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Remote Inova Rn Jobs in Oak Lawn, IL (NOW HIRING)

Silver Cross Hospital

Utilization Review Nurse

New Lenox, IL · On-site +1

$34.73 - $45.15/hr

Nurse, Registered (RN) licensure * BSN preferred. 2-5 years previous Utilization Review experience ... Days, Primarily remote; onsite orientation requirement; weekend and holiday rotation; on site ...

Humana

Care Coordinator, RN Field Based

Gary, IN · Remote

Licensed Registered Nurse (RN) in the state of Indiana without restrictions * At least one (2) ... Combination remote work at home and onsite member visits Location: Must reside in Indiana Hours:

Humana

Care Coordinator, RN Field Based

Gary, IN · Remote

Licensed Registered Nurse (RN) in the state of Indiana without restrictions * At least one (2) ... Combination remote work at home and onsite member visits Location: Must reside in Indiana Hours:

Humana

Care Coordinator, RN Field Based

Hammond, IN · Remote

Licensed Registered Nurse (RN) in the state of Indiana without restrictions * At least one (2) ... Combination remote work at home and onsite member visits Location: Must reside in Indiana Hours:

Humana

Care Coordinator, RN Field Based

Hammond, IN · Remote

Licensed Registered Nurse (RN) in the state of Indiana without restrictions * At least one (2) ... Combination remote work at home and onsite member visits Location: Must reside in Indiana Hours:

Humana

Care Coordinator, RN Field Based

Hammond, IN · Remote

Licensed Registered Nurse (RN) in the state of Indiana without restrictions * At least one (2) ... Combination remote work at home and onsite member visits Location: Must reside in Indiana Hours:

Humana

Care Coordinator, RN Field Based

Gary, IN · Remote

Licensed Registered Nurse (RN) in the state of Indiana without restrictions * At least one (2) ... Combination remote work at home and onsite member visits Location: Must reside in Indiana Hours:

SMARTCARDIA INC

Cardiac Technician

Des Plaines, IL · Remote

$28 - $32/hr

Remote (U.S.) | Hybrid preferred for candidates near our Des Plaines, IL office At SmartCardia, w ... Certified Cardiovascular Technician (CCT), Registered Nurse (RN), Emergency Medical Technician (EMT ...

SMARTCARDIA INC

Cardiac Technician

Des Plaines, IL · Remote

$28 - $32/hr

Remote (U.S.) | Hybrid preferred for candidates near our Des Plaines, IL office At SmartCardia, w ... Certified Cardiovascular Technician (CCT), Registered Nurse (RN), Emergency Medical Technician (EMT ...

SMARTCARDIA INC

Cardiac Technician

Des Plaines, IL · Remote

$28 - $32/hr

Remote (U.S.) | Hybrid preferred for candidates near our Des Plaines, IL office At SmartCardia, w ... Certified Cardiovascular Technician (CCT), Registered Nurse (RN), Emergency Medical Technician (EMT ...

Protouch Staffing

PT Case Manager HH

Oak Brook, IL · Remote

$2.5K/wk

Home Health Physical Therapist (PT) - Remote Field-Based Role ???? Central Metro E - Chicago, IL ... Effective collaboration with interdisciplinary teams: * RN * OT * PT * Speech Therapy Technology ...

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Quality Review Specialist (RN or LPN/LVN)

VIVA USA INC

Downers Grove, IL • On-site, Remote

Contractor

Posted 14 days ago

Job description

Work closely with Utilization Management (UM), Case Management (CM) and Customer Service (CS) to ensure appeal process meets established guidelines.
Adhere to accreditation and regulatory requirements to improve customer service and achieve organizational goals related to complaint and appeal resolution.
Manage individual inventory through appropriate workflow.
Facilitate final resolution of member and provider appeals.
Participate in department initiatives related to NCQA and URAC audits, DOI audits, revision project, audits, and correspondence revision projects.
Serve on workgroups.
Adhere to compliance with external regulatory and accreditation standards.
Facilitate access to appeal files by members or member designee under federal guidelines.
Provide data for required reporting. 10.Work directly with members and providers to resolve appeals.
Support other team members in appeal resolution and in fulfilling other department responsibilities.
Assist in maintaining working relationships across organizational lines.
Ensure our member/providers requirements are met at all times.
Communicate and interact effectively and professionally with co-workers, management, customers, etc.
Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
Maintain complete confidentiality of company business.
Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.
JOB REQUIREMENTS:
Applicants must hold an active RN or LPN/LVN license in good standing.
Bachelor's Degree OR 4 years in health care experience.
5 years utilization management, appeals, claims and mainframe system experience.
Experience in health operations.
Experience with internal/external customer relations.
Knowledge of managed care processes.
Knowledge and familiarity of national accreditation standards, specifically NCQA and URAC standards.
Knowledge of state and federal health care and health operations regulations.
Organizational skills and ability to meet deadlines and manage multiple priorities.
Verbal and written communication skills to include interfacing with staff across organizational lines plus interfacing with members and providers.
PC proficiency to include Microsoft Word, Access, and Excel.
PREFERRED JOB REQUIREMENTS:
Appeals or Utilization management experience.
Notes:
Fully remote
This is a M-F shift 40 hours per week, with MANDATORY holiday and weekend rotations.
Holidays rotation scheduled 3-4 holidays per year and one weekend every 3rd weekend.
This is a contract role with the possibility of conversion to full-time based on business needs and performance
VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

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