Recruitment Manager @ Integrated Resources, Inc | Human Resources Management Location: 100% Remote Schedule: M-F 9:00am to 5:30pm with rotating Saturdays from 7-11am CST, including holiday rotation Job Description This position is fully remote, but candidates need to have an Illinois state RN license Assess and analyze clinical service requests (e.g., surgeries, outpatient therapies, DME) using evidence-based MCP/MCG criteria. Verify member benefits and eligibility Process prior authorization determinations within regulatory timelines Collaborate with multidisciplinary teams Summary Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing clients' members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Client Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines. Provides concurrent review and prior authorizations (as needed) according to Client policy for Client members as part of the Utilization Management team. Consults with and refers cases to Client medical directors regularly, as necessary. Complies with required workplace safety standards. Required License/Certification Active, unrestricted IL State Registered Nursing (RN) license in good standing. Required Years of Experience 1-3 years of hospital or medical clinic, utilization review or prior authorization experience Seniority level Associate Employment type Contract Job function Health Care Provider Industries Hospitals and Health Care and Public Health #J-18808-Ljbffr
...succession planning, etc.). Experience with SuccessFactors HRIS a plus. Coordinate with Director of Organizational Development and hiring managers across the company to support and administer talent acquisition and recruiting activities such as: updating job...
...Perks Competitive Compensation Great Work Environment Career Advancement Opportunities Job Summary We are seeking a Printing Press Operator to join our team! As a Printing Press Operator on the team, you will be responsible for incoming printing jobs,...
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...Tanker truck driver Average pay: $1,180-$1,450 weekly Home time: Every other week Experience: All CDL holders Overview ~ Haul 75% non-hazardous freight in tanker trailers. ~ Get home for three days every other weekend. ~3-5 loads per week...
...Description We are seeking a dependable and organized Class A truck driver who possesses a great deal of physical and mental stamina who... ...livestock, etc. from the place of origin to assigned destination Pick-up loads and organizes goods in an ordered, logical manner Ensure...