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Spectrum Billing Solutions
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Skokie, Illinois
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Spectrum Billing Solutions offers industry-leading revenue cycle management services for ... .
Utilization Review Specialist | Utilization Management Specialist | UR Specialist | Revenue Cycle Specialist
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Humana
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Springfield, Illinois
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communication of medical services and/or benefit administration determinations. The Manager, Utilization ... approach, resources, schedules and goals.
The Manager, Utilization Management Nursing is responsible for
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Carle Foundation Hospital
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Urbana, Illinois
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and payers to plan and execute a safe discharge* Collaborates with Utilization Management team on ... reimbursement processes to facilitate medical cost management, including best practices, effective utilization
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Humana
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Springfield, Illinois
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Experience with Pharmacy Benefit Manager, Pharmacy, or Healthcare data, in particular drug utilization ... company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for
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Mindoula Health
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Remote, Illinois
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interdisciplinary team meetings and utilization management rounds and provides information to assist with safe ... level of care.
Collaborates with member, family and healthcare providers to develop an
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Humana
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Springfield, Illinois
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medical interpretation and determinations whether services provided by other healthcare professionals are ... in teams focusing on quality management, utilization management, case management, discharge planning
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Huron Consulting Group
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Chicago, Illinois
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ensuring the appropriate utilization of healthcare services by reviewing patient cases for medical ... outcomes while managing healthcare costs. The Utilization Management Specialist ensures compliance with
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Humana
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Springfield, Illinois
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communication of medical services and/or benefit administration determinations. The Utilization Management Nurse ... the appropriate courses of action.
The Post-Acute Utilization Management Nurse 2:
Review
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KEPRO
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Chicago, Illinois
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operations for Clinical Operations, Utilization Management, and/or Clinical Reviewers, assuring quality ... and managing the day-to-day activities of the assigned case management and utilization review teams
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Amergis
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Chicago, Illinois
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health care and services
Supports implementation of new workflows to bring health care utilization and cost in alignment with departmental policies and procedures
Manages care according to
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Humana
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Springfield, Illinois
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, other healthcare providers, clinical group practice management.
Utilization management experience ... medical interpretation and determinations whether services provided by other healthcare professionals are
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Carle Foundation Hospital
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Urbana, Illinois
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in areas of Care Management and Social Work Services.
Analyzes data and establishes ... Director of Regional Care Management East/South
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Huron Consulting Group
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Chicago, Illinois
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leadership in the markets they serve. We help healthcare organizations build innovation capabilities and ... , clinical services and technology is not enough to create meaningful and substantive change. To succeed long
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Trinity Health
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Maywood, Illinois
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quality and safety focusing on appropriate utilization of supplies and services. Works with key ... **
Indirect / Healthcare Support Services: (OSHA: Healthcare support services mean services that facilitate
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CVS Health
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Chicago, Illinois
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— our purpose sends a personal message that how we deliver our services is just as important as what we ... goal of this team is to provide accurate, relevant data and analysis for utilization and unit cost
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Highmark Health
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Springfield, Illinois
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captures all inbound phone inquires for utilization management review from providers and pharmacies. The ... Highmark's Utilization Management system for Prior Authorization clinical review, status research, etc
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CVS Health
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Springfield, Illinois
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Position Summary:
The Associate Manager is responsible for oversight of Utilization Management ... , operational, and quality objectives of the unit.
Oversees the implementation of healthcare management
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The University of Chicago
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Chicago, Illinois
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and pathology test utilization improvements and help to focus and
monitor departmental and ... collaborate on targeted healthcare
service improvements. Other duties will include teaching and supervision
of
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Humana
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Springfield, Illinois
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insurance, other healthcare providers, clinical group practice management.
Utilization management ... interpretation and determinations whether services provided by other healthcare professionals are in agreement
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Acadia Healthcare
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Chicago, Illinois
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REQUIREMENTS:
· Bachelor's degree in a clinical healthcare field, risk management, business, finance ... Description
ESSENTIAL FUNCTIONS:
· Direct and oversee the risk management
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AbbVie
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Mettawa, Illinois
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– immunology, oncology, neuroscience, and eye care – and products and services in our Allergan Aesthetics ... transforming marketing at AbbVie, accelerating smarter healthcare, with a mission to transform the way we drive
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Humana
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Springfield, Illinois
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Utilization Management operating model. The Advisor must exercise independent judgment and decision-making on ... Clinical - Utilization Management (UM) domain**
Serve as the primary point of contact (POC) to discuss
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Carle Foundation Hospital
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Urbana, Illinois
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care management and population health services to patients within the assigned region. Primary target ... healthcare utilization.
Data Analytics- Identify appropriate risk stratification via EHR encounters
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CenterWell
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Springfield, Illinois
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education opportunities to drive maximum utilization of available resources, and directing patients on the ... . Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and
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Molina Healthcare
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Chicago, Illinois
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& CSST resolution support, and National Contract Management support services.
• Serves as a ... and resolve issues related to utilization management, pharmacy, quality of care, and correct coding
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Humana
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Springfield, Illinois
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determinations whether services provided by other healthcare professionals are concordant with national ... , with prior experience participating in teams focusing on quality management, utilization management
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AbbVie
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Mettawa, Illinois
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specific market access issues/ trends. Understanding the impact of utilization management, tiering and ... – immunology, oncology, neuroscience, and eye care – and products and services in our Allergan Aesthetics
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CVS Health
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Springfield, Illinois
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utilization management, quality management, network management and clinical coverage and policies ... .
Coordinates with the MCOs' care management staff and providers on medical services not included in the aligned
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Compass Group, North America
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Chicago, Illinois
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Morrison Healthcare
Salary: $80000-$85000
Other Forms of Compensation:
Pay Grade: 13
Morrison Healthcare is a leading national food and nutrition services
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Rush University Medical Center
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Chicago, Illinois
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to promote increased utilization of services through business development and to develop, present ... reputation and build utilization of Cancer services.
•
Oversee development and implementation of
...
