Care Review Clinician (RN) - (IL Nursing License) Molina Healthcare IncCare Review Clinician (RN) - (IL Nursing License)Chicago, ILRemoteResponsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience.
Care Review Clinician (RN) - (IL Nursing license) Molina Healthcare IncCare Review Clinician (RN) - (IL Nursing license)ILRemoteResponsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience.
RN Health Care Facility Surveyor Greenlife Healthcare StaffingRN Health Care Facility SurveyorOak Lawn, ILRemote$75,000–$90,000 / yearThe Surveyor will serve as a team member or team leader on various types of surveys (i.e. re-certification, comparative, complaint investigation, and revisits) for long-term care and non-long-term care surveys, which can include; ambulatory surgical centers (ASC), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), end-stage renal disease (ESRD), Psychiatric Residential Treatment Facility (PRTF), hospital, critical access hospital, and hospice facilities. Impact Recruiting Solutions is currently seeking a RN Health Care Facility Surveyor to fill an opening with a Quality Improvement Consulting Company and will work in a technically exciting environment supporting internal and external customers nationwide.
NewCare Manager Telephonic Nurse Humana IncCare Manager Telephonic NurseILRemote$71,100–$97,800 / yearWork at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. The Care Manager, Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members'' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members.
Virtual Primary Care Physician Firefly HealthVirtual Primary Care PhysicianChicago, ILRemoteHave experience delivering care within value-based care models, including commercial risk arrangements or other risk-bearing care models, and understand the role of accurate clinical documentation, quality measurement, and population health initiatives in improving patient outcomes. You will practice as part of Firefly's multidisciplinary Care Team, collaborating closely with Nurse Practitioners (NPs), Registered Nurses (RNs), Health Guides, Behavioral Health Specialists, and other clinical partners to deliver coordinated, patient-centered care.
Care Transformation RN CommonSpirit HealthCare Transformation RNChicago, ILRemoteAs one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs.
Supervisor, Utilization Management TriWest Healthcare AllianceSupervisor, Utilization ManagementChicago, ILRemoteFull timeTechnical Skills: Thorough knowledge of policies and procedures, knowledge of managed care principles and methods; medical terminology; proficiency in the application of clinical criteria: InterQual, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders, current Procedural Terminology, and Healthcare Common Procedural Coding System, and American Dental codes; working knowledge with medical management systems; proficient with Microsoft Office; knowledge of UM Process; reporting techniques. • Prepares work schedules and monitors staff caseloads to ensure adequate staffing levels at all times and accurate data entry and application of the medical management system.
Adult Health Nursing Faculty BSN Visiting Professor Covista IncAdult Health Nursing Faculty BSN Visiting ProfessorChicago, ILRemote$53,520.90–$96,736.53 / yearA faculty member at the rank of Instructor demonstrates significant service the University by accepting or initiating, as part of the workload, responsibility for activities such as: Serving on University committees Serving on work groups that contribute to preparation for accreditation visits Gathering and analyzing data related to course, curriculum and program review to foster continuous quality improvement Documenting actions taken in faculty and committee meetings as appropriate. Our College of Nursing offers a Bachelor of Science in Nursing (BSN) degree program at 23 locations and online post-licensure degree programs and certificates including RN to BSN, RN to MSN, a Master of Science in Nursing (MSN) with six Specialty Tracks, and a Doctor of Nursing Practice (DNP).
NewSenior Manager, Field Success CVS Health CorpSenior Manager, Field SuccessChicago, ILRemote$82,940–$182,549 / yearManager, you will play a critical role in supporting our Oak Street Health patients, providers and business by supporting the successful execution, adoption, and operationalization of care management operations and new care management initiatives across Oak Street Health centers. This role serves as a key bridge between centralized care management strategy and field operations, partnering closely with center and regional leaders to drive understanding, alignment, and adoption of evolving care management workflows, processes, and team structures.
Associate Clinical Editor RELX Group plcAssociate Clinical EditorIllinois, ILRemote$71,600–$119,400 / yearIf performed in Colorado, the base pay range is $71,600 - $119,400.If performed in Illinois, the base pay range is $75,200 - $125,500.If performed in Chicago, IL, the base pay range is $78,700 - $131,400.If performed in Maryland, the base pay range is $75,200 - $125,500.If performed in Ohio, the base pay range is $68,000 - $113,400. Responsibilities: Review, update, and revise assigned content based on scheduled and triggered review cycles, as well as customer needs and requests, and current events in health care such as guideline update under the guidance of a Clinical Editor.
Onsite Care Coordination Nurse HumanaOnsite Care Coordination NurseMcHenry, IllinoisRemoteWork at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it.
Transition/Custodial Prevention Specialist Humana IncTransition/Custodial Prevention SpecialistILRemote$59,300–$80,900 / yearContact members telephonically and face-to-face to establish goals and priorities, evaluate resources, develop plans of care, and identify LTSS providers and community partnerships to provide a combination of services and supports that best address the needs and goals of members and caregivers through person centered thinking approaches. Work at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
Case Management Supervisor RN CorVelCase Management Supervisor RNDowners Grove, ILRemote$76,207–$117,662 / yearPay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. The Case Management Supervisor is responsible for directing the operations of their designated department, which may include one or more of the following functions: human resources, customer service, and limited sales management.
NewFlex Nurse Educator - Chicago S, IL IQVIA Holdings IncFlex Nurse Educator - Chicago S, ILChicago, ILRemote$80,000–$85,000 / yearIQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide.
NewFlex Nurse Educator - Elgin, IL IQVIA Holdings IncFlex Nurse Educator - Elgin, ILElgin, ILRemote$80,000–$85,000 / yearIQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide.
NewFlex Nurse Educator - Chicago N, IL IQVIA Holdings IncFlex Nurse Educator - Chicago N, ILNorth Chicago, ILRemote$80,000–$85,000 / yearIQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide.
Associate Account Executive, Biosimilars- West Region Organon & CoAssociate Account Executive, Biosimilars- West RegionChicago, ILRemote$125,400–$213,100 / yearThe AAE develops strategic and tactical account plans for assigned accounts focused in three core areas: Economic: Persuasively presenting GPO pricing programs and budget impact models to healthcare leaders with emphasis on pharmacy and supply chain. Leads account planning and pull through efforts for assigned accounts and manages ongoing communications to extended Team, including account coordination and access facilitation with FBEs that have overlapping contacts.
Associate Account Executive, Biosimilars- West Region State of OregonAssociate Account Executive, Biosimilars- West RegionChicago, PennsylvaniaRemote$125,400–$213,100 / yearThe AAE develops strategic and tactical account plans for assigned accounts focused in three core areas: Economic: Persuasively presenting GPO pricing programs and budget impact models to healthcare leaders with emphasis on pharmacy and supply chain. Leads account planning and pull through efforts for assigned accounts and manages ongoing communications to extended Team, including account coordination and access facilitation with FBEs that have overlapping contacts.
NewHolistic Health Specialist - Work From Home HCSCHolistic Health Specialist - Work From HomeChicago, IllinoisRemoteFunctioning in a clinical care advisory role, assessing members for wellness education and disease management, introduces members to our website tools, educates members regarding wellness and specific conditions, and facilitates the coordination of care for identified members. Identifies alternate treatment programs; consults with physicians, providers, members, and other resources to evaluate options and services required to meet an individual’s health needs.
Clinical Retention Specialist (Central - MI, IN, IL, WI, OH, MN, IA, SD, ND) Insulet CorpClinical Retention Specialist (Central - MI, IN, IL, WI, OH, MN, IA, SD, ND)Chicago, ILRemote$79,300–$118,900 / yearInsulet's flagship innovation, the Omnipod 5 Automated Insulin Delivery System, integrates with a continuous glucose monitor to manage blood sugar with no multiple daily injections, zero fingersticks, and can be controlled by a compatible personal smartphone in the U.S. or by the Omnipod 5 Controller. Identify early indicators of disengagement or churn through data assessment and analytics in partnership with the data science teams and collaborate with Customer Success teams to deploy targeted, regionally informed save strategies.