Utilization Review Jobs in Illinois (NOW HIRING)

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.

Responsibilities Full-time Utilization Review Coordinator Opening The Pavilion Behavioral Health System has been the leading provider of behavioral health and addictions treatment for families in ...

BSN preferred. 2-5 years previous Utilization Review experience preferred. * Current CPR * Relevant hospital nursing; hospital case management; insurance case management or utilization management ...

Responsibilities Full-time Utilization Review Coordinator Opening The Pavilion Behavioral Health System has been the leading provider of behavioral health and addictions treatment for families in ...

We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist will utilize his or her knowledge and skills to review clinical information and obtain ...

Ensure timely and accurate utilization review activities and payer communications. * Monitor patient progression, discharge planning, and continuity of care processes. * Collaborate with physicians ...

Ensure timely and accurate utilization review activities and payer communications. * Monitor patient progression, discharge planning, and continuity of care processes. * Collaborate with physicians ...

The Utilization Review Clinician owns the clinical utilization review function for Clarity Clinic, covering prior authorization for admission, concurrent and continued stay review, peer to peer ...

The Utilization Review Clinician owns the clinical utilization review function for Clarity Clinic, covering prior authorization for admission, concurrent and continued stay review, peer to peer ...

The Utilization Review Specialist will work closely with healthcare providers, insurance companies, and patients to ensure optimal resource utilization and effective care management. Essential Duties ...

Manage payer denials and appeals by reviewing technical denials, determining appeal eligibility, preparing appeal correspondence, and tracking outcomes to support reimbursement efforts. * Coordinate ...

Performs a variety of utilization review activities to promote quality, clinical and cost-effective outcomes, including evaluation of length of stay and resource consumption. Manages activities of ...

Conducts admission reviews for Medicare, Medicaid beneficiaries, as well as private insurers and ... Adheres to CMS guidelines for utilization reviews as evidenced by utilization of the relevant ...

Required Work Experience: 5 years clinical and utilization review to include 2 years supervisory or team lead experience or equivalent military experience in grade E4 or above. * Required Skills and ...

Administrative Assistant for Utilization Review Lake Behavioral Hospital - Waukegan, IL 60085 Salary Range $19.00 - $26.00 Hourly Position Type Part Time Job Shift Day Join Our Team As A ...

The Utilization Specialist is responsible for reviewing of assigned admissions, continued stays, utilization practices and discharge planning according to approved clinically valid criteria which ...

Required Work Experience: 5 years clinical and utilization review to include 2 years supervisory or team lead experience or equivalent military experience in grade E4 or above. * Required Skills and ...

The Case Manager - Utilization Review RN collaborates with physicians, interdisciplinary team members, physician advisors, social workers, revenue cycle staff, and third-party payers to ensure ...

The Case Manager - Utilization Review RN collaborates with physicians, interdisciplinary team members, physician advisors, social workers, revenue cycle staff, and third-party payers to ensure ...

Care Review Clinician works with the Utilization Management team primarily responsible for medical necessity/utilization review aimed at providing members with the right care. * Assess and analyze ...