Utilization Review Jobs in Chicago
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Search Results - Utilization Review Jobs in Chicago
CenterWell Home Health-Chicago
to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts regular staff education as needed.
• Analyzes situations, identifies problems, identifies and evaluates alternative courses of action through...
appcast.io -
Greywood Health Center-Chicago
completion of client FMLA paperwork and similar documentation
• Maintain confidentiality of sensitive information
• Participate in orientation of newly enrolled clients
• Perform utilization reviews: initiate prior authorizations and complete concurrent...
mindmatch.ai -
Medrina Completes Fourth Acquisition: Radial Health-Chicago
for medical practice issues within the Company
• Develop and promote evidence-based clinical pathways and guidelines
• Participate in utilization review and quality monitoring activities
• Support billing and coding compliance activities
• Develop...
appcast.io -
Chicago
procedures, and performance standards and URAAC guidelines and state regulations.
Responsibilities:
MAJOR DUTIES AND RESPONSIBILITIES:
• Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity...
icims.com -
Paycor-Chicago
and unless expressly allowed by state or federal law, are in a state or territory of the United States when conducting appeal considerations.
• Conduct peer-to-peer consultations, adverse determinations, and appeals for drug utilization review...
appcast.io -
Northwestern Memorial Healthcare-Chicago
and maintenance of protocols. Assures established protocols meet compliance and regulatory requirements.
Provides guidance to clinical research staff on projects related to new research study submissions, utilization reviews, wording/phrasing of medical orders...
resume-library.com -
Paycor-Chicago
of such an individual; and unless expressly allowed by state or federal law, are in a state or territory of the United States when conducting appeal considerations.
7. Conduct peer-to-peer consultations, adverse determinations, and appeals for drug utilization review...
appcast.io -
Chicago
intermediary etc.; gathering clinical and fiscal information and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and use sound judgment.
Knowledge...
icims.com -
Rising Medical Solutions-Chicago
Fixed Width, Delimited, XML)
• Other medical/health care/insurance industry experience a plus
• Medical bill review or workers compensation experience, or administrative support for utilization review a plus
• Experience with python is a plus.
Skills...
workable.com -
Chicago
Acentra seeks an OBGYN Physician Reviewer (PRN) to join our growing team.
Job Summary:
The OB/GYN Physician Reviewer will provide principal leadership and clinical expertise to operations relating to the peer review process, utilization review activities...
acentra.com -
Xsolis-Chicago
and interaction between utilization review, case management, and revenue cycle metrics (e.g., linkage between observation rate and denial rate)
• Conducts deeper analysis into metrics to understand the key drivers and potential impacts to numbers
• Responsible...
appcast.io -
Chicago
Acentra seeks an Psychiatrist Physician Reviewer (PRN) to join our growing team.
Job Summary:
The Psychiatrist Physician Reviewer will provide principal leadership and clinical expertise to operations relating to the peer review process, utilization...
acentra.com -
Community Health & Wellness Center (CHWC)-Chicago
as required and participate in Quality Assurance and Utilization Reviews.
13. Participate in Accountable Care Organization activities as required.
14. Perform diagnostic tests and procedures and therapeutic procedures, within the scope of practice, including...
appcast.io -
Chicago
Acentra seeks an Pediatric Physician Reviewer (PRN) to join our growing team.
Job Summary:
The Pediatric Physician Reviewer will provide principal leadership and clinical expertise to operations relating to the peer review process, utilization review...
acentra.com -
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