviewer is responsible for ensuring medically...

Dane Street, a certified "Great Place to Work'' company, is searching for Board Certified Internal Medicine physicians to conduct Independent Medical Exams (IME) and Peer Reviews. This opportunity allows you to customize your schedule and caseload within a standard Monday - Friday work week while maintaining client-mandated turnaround times. We will reach...

Description Home Search Jobs Job Description Medical reviewer Remote: North Chicago, Illinois, US Salary: $35.00 Per Hour Job Code: 348494 End Date: 2024-05-19 Days Left: 3 hours left Apply Position Details: Industry: Pharmaceutical Job Title: Medical Reviewer/Safety Reviewer Location: Remote Job Description: Provides timely assessment of reported...

Hire Counsel has an immediate opportunity to work with one of the top law firms on a document review position. We are seeking licensed attorneys for a document review project that's available remotely, which is expected to start March 8, 2023.Responsibilities Include:Review documents for relevance and privilege for ongoing litigation Utilize e-Discovery...

**Quality Assurance Utilization for Program Planning** 4534 S Western Ave Chicago, IL 60609 Full Time **Healthcare Alternative Systems, Inc. (H.A.S.) **is a 501 (c) 3 non-profit organization providing behavioral health services to Chicago and the surrounding communities. We offer a continuum of programs addressing substance abuse, mental health,...

Extra Help Health Care Utilization Review Coordinator (HURC II) - Continuum of CareThis Position is temporary, non-benefits eligible, and is limited to 900 hours.Hiring Department: Continuum of CareLocation: Chicago, IL USARequisition ID: 1022315FTE : 0Work Schedule - Shift : # of Position: 2Posting Date: 11/20/2023About the University of Illinois ChicagoUIC...

Responsibilities JOB SUMMARY: Responsible for all denial and appeal activities for the Utilization Management department, including Expedited Appeals, Standard Appeals, External Independent Reviews, Retrospective Reviews, and State Fair Hearings. Review clinical information for all appeals utilizing nationally recognized criteria to determine medical...

Responsibilities JOB SUMMARY: Responsible for all denial and appeal activities for the Utilization Management department, including Expedited Appeals, Standard Appeals, External Independent Reviews, Retrospective Reviews, and State Fair Hearings. Review clinical information for all appeals utilizing nationally recognized criteria to determine medical...

Extra Help Health Care Utilization Review Coordinator (HURC II) - Continuum of CareThis Position is temporary, non-benefits eligible, and is limited to 900 hours.Hiring Department: Continuum of CareLocation: Chicago, IL USARequisition ID: 1022306FTE : 0Work Schedule - Shift : # of Position: 2Posting Date: 11/20/2023About the University of Illinois ChicagoUIC...

**Maintenance & Utilities Manager** **Chicago, Illinois** **Position is 100% on-site** **Skills and Certifications**: Engineering / Bachelors Degree Authorized to work in the US without sponsorship Strong TPM experience The Utilities Maintenance Manager is directly responsible for improving the total uptime performance of the site’s Utilities assets...

Responsible for all denial and appeal activities for the Utilization Management department, including Expedited Appeals, Standard Appeals, External Independent Reviews, Retrospective Reviews, and State Fair Hearings. Review clinical information for a Appeals, Management, Behavioral Health, Coordinator, Healthcare

Performs timely, daily clinical reviews with all payer types, to secure authorization for initial and continued treatment based on payers criteria and in accordance with the hospital wide Utilization Management Plan. Serves as liaison to 3rd and 4th Management, Behavioral Health, Coordinator, Operations, Healthcare, Hospital

Responsibilities JOB SUMMARY: Performs timely, daily pre-certifications, to secure initial authorization based on payer's criteria and in accordance with the hospital wide Utilization Management Plan. Coordinates with the Business Office, Admissions Department and Utilization Management Department. Obtains billing and insurance information, verification of...

Responsibilities JOB SUMMARY: Performs timely, daily pre-certifications, to secure initial authorization based on payer's criteria and in accordance with the hospital wide Utilization Management Plan. Coordinates with the Business Office, Admissions Department and Utilization Management Department. Obtains billing and insurance information, verification of...

**Location**:Chicago, IL **Hospital**:RUSH University Medical Center **Department**:Hematology/Oncology PBC RUMC **Work Type**:Full Time (Total FTE between 0.9 and 1.0) **Shift: Shift 1** **Work Schedule**:10 Hr (7:00:00 AM - 5:30:00 PM) Summary: The Ambulatory Clinical Nurse Leader functions as an advanced generalist providing and managing care for...

**Location**:Chicago, IL **Hospital**:RUSH University Medical Center **Department**:Hematology/Oncology PBC RUMC **Work Type**:Full Time (Total FTE between 0. 9 and 1. 0) **Shift: Shift 1** **Work Schedule**:10 Hr (7:00:00 AM - 5:30:00 PM) Summary: The Ambulatory Clinical Nurse Leader functions as an advanced generalist providing and managing care for...