Chicago, IL · On-site
Staff may be required to contact the providers of record, vendors, or internal Aetna departments to ... MUST HAVE UM experience, inpatient utilization management review. * MUST HAVE 1 YEAR OF UTILIZATION ...
Chicago, IL · On-site
Staff may be required to contact the providers of record, vendors, or internal Aetna departments to ... MUST HAVE UM experience, inpatient utilization management review. * MUST HAVE 1 YEAR OF UTILIZATION ...
Skokie, IL · On-site
$25 - $30/hr
... management, utilization review or equivalent experience in a health care environment * Epic ... LaSalle Network is the leading provider of direct hire and temporary staffing services. For over ...
New
Skokie, IL · On-site
$25 - $30/hr
... management, utilization review or equivalent experience in a health care environment * Epic ... LaSalle Network is the leading provider of direct hire and temporary staffing services. For over ...
New
$46K - $112K/yr
... Aetna, FEHBP, and Maintenance Choice. Reporting to the Senior Manager, FP&A Non-Medicare Drug ... utilization trends. * Prepares weekly performance updates and management reporting packages ...
$46K - $112K/yr
... Aetna, FEHBP, and Maintenance Choice. Reporting to the Senior Manager, FP&A Non-Medicare Drug ... utilization trends. * Prepares weekly performance updates and management reporting packages ...
Chicago, IL · Remote
$18.50 - $38.82/hr
Position Summary CVS Health Aetna has an opportunity for a full-time Care Management Associate (CMA ... Review, prioritize, and triage incoming Care Team tasks to ensure timely follow-up and resolution
Chicago, IL · Remote
$18.50 - $38.82/hr
Position Summary CVS Health Aetna has an opportunity for a full-time Care Management Associate (CMA ... Review, prioritize, and triage incoming Care Team tasks to ensure timely follow-up and resolution
Aurora, IL · Remote
$18.50 - $38.82/hr
Position Summary CVS Health Aetna has an opportunity for a full-time Care Management Associate (CMA ... Review, prioritize, and triage incoming Care Team tasks to ensure timely follow-up and resolution
Aurora, IL · Remote
$18.50 - $38.82/hr
Position Summary CVS Health Aetna has an opportunity for a full-time Care Management Associate (CMA ... Review, prioritize, and triage incoming Care Team tasks to ensure timely follow-up and resolution
Assess market segments to determine the best product strategies for increasing utilization ... Bundled consumer-driven Medical (Blue Cross Blue Shield), Dental (Aetna), and Vision (VSP) pricing.
Assess market segments to determine the best product strategies for increasing utilization ... Bundled consumer-driven Medical (Blue Cross Blue Shield), Dental (Aetna), and Vision (VSP) pricing.
Chicago, IL · Hybrid
$24 - $31/hr
Review and mark up architectural drawings using Bluebeam Revu * Redline and coordinate floor plans ... Analyze customer and employee traffic flow to improve functionality and space utilization * Assist ...
Quick apply
Chicago, IL · Hybrid
$24 - $31/hr
Review and mark up architectural drawings using Bluebeam Revu * Redline and coordinate floor plans ... Analyze customer and employee traffic flow to improve functionality and space utilization * Assist ...
Oak Brook, IL · On-site
$62K - $77K/hr
Reviews caseloads for compliance with Agency requirements regarding paperwork. Approves assessments ... Oversees the utilization of outsourced clinical services, identifying providers, approving each ...
Oak Brook, IL · On-site
$62K - $77K/hr
Reviews caseloads for compliance with Agency requirements regarding paperwork. Approves assessments ... Oversees the utilization of outsourced clinical services, identifying providers, approving each ...
Oak Brook, IL · On-site
$62K - $77K/yr
Reviews caseloads for compliance with Agency requirements regarding paperwork. Approves assessments ... Oversees the utilization of outsourced clinical services, identifying providers, approving each ...
Oak Brook, IL · On-site
$62K - $77K/yr
Reviews caseloads for compliance with Agency requirements regarding paperwork. Approves assessments ... Oversees the utilization of outsourced clinical services, identifying providers, approving each ...
Lake Forest, IL · On-site
$17 - $18/hr
Join Consumers Credit Union (CCU) as a temporary employee for a 6-month assignment working as a ... For further information, please review the Know Your Rights notice from the Department of Labor.
Lake Forest, IL · On-site
$17 - $18/hr
Join Consumers Credit Union (CCU) as a temporary employee for a 6-month assignment working as a ... For further information, please review the Know Your Rights notice from the Department of Labor.
... assign and review maintenance work; perform a variety of responsible duties related to the ... Reconcile hours with Mechanics to ensure 100% utilization * Schedule mechanics for weekend ...
New
... assign and review maintenance work; perform a variety of responsible duties related to the ... Reconcile hours with Mechanics to ensure 100% utilization * Schedule mechanics for weekend ...
New
... assign and review maintenance work; perform a variety of responsible duties related to the ... Reconcile hours with Mechanics to ensure 100% utilization * Schedule mechanics for weekend ...
New
Quick apply
... assign and review maintenance work; perform a variety of responsible duties related to the ... Reconcile hours with Mechanics to ensure 100% utilization * Schedule mechanics for weekend ...
New
Chicago, IL · Remote
$85K - $100K/yr
Review current programs, evaluate claims and utilization data * Take proposals to market to help ... 1099 and temp-to-perm). We work nationally with expertise that spans top executives, middle ...
Quick apply
Chicago, IL · Remote
$85K - $100K/yr
Review current programs, evaluate claims and utilization data * Take proposals to market to help ... 1099 and temp-to-perm). We work nationally with expertise that spans top executives, middle ...
Analyze application portfolios across cost (license + support + infra), utilization, functional ... Review Boards (ARBs). * Participate in weekly intake triage: classify and route work to ART ...
Quick apply
Analyze application portfolios across cost (license + support + infra), utilization, functional ... Review Boards (ARBs). * Participate in weekly intake triage: classify and route work to ART ...
Chicago, IL · On-site
$130K - $195K/yr
... Review of temporary works interfaces (as required/appropriate) Communicate technical findings ... Assign and manage work across project engineers, designers, and drafters; balance utilization and ...
Quick apply
Chicago, IL · On-site
$130K - $195K/yr
... Review of temporary works interfaces (as required/appropriate) Communicate technical findings ... Assign and manage work across project engineers, designers, and drafters; balance utilization and ...
$130K - $195K/yr
Review of temporary works interfaces (as required/appropriate) * Communicate technical findings ... Assign and manage work across project engineers, designers, and drafters; balance utilization and ...
$130K - $195K/yr
Review of temporary works interfaces (as required/appropriate) * Communicate technical findings ... Assign and manage work across project engineers, designers, and drafters; balance utilization and ...
Chicago, IL · On-site
$130.10 - $195.10/hr
Review of temporary works interfaces (as required/appropriate) * Communicate technical findings ... Assign and manage work across project engineers, designers, and drafters; balance utilization and ...
Chicago, IL · On-site
$130.10 - $195.10/hr
Review of temporary works interfaces (as required/appropriate) * Communicate technical findings ... Assign and manage work across project engineers, designers, and drafters; balance utilization and ...
Chicago, IL · On-site
$130K - $195K/yr
Review of temporary works interfaces (as required/appropriate) * Communicate technical findings ... Assign and manage work across project engineers, designers, and drafters; balance utilization and ...
Chicago, IL · On-site
$130K - $195K/yr
Review of temporary works interfaces (as required/appropriate) * Communicate technical findings ... Assign and manage work across project engineers, designers, and drafters; balance utilization and ...
The Temporary Contract Complex Claims Specialist-Professional Liability is an individual ... Reviews and provides analysis of claim documentation and legal filings * Drives litigation best ...
The Temporary Contract Complex Claims Specialist-Professional Liability is an individual ... Reviews and provides analysis of claim documentation and legal filings * Drives litigation best ...
Chicago, IL · On-site
The Temporary Contract Complex Claims Specialist-Professional Liability is an individual ... Reviews and provides analysis of claim documentation and legal filings * Drives litigation best ...
Chicago, IL · On-site
The Temporary Contract Complex Claims Specialist-Professional Liability is an individual ... Reviews and provides analysis of claim documentation and legal filings * Drives litigation best ...
$21.05 - $25.31
2% of jobs
$25.31 - $29.57
9% of jobs
$32.48 is the 25th percentile. Wages below this are outliers.
$29.57 - $33.83
21% of jobs
The median wage is $37.27 / hr.
$33.83 - $38.08
23% of jobs
$38.08 - $42.34
13% of jobs
$45.65 is the 75th percentile. Wages above this are outliers.
$42.34 - $46.60
10% of jobs
$46.60 - $50.86
8% of jobs
$50.86 - $55.11
5% of jobs
$55.11 - $59.37
5% of jobs
$59.37 - $63.63
2% of jobs
$63.63 - $67.89
2% of jobs
$21
$41
$67
| Aspect | Temporary Aetna Utilization Review | Temporary Health Insurance Claims Processor |
|---|---|---|
| Credentials | Typically requires healthcare-related certifications (e.g., RN, LPN, or medical background) | Requires knowledge of insurance policies and claims processing, often with insurance or administrative certifications |
| Work Environment | Healthcare settings, insurance companies, or remote | Insurance companies, claims departments, or remote |
| Employer & Industry Usage | Health insurance providers, healthcare organizations | Insurance carriers, third-party administrators |
| Search & Comparison Intent | Understanding utilization review roles within health insurance | Comparing claims processing roles in insurance industry |
Temporary Aetna Utilization Review involves assessing the necessity and appropriateness of healthcare services, often requiring medical credentials. In contrast, Temporary Health Insurance Claims Processors handle claims submissions and reimbursements, focusing on administrative tasks. Both roles are essential in health insurance but differ in responsibilities, credentials, and work environment.
Chicago, IL
Contract
Job Description:
Participates in the development and ongoing implementation of QM Work Plan activities.
Improve quality products and services, by using measurement and analysis to process, evaluate and make recommendations to meet QM objectives
Responsibilities:
Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations.
Considers all documented system information as well as any additional records/data presented to develop a determination or recommendation.
Data gathering requires navigation through multiple system applications.
Staff may be required to contact the providers of record, vendors, or internal Aetna departments to obtain additional information.
Evaluates documentation/information to determine compliance with clinical policy, regulatory and accreditation guidelines.
Responsible for the review and evaluation of clinical information and documentation.
Reviews documentation and interprets data obtained form clinical records or systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and/or provider issues.
Works Potential Quality of Care cases across all lines of business (Commercial and Medicare).
Independently coordinates the clinical resolution with internal/external clinician support as required.
Processes and evaluates complex data and information sets -Converts the results of data analysis into meaningful business information and reaches conclusions about the data
Prepares and completes QM documents based on interpretation and application of business requirements
Documents QM activities to demonstrate compliance with business, regulatory, and accreditation requirements
Assists in the development and implementation of QM projects and activities
Accountable for completing and implementation of QM Work Plan Activities
Experience:
3+ years of experience as an RN
Registered Nurse in state of residence
Must have prior authorization utilization experience
Experience with Medcompass
Skills:
MUST HAVE MEDCOMPASS or ASSURECARE exp.
MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge.
MUST HAVE UM experience, inpatient utilization management review.
MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG.
MUST HAVE 6 months of Prior Authorization.
Education:
Questionnaire:
Do you have experience with Medcompass?
Do you have experience with Prior Authorization?
Do you have experience with Utilization Review?
Do you have an Active Registered Nurse License?
About US Tech Solutions:
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com (http://www.ustechsolutionsinc.com) .
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
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US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions.
It services
1,001 - 5,000 Employees
Jersey City, NJ, US
2000
