Milliman Utilization Review Jobs in Usa
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We are looking for a hard-working production worker to assist in the manufacturing process. The Production Worker's responsibilities include keeping the production area clean, preparing machinery and equipment for use, working the production line as instructed, and strictly following health and safety guidelines.
To be successful as a production worker you should be able to work on the production line with consistent speed and accuracy. An outstanding production worker should be able to maintain production standards and work towards improving productivity without compromising quality.
Production Worker Responsibilities:
- Following health and safety standards.
- Maintaining a clean workstation and production floor.
- Assembling products and parts.
- Following production guidelines and specifications.
- Finalizing and packaging products for shipment.
- Operating and maintaining machinery and production line equipment.
- Monitoring the assembly line and removing faulty products.
- Working on the production line and meeting production targets.
- Reporting any issues to the supervisor on duty.
- Performing other tasks as assigned.
- High school diploma/GED.
- Previous experience working in a factory is beneficial.
- Experience operating manufacturing machinery.
- Able to work as part of a team.
- Good communication skills.
- Basic math skills.
- Physical dexterity.
- Ability to operate a forklift is preferred
- Available for shift work.
Railroad Permitting Specialist
Akron, OH
12-Month Contract (Potential Longer-Term Extension)
We are seeking an experienced Railroad Permitting Specialist to support major transmission line and substation expansion projects. This role will focus on securing railroad and related infrastructure permits while coordinating with cross-functional teams to ensure projects move forward on schedule.
If you have strong experience with linear project permitting and railroad crossings, this is a great opportunity to support large-scale infrastructure initiatives.
Key Responsibilities
- Coordinate with project managers, design engineers, environmental consultants, GIS specialists, and real estate teams to prepare and submit railroad permit applications.
- Manage the full permitting lifecycle from application preparation through approval.
- Obtain permits and authorizations for railroad crossings, turnpike crossings, and other linear infrastructure crossings related to transmission line projects.
- Secure entry and access permits required for project work.
- Support environmental permitting efforts when needed.
- Assist with fiber and communications permitting activities when required.
- Collaborate with construction contractors across transmission lines, fiber, road building, foundations, geotechnical, surveying, and restoration regarding permitting compliance.
- Conduct document research and provide permitting support for electrical distribution projects.
- Track and manage multiple permit applications while ensuring timelines are met.
Required Qualifications
- Bachelor’s degree in Environmental Science, Environmental Studies, or related field
- 5+ years of experience permitting linear infrastructure projects in Pennsylvania
- Experience with railroad crossing permitting
- Strong written and verbal communication skills
- Ability to work in a fast-paced, cross-functional environment
- Excellent analytical, organizational, and time-management skills
- Valid Driver’s License
What We’re Looking For
Experience navigating railroad permitting processes
Strong coordination across engineering, environmental, and construction teams
Ability to manage multiple permitting efforts simultaneously
Interested or know someone who might be a great fit?
Send me a message or apply directly to learn more about this opportunity.
Why USAA?
At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families.
Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful.
The Opportunity
***Multiple Openings***
As a dedicated Quality Property Reinspector, you will ensure a quality property repair estimate and valuation product by focusing on targeted areas to continuously calibrate the reinspection process, validates reported findings and provides an objective subject matter expert (SME) knowledge to the Property Claims community and Third-Party vendors. Drives USAA’s financial strength by measuring and reporting estimate accuracy for Property Claims and Third-Party vendors.
This is a field-based role that will require you to reside and work within one of the following regions: San Antonio, TX, Austin, TX, Dallas/Ft Worth, TX, or Houston, TX. Candidates who are willing and able to work in the following regions: San Antonio, TX, Austin, TX, Dallas/Ft Worth, TX, or Houston, TX are encouraged to apply. Relocation assistance is not available for this position.
What you’ll do:
- Measures property estimates accuracy and efficiency through conducting thorough, timely re-inspections/audits of property and property repair estimates, and reports on payment accuracy and compliance by method of inspection (Staff, PDRP, Independents and Third-Party vendors).
- Reports reinspection/audit findings on estimate accuracy and compliance by method of inspection (Staff, PDRP, Independents and Third-Party vendors) for corporate score cards.
- Assesses the health of property estimating through participation in ad-hoc and market audits, working closely with Claims stakeholders to identify areas for improvement.
- Provides objective, proactive, and actionable feedback of Physical Damage (PD) policy, procedures and regulations to the Claims Stakeholders and Third-Party vendors.
- Creates awareness and drives understanding of Property adjusting and estimating procedures by delivering a work product that is consistent and compliant with policy, procedures, and regulations to Claims Stakeholders.
- Serves as a Property Adjusting SME on property estimating through post audit calibration meetings, ride-a-longs with other Property employees inspecting property, training materials, Property Director teleconferences and Property Champion teleconferences.
- Applies expert knowledge of P&C insurance industry products, services, and processes to include P&C insurance policy contracts and coverages, USAA property estimate/repair process and procedures.
- Provides support for the presentation, discussion, and auditing of diagnostic estimates within key regional markets, contributing to the assessment of estimate quality. During a catastrophe, or post event, performs property reinspections for catastrophe claims with a minimum of 28 consecutive days during the catastrophe event or post event. Requires working time requirement of 7 consecutive days, 7:00AM 7:00PM, member time.
- Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.
What you’ll have:
- High School Diploma or General Equivalency Diploma.
- 2 years relevant property field adjusting experience.
- Experience writing estimates in Xactimate and XactAnalysis.
- Knowledge and experience of property claims contracts.
- Knowledge of property construction and structural repair techniques.
- Working knowledge of Microsoft Office applications (Outlook, Word, Excel).
What sets you apart:
- Previous experience managing TPA estimating, QA, Audits.
- Strong analytical skills with demonstrated ability to perform root cause analysis and provide useful insights.
- 4+ recent years writing Dwelling estimates in Xactimate and XactAnalysis.
- 4+ recent years of working property claims contract knowledge.
- Experience working with both internal and external partners/suppliers.
- Willingness to travel at least one week per month.
- Currently reside or work within any of the following regions: San Antonio, TX, Austin, TX, Dallas/Ft Worth, TX, or Houston, TX.
Physical Demand Requirements:
- Ability to lift a minimum of 35 pounds to include lifting a ladder in and out of the trunk of a car.
- Ability to climb ladders and traverse roofs, this includes the ability to work at heights while inspecting roofs and attics.
- Ability to crouch and stoop to inspect confined attic spaces and go beneath homes into crawl spaces.
- Meet all USAA safe driving requirements including verification of driving record through MVR & possession of valid driver’s license.
The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.
Compensation range: $77,120-$147,390.
USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.).
Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.
Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.
The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.
Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.
For more details on our outstanding benefits, visit our benefits page on .
Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.
USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
The Valley Health System has expanded into an integrated health network that serves more than two million people in Southern Nevada. Starting with Valley Hospital Medical Center in 1979, the Valley Health System has grown to include Centennial Hills Hospital Medical Center, Spring Valley Hospital Medical Center, Summerlin Hospital Medical Center,Henderson Hospital , Valley Health Specialty Hospital and West Henderson Hospital.
Benefit Highlights:
- Comprehensive education and training center
- Competitive Compensation & Generous Paid Time Off
- Excellent Medical, Dental, Vision and Prescription Drug Plans
- 401(K) with company match and discounted stock plan
- Career opportunities within VHS and UHS Subsidies
- Challenging and rewarding work environment
Job Description: Responsible for the overall management of the Performance Improvement processes related to physicians performance.
Qualifications
Education: Bachelors (BSN) degree in nursing or Master's Degree in a healthcare related field from an accredited program.
Experience: Five (5) years clinical experience with two (2) to four (4) years QA or PI experience required, and a minimum of two (2) years progressive management experience required.
Technical Skills: Computer proficiency to include word processing, spreadsheet, and database.
License/Certification: Current RN license in the State of Nevada is required if RN. Certified Professional Healthcare Quality (CPHQ) required for non-RN.
Other: Must be able to demonstrate the knowledge and skills necessary to provide service appropriate to the age of the patient. Travel Required.
EEO Statement
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
Notice
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: or 1-8
Whether you are searching for a position in your area or in another state, we have professionals to help you achieve your goals through our relationships with facilities nationwide
- in rural settings, small cities, and major metropolitan areas.
Contact your personal consultant to tell them what you are looking for in a telehealth position.
CompHealth can make finding great opportunities simple, less stressful, and personalized to fit your needs.
We have phenomenal relationships with facilities around the country, and a team dedicated to helping you with every step of the hiring process.
Contact Gordon Diaz .
100% remote; open to FM and IM physicians Work at your own pace; must have an active state license Great salary to supplement current work; malpractice coverage via occurrence policy Physician is responsible for learning the aspects of compliance in the company Physician will implement and communicate policies, processes, and procedures Must be board certified or board eligible (if a resident) Great work-life balance; possible relocation assistance Live in a beautiful suburb with access to many shops and restaurants Our services are free for you We help negotiate your salary and contract We coordinate interviews and help with licenses Specialized recruiters match your career preferences Experienced support teams take care of every detail
Physician Advisor Lead
StartDate: ASAP Pay Rate: $28 $300000.00
Nuvance Health, now a part of Northwell Health, an award-winning non-profit health system, is seeking their next Physician Advisor Lead in Danbury, Connecticut!
The Position
- The Physician Advisor will provide clinical leadership and expertise in utilization management, level-of-care(LOC) determinations, and clinical documentation across the organization.
- This physician leader will oversee approximately 10+ FTEs including two direct physician reports, and will work closely with medical staff, case management, and revenue cycle teams to ensure appropriate utilization of healthcare resources while maintaining high standards of patient care and regulatory compliance. This individual will provide oversight for other physician advisors for both the centralized denial prevention unit and the local hospitals.
- This role will serve as a key clinical resource for physicians and care teams, providing guidance related to hospitalization appropriateness, level-of-care status, length-of-stay management, and continued stay reviews. The Physician Advisor will support care teams in navigating complex cases and ensuring appropriate patient placement and discharge planning.
- The Physician Advisor will play an important role in supporting the organization's denial prevention and denial management strategies. This includes conducting peer-to-peer reviews with payers, assisting with complex appeals, and providing clinical expertise to overturn denied or downgraded coverage determinations.
- This leader will work closely with utilization management and clinical documentation teams to promote best practices, ensure compliance with regulatory and accreditation standards, and improve documentation integrity across the medical staff.
- The Physician Advisor will also serve as a consultant and mentor to other Physician Advisors and attending physicians, helping to standardize workflows, policies, and approaches related to utilization review, clinical documentation, and payer interactions.
- A key priority for this role will be educating and engaging physicians throughout the organization, strengthening understanding of utilization management processes, regulatory requirements, and documentation expectations.
- The ideal candidate is a collaborative and respected physician leader who can build strong relationships across departments, communicate effectively with both clinical and administrative teams, and support high-quality, efficient patient care.
Requirements
- MD/DO is required.
- Completion of specialty residency (e.g. Internal Medicine)
- Board Certified/Eligible Physician licensed in the applicable states
- American College of Physician Advisors (ACPA) certification preferred
- Minimum of three years of physician advisor experience preferred
- Minimum of five years of Hospitalist and/or Internal Medicine experience is strongly preferred.
- Strong clinical acumen, knowledge of care management/utilization review, third payor guidelines, medical necessity criteria, denials management, clinical documentation requirements
- This position requires relocation to the local area and onsite presence.
Compensation Details
- The base salary range for this position is $280,000 to $300,000 annually. In addition, a leader may be eligible for other benefits, including but not limited to health insurance coverage, retirement benefits, and bonuses. The total compensation for the finalist selected for this role will be determined based on various factors, including but not limited to scope of role, level of experience, education, accomplishments, internal equity, budget, and subject to Fair Market Value evaluation. The base salary range listed above is a good faith determination of potential base compensation at the time of this job advertisement and may be modified in the future.
The Organization
- Nuvance Health, (Nuvance), now part of Northwell Health, an innovative, award-winning, non-profit health system, was formed in April 2019 through the merger of two leading health systems, Health Quest and Western Connecticut Health Network. "Nuvance", derived from a combination of the words "new" and "advance," reflects a mission to "continually progress and pursue impossible to enhance the health and well-bring of every person in the communities served."
- The newly created health system was developed to provide communities across New York's Hudson Valley and western Connecticut with more convenient, accessible, and affordable care. Nuvance Health is governed by a 17-member Board of Trustees. With seven hospitals, more than 2,600 aligned physicians, and 11,000 employees, Nuvance Health serves more than 1.5 million residents across western Connecticut and the Hudson River Valley.
- This region benefits from a strong economic base and a stable to growing population. The system's flagship hospitals, Danbury Hospital and Vassar Brothers Medical Center, each benefit from geographic positioning with minimal significant hospital-based service competition, while Norwalk Hospital operates within a highly competitive Fairfield County market. For FY 2021, Nuvance Health generated a breakeven operating margin on revenues of approximately $2.5M, and the system's balance sheet is solid. Leadership is focused on the continuing advancement of system integration to realize benefits of synergy and scale.
The Community
- Danbury, located in Fairfield County, Connecticut, is a vibrant city known for it's history, thriving economy, and proximity to both natural beauty and urban amenities.
- Danbury offers variety of attractions including the Danbury Railway Museum, Tarrywile Park & Mansion, Danbury Fair Mall, and the Danbury Ice Museum.
- Served by a well-regarded public school system, Danbury offers a multitude of educational opportunities including Danbury Public Schools, Western Connecticut State University, and Sacred Heart University. In addition, Danbury is also home to multiple private and charter schools including St. Gregory the Great School.
- Danbury offers a wide variety of family activities including Danbury Library, Danbury Farmer's Market, The Danbury Music Centre, and many annual cultural, music, and food festivals.
Please direct all inquiries, applications, and referrals to:
?Christine Young
Executive Recruiter
913-752-4532
#BESrecruitment
#LI-CY1
Job Benefits
About the Company
At AMN Healthcare, we strive to be recognized as the most trusted, innovative, and influential force in helping healthcare organizations provide quality patient care that continually evolves to make healthcare more human, more effective, and more achievable.
Medical Director
$40.45 - $62.70 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.
Position Highlights:
* Position: RN Patient Care Navigator
* Location: Skokie, IL
* Full Time: 40 hours
* Hours: Monday-Friday, 8:00a-4:30p rotating every 3rd weekend
* I winter holiday (Thanksgiving, Christmas, New Year) and 1 summer (Labor Day, July 4th, Memorial Day) coverage
* Required Travel: Highland Park, Glenbrook, Evanston, Swedish based on clinical needs, less than 1%
A Brief Overview:
The RN Transitional Care Navigator (Population Health) is responsible for the case management, care coordination management, and utilization management of his/her population of patients across multiple care levels and settings. Serves as a catalyst to promote patients understanding their diagnosis, treatment options, and available resources and ensure that they are connected with the optimal resources across the continuum of care. This role will coordinate and facilitate smooth and safe care transitions while ensuring quality cost-effective patient outcomes. Serves as a liaison between their patient population and all other providers. Will be responsible for key metrics of success, which include improving the overall cost of care, length of stay optimization, reduction in excess days, reduction in SNF utilization and improvement in SNF care transitions, reduction in 30-day readmission rate and ED utilization.
What you will do:
* Guides high-risk patient and family through the health system from diagnosis, testing, treatment and follow-up care to assist patients with navigating the continuum of care. Eliminates barriers to patient's access to health care services and facilitates continuity of care/care coordination.
* Establishes and documents an individualized plan of care for assigned patients using evidence-based treatment guidelines considering the patients individual health goals with a focus on wellness, health management, disease prevention and chronic disease management.
* Partners with the healthcare team to ensure clinical decision-making, implementation of recommendations, and discharge planning are timely and appropriate.
* Performs daily coordination between multiple departments, multi-disciplinary team, medical clinics, and community outreach to gain knowledge of patient, assure patient safety, smooth transitions of care, and manage utilization and total cost of care.
* Acts as advisor/educator by partnering with social work in providing emotional support including goals of care and counseling. Provides and/or arranges clinical education including medication management, community resources, financial resources, and expert guidance to patients and families to promote their ability to understand and meaningfully participate in the healthcare process and personal decision-making.
* Facilitates appointments for appropriate consultations and support services within established protocols
* Completes Utilization Management for assigned patients.
* Applies Milliman Care Guidelines (Indicia) criteria to monitor appropriateness of admissions and continued stays and documents findings based on Department standards.
* Monitors LOS and ancillary resource use on an ongoing basis. Takes actions to achieve continuous improvement in both areas.
* May need to travel to visit the patient at home from time to time.
* Available to his/her assigned patient population and participates as part of a call coverage structure.
* Participates in the collection and analysis of data to identify under/over utilization; improve resource consumption; promote potential reduction in cost; and enhance quality of care consistent with organization strategic goals and objectives.
*
What you will need:
* Bachelors Degree Health Administration Required Or
* Bachelors Degree Nursing Required
* 3 Years Utilization review, discharge planning, case management or disease management preferred. Nursing experience in home services, ambulatory services working with high-risk patients beneficial.
* 2 Years Clinical nursing experience preferred.
* Adheres to and practices in alignment with contemporary standards of care as established by leading professional organizations, including but not limited to the American Academy of Ambulatory Care Nursing (AAACN), the American Case Management Association (ACMA), and the Case Management Society of America (CMSA).
* Interacts with and contributes to professional development of peers and other health care providers as colleagues. Shares knowledge and provides feedback with peers to contribute to an environment supportive of clinical education.
* Knowledge of InterQual or MCG criteria preferred.
* Clinical certification, such as case management certification, is beneficial.
* Able to communicate and work collaboratively with a range of stakeholders and team members.
* Knowledge of community resources.
* Experience with Microsoft Office Suite.
* Strong interpersonal and oral communication skills.
* Strong computer and data entry skills.
* Experience with Electronic Medical Record (EMR) platform preferred.
* Proven leadership skills.
* Ability to work independently, setting priorities to coordinate care plan efficiently.
* Registered Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR) Required And
* Certified Case Manager (CCM?) - Commission for Case Manager Certification (CCMC) Preferred Or
* Ambulatory Care Nursing (RN-BC) - American Nurses Credentialing Center (ANCC) Preferred And
* BLS - Basic Life Support (CPR and AED) - American Heart Association (AHA) Required
Benefits (for full and part time positions):
* Premium pay for eligible employees.
* Career Pathways to Promote Professional Growth and Development
* Various Medical, Dental, and Vision options
* Tuition Reimbursement
* Free Parking at designated locations
* Wellness Program Savings Plan
* Health Savings Account Options
* Retirement Options with Company Match
* Paid Time Off
* Community Involvement Opportunities
Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals - Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) - all recognized as Magnet hospitals for nursing excellence. For more information, visit you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.
Please explore our website ( ) to better understand how Endeavor Health delivers on its mission to "help everyone in our communities be their best".
Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.
Diversity, equity and inclusion is at the core of who we are; being there for our patients and each other with compassion, respect and empathy. We believe that our strength resides in our differences and in connecting our best to provide community-connected healthcare for all.
EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disabil
The working Manager of Case Management is responsible for the development of staff and systems to effectively operate a comprehensive Case Management Program. Provides leadership and supervision to case managers, social workers, case management coordinators/discharge planners, utilization review coordinators and utilization review technicians. Assesses needs and plans, communicates and designs services that are appropriate to the hospital mission and patient/family needs. Integrates and coordinates services using continuous quality improvement tools.
Required qualifications:
1. Licensed RN in PA.
2. Minimum 5 years’ experience in a Case Management position.
3. Must have analytical ability for problem identification and assessment and evaluation of data/statistics obtained from an on-going review process.
4. Experience and knowledge in basic to intermediate computer skills.
Preferred qualifications:
1. Certification in Case Management, BS or BSN or related field preferred.
2. Current BCLS certificate preferred.
3. Knowledge of Milliman Criteria and InterQual Criteria preferred.
Great opportunity for a Clinical Documentation Specialist RN to work in an organization that focuses on treating the whole person, physically, emotionally and spiritually.
We are seeking a Clinical Documentation Specialist RN who is dedicated to providing exceptional care to those we serve at Loyola Medicine. In return, we provide a supportive atmosphere where you can grow your career and make a lasting impact.
Full Time - 8-5pm (days), Registered Nurse (RN) and 3 - 5 years of experience required
Position Responsibilities:
Using knowledge of medical necessity and appropriateness of setting as gained through a thorough understanding of Milliman and InterQual criteria, conducts concurrent utilization review. Interacts with insurers, third party payors, and review entities such as EQ Health for Medicaid to relay clinical information and to certify inpatient care for payment. Records all interactions in department databases and software such as Allscripts.
Perks & Benefits
- Benefits from Day One (Medical and Dental)
- Daily Pay
- Competitive Shift Differentials
- Career Development
- Tuition Reimbursement
- Participation in the Public Service Loan Forgiveness Program
- 403(b) with Employer Match
- On Site Fitness Center (Gottlieb Memorial Hospital & LUMC)
- Referral Rewards
- Perks Program
Our Promise to You
Joining Loyola Medicine is being a part of an organization that treats the human spirit in our patients and fellow colleagues. We are a part of a community which believes in giving back to those we serve.
- We serve together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities
- We live and breathe our guiding behaviors: we support each other in serving, we communicate openly, honestly, respectfully, and directly, we are fully present, we are all accountable, we trust and assume goodness in intentions, and we are continuous learners
Here's what you'll need
Required:
- Education: Required: Bachelors Degree
- Experience: Required: 3-5 years of previous job-related experience
- Licensure/Certifications: Required: Current Registered Nurse License State of Illinois
Compensation:
Pay Range: $67,828.80 - $105,144.00 per year
Actual compensation will fall within the range but may vary based on factors such as experience, qualifications, education, location, licensure, certification requirements, and comparisons to colleagues in similar roles.
Trinity Health Benefits Summary
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
Great opportunity for a Clinical Documentation Specialist RN to work in an organization that focuses on treating the whole person, physically, emotionally and spiritually.
We are seeking a Clinical Documentation Specialist RN who is dedicated to providing exceptional care to those we serve at Loyola Medicine. In return, we provide a supportive atmosphere where you can grow your career and make a lasting impact.
Full Time - 8-5pm (days), Registered Nurse (RN) and 3 - 5 years of experience required
Position Responsibilities:
Using knowledge of medical necessity and appropriateness of setting as gained through a thorough understanding of Milliman and InterQual criteria, conducts concurrent utilization review. Interacts with insurers, third party payors, and review entities such as EQ Health for Medicaid to relay clinical information and to certify inpatient care for payment. Records all interactions in department databases and software such as Allscripts.
Perks & Benefits
- Benefits from Day One (Medical and Dental)
- Daily Pay
- Competitive Shift Differentials
- Career Development
- Tuition Reimbursement
- Participation in the Public Service Loan Forgiveness Program
- 403(b) with Employer Match
- On Site Fitness Center (Gottlieb Memorial Hospital & LUMC)
- Referral Rewards
- Perks Program
Our Promise to You
Joining Loyola Medicine is being a part of an organization that treats the human spirit in our patients and fellow colleagues. We are a part of a community which believes in giving back to those we serve.
- We serve together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities
- We live and breathe our guiding behaviors: we support each other in serving, we communicate openly, honestly, respectfully, and directly, we are fully present, we are all accountable, we trust and assume goodness in intentions, and we are continuous learners
Here's what you'll need
Required:
- Education: Required: Bachelors Degree
- Experience: Required: 3-5 years of previous job-related experience
- Licensure/Certifications: Required: Current Registered Nurse License State of Illinois
Compensation:
Pay Range: $67,828.80 - $105,144.00 per year
Actual compensation will fall within the range but may vary based on factors such as experience, qualifications, education, location, licensure, certification requirements, and comparisons to colleagues in similar roles.
Trinity Health Benefits Summary
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
