Nurse RN Salary in Chicago, IL

Location: REMOTESalary: $80,000.00 USD Annually - $95,000.00 USD AnnuallyDescription: Our client is currently seeking a Remote Nurse Practitioner Case Manager The Judge Group is looking for a REMOTE Case Manager to work in the Largo Florida Area Nurse Care Manager - Fracture Prevention Fulltime Remote - Eastern Time Zone Full Benefits You'll be an ideal candidate if you: 1. Have relevant education and licensure Graduate of an accredited RN and NP Program (Master's Degree) 2. Current FL RN License OR •Current FL APRN, Nurse Practitioner Certification and NP Furnishing Number 3.Current National certification from an approved organization (American Nurses Credentialing Center, American Academy of Nurse Practitioners, National Certification Board of Pediatric Practitioners, 4. National Certification Corporation for Obstetric, Gynecologic and Neonatal Nursing Specialties)•Have relevant work experience 3 years of clinical experience with a minimum of 2 years of clinical case management experience Partnered successfully with physicians to enable outstanding care delivery •Are seeking a professional environment to grow, learn, and make an impact Possess a desire to improve the experience of patients, providers, and partners Are a natural problem solver, self-starter, and creative thinker In this role you will:•Be the cornerstone of our Fracture Prevention Program, focused on diagnosing and treating patients who are high-risk for costly, life-altering fractures Send your updated resume to [email protected] for consideration I look forward to hearing from you, Contact: [email protected] job and many more are available through The Judge Group. Find us on the web at www.judge.com

The Nurse Case Manager (NCM) is the single point of contact for patients and their caregivers. They are aligned regionally and are responsible for educating patients, caregivers and families affected by generalized Myasthenia Gravis (gMG) about the disease and argenx's products and support services. The NCM may provide resources to help patients better manage their disease and coordinate their treatment. The NCM is responsible for participating in one-on-one communications with patients and their caregivers.Roles and Responsibilities:Provide direct educational training and support to patients and caregivers about gMG and prescribed argenx productsWill manage patient cases across regions as coverage and volume requires.Communicate insurance coverage updates and findings to the patient and/or caregiverReview and educate the patients and/or caregivers on financial assistance programs thatthey may be eligible for. Coordinate logistical support for patient to receive therapy and manage their diseaseCollaborate with argenx Patient Access Specialist, Case Coordinator, and FieldReimbursement Manager teams to troubleshoot and resolve reimbursement-related issuesEngage with patients and provider case coordinators to ensure appropriate support is being given on an individualized basisProvide patient-focused education to empower patients to advocate on their behalfDevelop relationships and manage multiple and complex challenges that patient and caregivers are facingEnsure compliance with relevant industry laws and argenx's policiesAligned regional travel will be required for patient education to support patient programsMust be an excellent communicator and problem-solverDemonstrated time management skills; planning and prioritization skills; ability to multi-task and maintain prioritization of key projects and deadlinesSkills and Competencies:Demonstrated effective presentation skills; ability to motivate others; excellent interpersonal(written and verbal) skills - with demonstrated effectiveness to work cross-functional and independentlyDemonstrated ability to develop, follow and execute plans in an independent environmentDemonstrated ability to effectively build positive relationships both internally & externallyDemonstrated ability to be adaptable to changing work environments and responsibilitiesMust be able to thrive in team environment and willing to contribute at all levels with flexibility and a positive attitudeFully competent in MS Office (Word, Excel, PowerPoint)Flexibility to work weekends and evenings, as neededParticipate in and complete required pharmacovigilance trainingComply with all relevant industry laws and argenx's policiesTravel requirements less than 50% of the timeEducation, Experience and Qualifications:Current RN License in good standingBachelor's degree Preferred5 + yrs.' clinical experience in healthcare to include hospital, home health, pharmaceutical or biotech2-5+years of case management2+ plus years' experience in pharmaceutical/ biotech industry a plusReimbursement experience a plusBilingual or multilingual a plus#LI-RemoteAt argenx we strive to create a welcoming and inclusive environment. Here all applicants will receive equal consideration for employment without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, or any other applicable legally protected characteristics. argenx is proud to be an equal opportunity employer.If you require reasonable accommodation in completing your application, interviewing, or otherwise participating in the candidate selection process please contact us at [email protected]. Only inquiries related to an accommodation request will receive a response.PDN-9bd966c1-adb5-4b9b-a939-1ba531dec6a5

The Nurse Case Manager (NCM) is the single point of contact for patients and their caregivers. They are aligned regionally and are responsible for educating patients, caregivers and families affected by generalized Myasthenia Gravis (gMG) about the disease and argenx's products and support services. The NCM may provide resources to help patients better manage their disease and coordinate their treatment. The NCM is responsible for participating in one-on-one communications with patients and their caregivers.Roles and Responsibilities:Provide direct educational training and support to patients and caregivers about gMG and prescribed argenx productsWill manage patient cases across regions as coverage and volume requires.Communicate insurance coverage updates and findings to the patient and/or caregiverReview and educate the patients and/or caregivers on financial assistance programs thatthey may be eligible for. Coordinate logistical support for patient to receive therapy and manage their diseaseCollaborate with argenx Patient Access Specialist, Case Coordinator, and FieldReimbursement Manager teams to troubleshoot and resolve reimbursement-related issuesEngage with patients and provider case coordinators to ensure appropriate support is being given on an individualized basisProvide patient-focused education to empower patients to advocate on their behalfDevelop relationships and manage multiple and complex challenges that patient and caregivers are facingEnsure compliance with relevant industry laws and argenx's policiesAligned regional travel will be required for patient education to support patient programsMust be an excellent communicator and problem-solverDemonstrated time management skills; planning and prioritization skills; ability to multi-task and maintain prioritization of key projects and deadlinesSkills and Competencies:Demonstrated effective presentation skills; ability to motivate others; excellent interpersonal(written and verbal) skills - with demonstrated effectiveness to work cross-functional and independentlyDemonstrated ability to develop, follow and execute plans in an independent environmentDemonstrated ability to effectively build positive relationships both internally & externallyDemonstrated ability to be adaptable to changing work environments and responsibilitiesMust be able to thrive in team environment and willing to contribute at all levels with flexibility and a positive attitudeFully competent in MS Office (Word, Excel, PowerPoint)Flexibility to work weekends and evenings, as neededParticipate in and complete required pharmacovigilance trainingComply with all relevant industry laws and argenx's policiesTravel requirements less than 50% of the timeEducation, Experience and Qualifications:Current RN License in good standingBachelor's degree Preferred5 + yrs.' clinical experience in healthcare to include hospital, home health, pharmaceutical or biotech2-5+years of case management2+ plus years' experience in pharmaceutical/ biotech industry a plusReimbursement experience a plusBilingual or multilingual a plus#LI-RemoteAt argenx we strive to create a welcoming and inclusive environment. Here all applicants will receive equal consideration for employment without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, or any other applicable legally protected characteristics. argenx is proud to be an equal opportunity employer.If you require reasonable accommodation in completing your application, interviewing, or otherwise participating in the candidate selection process please contact us at [email protected]. Only inquiries related to an accommodation request will receive a response.PDN-9bd966c2-8cf8-4b95-bec6-bfdfe803856c

The Nurse Case Manager (NCM) is the single point of contact for patients and their caregivers. They are aligned regionally and are responsible for educating patients, caregivers and families affected by generalized Myasthenia Gravis (gMG) about the disease and argenx's products and support services. The NCM may provide resources to help patients better manage their disease and coordinate their treatment. The NCM is responsible for participating in one-on-one communications with patients and their caregivers.Roles and Responsibilities:Provide direct educational training and support to patients and caregivers about gMG and prescribed argenx productsWill manage patient cases across regions as coverage and volume requires.Communicate insurance coverage updates and findings to the patient and/or caregiverReview and educate the patients and/or caregivers on financial assistance programs thatthey may be eligible for. Coordinate logistical support for patient to receive therapy and manage their diseaseCollaborate with argenx Patient Access Specialist, Case Coordinator, and FieldReimbursement Manager teams to troubleshoot and resolve reimbursement-related issuesEngage with patients and provider case coordinators to ensure appropriate support is being given on an individualized basisProvide patient-focused education to empower patients to advocate on their behalfDevelop relationships and manage multiple and complex challenges that patient and caregivers are facingEnsure compliance with relevant industry laws and argenx's policiesAligned regional travel will be required for patient education to support patient programsMust be an excellent communicator and problem-solverDemonstrated time management skills; planning and prioritization skills; ability to multi-task and maintain prioritization of key projects and deadlinesSkills and Competencies:Demonstrated effective presentation skills; ability to motivate others; excellent interpersonal(written and verbal) skills - with demonstrated effectiveness to work cross-functional and independentlyDemonstrated ability to develop, follow and execute plans in an independent environmentDemonstrated ability to effectively build positive relationships both internally & externallyDemonstrated ability to be adaptable to changing work environments and responsibilitiesMust be able to thrive in team environment and willing to contribute at all levels with flexibility and a positive attitudeFully competent in MS Office (Word, Excel, PowerPoint)Flexibility to work weekends and evenings, as neededParticipate in and complete required pharmacovigilance trainingComply with all relevant industry laws and argenx's policiesTravel requirements less than 50% of the timeEducation, Experience and Qualifications:Current RN License in good standingBachelor's degree Preferred5 + yrs.' clinical experience in healthcare to include hospital, home health, pharmaceutical or biotech2-5+years of case management2+ plus years' experience in pharmaceutical/ biotech industry a plusReimbursement experience a plusBilingual or multilingual a plus#LI-RemoteAt argenx we strive to create a welcoming and inclusive environment. Here all applicants will receive equal consideration for employment without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, or any other applicable legally protected characteristics. argenx is proud to be an equal opportunity employer.If you require reasonable accommodation in completing your application, interviewing, or otherwise participating in the candidate selection process please contact us at [email protected]. Only inquiries related to an accommodation request will receive a response.PDN-9bd966c3-619e-4ebe-96e6-7edfa6b875ce

The Nurse Case Manager (NCM) is the single point of contact for patients and their caregivers. They are aligned regionally and are responsible for educating patients, caregivers and families affected by generalized Myasthenia Gravis (gMG) about the disease and argenx's products and support services. TheNCM may provide resources to help patients better manage their disease and coordinate their treatment. The NCM is responsible for participating in one-on-one communications with patients and their caregivers.Roles and Responsibilities:Provide direct educational training and support to patients and caregivers about gMG and prescribed argenx productsWill manage patient cases across regions as coverage and volume requires.Communicate insurance coverage updates and findings to the patient and/or caregiverReview and educate the patients and/or caregivers on financial assistance programs thatthey may be eligible for. Coordinate logistical support for patient to receive therapy and manage their diseaseCollaborate with argenx Patient Access Specialist, Case Coordinator, and FieldReimbursement Manager teams to troubleshoot and resolve reimbursement-related issuesEngage with patients and provider case coordinators to ensure appropriate support is being given on an individualized basisProvide patient-focused education to empower patients to advocate on their behalfDevelop relationships and manage multiple and complex challenges that patient and caregivers are facingEnsure compliance with relevant industry laws and argenx's policiesAligned regional travel will be required for patient education to support patient programsMust be an excellent communicator and problem-solverDemonstrated time management skills; planning and prioritization skills; ability to multi-task and maintain prioritization of key projects and deadlinesSkills and Competencies:Demonstrated effective presentation skills; ability to motivate others; excellent interpersonal(written and verbal) skills - with demonstrated effectiveness to work cross-functional and independentlyDemonstrated ability to develop, follow and execute plans in an independent environmentDemonstrated ability to effectively build positive relationships both internally & externallyDemonstrated ability to be adaptable to changing work environments and responsibilitiesMust be able to thrive in team environment and willing to contribute at all levels with flexibility and a positive attitudeFully competent in MS Office (Word, Excel, PowerPoint)Flexibility to work weekends and evenings, as neededParticipate in and complete required pharmacovigilance trainingComply with all relevant industry laws and argenx's policiesTravel requirements less than 50% of the timeEducation, Experience and Qualifications:Current RN License in good standingBachelor's degree Preferred5 + yrs.' clinical experience in healthcare to include hospital, home health, pharmaceutical or biotech2-5+years of case management2+ plus years' experience in pharmaceutical/ biotech industry a plusReimbursement experience a plusBilingual or multilingual a plus#LI-RemoteAt argenx we strive to create a welcoming and inclusive environment. Here all applicants will receive equal consideration for employment without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, or any other applicable legally protected characteristics. argenx is proud to be an equal opportunity employer.If you require reasonable accommodation in completing your application, interviewing, or otherwise participating in the candidate selection process please contact us at [email protected]. Only inquiries related to an accommodation request will receive a response.PDN-9bd966c4-25c7-44f0-aac5-e88e9367944e

The Nurse Case Manager (NCM) is the single point of contact for patients and their caregivers. They are aligned regionally and are responsible for educating patients, caregivers and families affected by generalized Myasthenia Gravis (gMG) about the disease and argenx's products and support services. TheNCM may provide resources to help patients better manage their disease and coordinate their treatment. The NCM is responsible for participating in one-on-one communications with patients and their caregivers.Roles and Responsibilities:Provide direct educational training and support to patients and caregivers about gMG and prescribed argenx productsWill manage patient cases across regions as coverage and volume requires.Communicate insurance coverage updates and findings to the patient and/or caregiverReview and educate the patients and/or caregivers on financial assistance programs thatthey may be eligible for. Coordinate logistical support for patient to receive therapy and manage their diseaseCollaborate with argenx Patient Access Specialist, Case Coordinator, and FieldReimbursement Manager teams to troubleshoot and resolve reimbursement-related issuesEngage with patients and provider case coordinators to ensure appropriate support is being given on an individualized basisProvide patient-focused education to empower patients to advocate on their behalfDevelop relationships and manage multiple and complex challenges that patient and caregivers are facingEnsure compliance with relevant industry laws and argenx's policiesAligned regional travel will be required for patient education to support patient programsMust be an excellent communicator and problem-solverDemonstrated time management skills; planning and prioritization skills; ability to multi-task and maintain prioritization of key projects and deadlinesSkills and Competencies:Demonstrated effective presentation skills; ability to motivate others; excellent interpersonal(written and verbal) skills - with demonstrated effectiveness to work cross-functional and independentlyDemonstrated ability to develop, follow and execute plans in an independent environmentDemonstrated ability to effectively build positive relationships both internally & externallyDemonstrated ability to be adaptable to changing work environments and responsibilitiesMust be able to thrive in team environment and willing to contribute at all levels with flexibility and a positive attitudeFully competent in MS Office (Word, Excel, PowerPoint)Flexibility to work weekends and evenings, as neededParticipate in and complete required pharmacovigilance trainingComply with all relevant industry laws and argenx's policiesTravel requirements less than 50% of the timeEducation, Experience and Qualifications:Current RN License in good standingBachelor's degree Preferred5 + yrs.' clinical experience in healthcare to include hospital, home health, pharmaceutical or biotech2-5+years of case management2+ plus years' experience in pharmaceutical/ biotech industry a plusReimbursement experience a plusBilingual or multilingual a plus#LI-RemoteAt argenx we strive to create a welcoming and inclusive environment. Here all applicants will receive equal consideration for employment without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, or any other applicable legally protected characteristics. argenx is proud to be an equal opportunity employer.If you require reasonable accommodation in completing your application, interviewing, or otherwise participating in the candidate selection process please contact us at [email protected]. Only inquiries related to an accommodation request will receive a response.PDN-9bd966c4-f17f-40d6-92a3-4a4426ac3f52

The Nurse Case Manager (NCM) is the single point of contact for patients and their caregivers. They are aligned regionally and are responsible for educating patients, caregivers and families affected by generalized Myasthenia Gravis (gMG) about the disease and argenx's products and support services. TheNCM may provide resources to help patients better manage their disease and coordinate their treatment. The NCM is responsible for participating in one-on-one communications with patients and their caregivers.Roles and Responsibilities:Provide direct educational training and support to patients and caregivers about gMG and prescribed argenx productsWill manage patient cases across regions as coverage and volume requires.Communicate insurance coverage updates and findings to the patient and/or caregiverReview and educate the patients and/or caregivers on financial assistance programs thatthey may be eligible for. Coordinate logistical support for patient to receive therapy and manage their diseaseCollaborate with argenx Patient Access Specialist, Case Coordinator, and FieldReimbursement Manager teams to troubleshoot and resolve reimbursement-related issuesEngage with patients and provider case coordinators to ensure appropriate support is being given on an individualized basisProvide patient-focused education to empower patients to advocate on their behalfDevelop relationships and manage multiple and complex challenges that patient and caregivers are facingEnsure compliance with relevant industry laws and argenx's policiesAligned regional travel will be required for patient education to support patient programsMust be an excellent communicator and problem-solverDemonstrated time management skills; planning and prioritization skills; ability to multi-task and maintain prioritization of key projects and deadlinesSkills and Competencies:Demonstrated effective presentation skills; ability to motivate others; excellent interpersonal(written and verbal) skills - with demonstrated effectiveness to work cross-functional and independentlyDemonstrated ability to develop, follow and execute plans in an independent environmentDemonstrated ability to effectively build positive relationships both internally & externallyDemonstrated ability to be adaptable to changing work environments and responsibilitiesMust be able to thrive in team environment and willing to contribute at all levels with flexibility and a positive attitudeFully competent in MS Office (Word, Excel, PowerPoint)Flexibility to work weekends and evenings, as neededParticipate in and complete required pharmacovigilance trainingComply with all relevant industry laws and argenx's policiesTravel requirements less than 50% of the timeEducation, Experience and Qualifications:Current RN License in good standingBachelor's degree Preferred5 + yrs.' clinical experience in healthcare to include hospital, home health, pharmaceutical or biotech2-5+years of case management2+ plus years' experience in pharmaceutical/ biotech industry a plusReimbursement experience a plusBilingual or multilingual a plus#LI-RemoteAt argenx we strive to create a welcoming and inclusive environment. Here all applicants will receive equal consideration for employment without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, or any other applicable legally protected characteristics. argenx is proud to be an equal opportunity employer.If you require reasonable accommodation in completing your application, interviewing, or otherwise participating in the candidate selection process please contact us at [email protected]. Only inquiries related to an accommodation request will receive a response.PDN-9bd966c5-b77f-4b71-8b0d-668cfc350241

The Nurse Case Manager (NCM) is the single point of contact for patients and their caregivers. They are aligned regionally and are responsible for educating patients, caregivers and families affected by generalized Myasthenia Gravis (gMG) about the disease and argenx's products and support services. TheNCM may provide resources to help patients better manage their disease and coordinate their treatment. The NCM is responsible for participating in one-on-one communications with patients and their caregivers.Roles and Responsibilities:Provide direct educational training and support to patients and caregivers about gMG and prescribed argenx productsWill manage patient cases across regions as coverage and volume requires.Communicate insurance coverage updates and findings to the patient and/or caregiverReview and educate the patients and/or caregivers on financial assistance programs thatthey may be eligible for. Coordinate logistical support for patient to receive therapy and manage their diseaseCollaborate with argenx Patient Access Specialist, Case Coordinator, and FieldReimbursement Manager teams to troubleshoot and resolve reimbursement-related issuesEngage with patients and provider case coordinators to ensure appropriate support is being given on an individualized basisProvide patient-focused education to empower patients to advocate on their behalfDevelop relationships and manage multiple and complex challenges that patient and caregivers are facingEnsure compliance with relevant industry laws and argenx's policiesAligned regional travel will be required for patient education to support patient programsMust be an excellent communicator and problem-solverDemonstrated time management skills; planning and prioritization skills; ability to multi-task and maintain prioritization of key projects and deadlinesSkills and Competencies:Demonstrated effective presentation skills; ability to motivate others; excellent interpersonal(written and verbal) skills - with demonstrated effectiveness to work cross-functional and independentlyDemonstrated ability to develop, follow and execute plans in an independent environmentDemonstrated ability to effectively build positive relationships both internally & externallyDemonstrated ability to be adaptable to changing work environments and responsibilitiesMust be able to thrive in team environment and willing to contribute at all levels with flexibility and a positive attitudeFully competent in MS Office (Word, Excel, PowerPoint)Flexibility to work weekends and evenings, as neededParticipate in and complete required pharmacovigilance trainingComply with all relevant industry laws and argenx's policiesTravel requirements less than 50% of the timeEducation, Experience and Qualifications:Current RN License in good standingBachelor's degree Preferred5 + yrs.' clinical experience in healthcare to include hospital, home health, pharmaceutical or biotech2-5+years of case management2+ plus years' experience in pharmaceutical/ biotech industry a plusReimbursement experience a plusBilingual or multilingual a plus#LI-RemoteAt argenx we strive to create a welcoming and inclusive environment. Here all applicants will receive equal consideration for employment without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, or any other applicable legally protected characteristics. argenx is proud to be an equal opportunity employer.If you require reasonable accommodation in completing your application, interviewing, or otherwise participating in the candidate selection process please contact us at [email protected]. Only inquiries related to an accommodation request will receive a response.PDN-9bd966c6-866f-41cb-bdfe-93f956725567

The Associate Director of Nurse Case Management works closely with the Director of Nurse Case Managers. The AD is responsible for managing a team of Regional Nurse Case Managers, who educate patients and caregivers as part of the argenx Patient Support Program. They will provide direction and coaching to the team, ensuring effective support of the unique needs of patients throughout their treatment journey. The AD will be responsible for the daily support of the Nurse Case Managers ensuring metrics and deliverables to strengthen the patient experience.Roles and Responsibilities:Assists in the process of developing and implementation of patient support case management processes, including identification of patient needs and utilization of all available resources to achieve desired outcomes for patients and educational processed for the Nurse Case Management teamEffectively manages patient access needs in treatment initiation and onboarding, collaborating with third-party partners and internal access teams as appropriateEvaluates patient case data to ensure that support is provided in accordance with clinical guidelines and organizational standardsDemonstrates leadership/example in all aspects of compliance including, but not limited to, program, data privacy, ongoing education, and pharmacovigilance (PV) adherenceMaintains and monitors quality case management documentation to assure compliance with program, data privacy, ongoing education, and PV adherenceDemonstrates strong communication skills with internal and external constituents and utilizes all available internal cross functional departments and available reporting tools to strategize the achievement of company goalsSkills and Competencies:Previous experience managing a regional team of Nurse Case Managers. Experience with case management oversight and cross-functional collaboration across a medium to large commercial organization preferredProven ability to effectively partner with internal access and field teams as well as thirty-party reimbursement partners to identify and resolve customer concerns and issuesPrevious case management and/or patient support experience in the pharmaceutical, biotech, or related industry is preferredKnowledge of clinical data and pharmacologyAbility to problem solve and communicate complex access and fulfilment scenario to regional teams responsible for educating patients and healthcare professionalsExperience with identifying and developing training content for the nurse case management teamDemonstrated time management skills; planning and prioritization skills; ability to multi-task and maintain prioritization of key projects and deadlines.Demonstrated effective presentation skills; ability to motivate others; excellent interpersonal (written and verbal) skills - with demonstrated effectiveness in working cross-functionally and independentlyDemonstrated ability to develop, follow and execute plans in an independent environmentDemonstrated ability to effectively build positive relationships both internally and externallyDemonstrated ability to be adaptable to changing and fast paced work environments and responsibilitiesMust be able to thrive in team environment and willing to contribute at all levels with flexibility and a positive attitudeFully competent in MS OfficeFlexibility to work weekends and evenings, as neededParticipate in and complete required pharmacovigilance trainingComply with all relevant industry laws and argenx policiesAbility to travel 50-60%Education, Experience and Qualifications:Bachelor's degree, Masters preferredBSN and/or RN licensureCurrent nursing license in good standing5 + years clinical experience in healthcare to include pharmaceutical or biotech3-5+ years of case management and reimbursement experience5+ plus years' experience in building and managing teams#LI-RemoteAt argenx we strive to create a welcoming and inclusive environment. Here all applicants will receive equal consideration for employment without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, or any other applicable legally protected characteristics. argenx is proud to be an equal opportunity employer.If you require reasonable accommodation in completing your application, interviewing, or otherwise participating in the candidate selection process please contact us at [email protected]. Only inquiries related to an accommodation request will receive a response.PDN-9bd966c7-4ea4-4e78-ba2c-2d46224ba01c

Description Nurse Reviewer I Location: Within 50 miles of a pulse point in Illinois Shift: 9:30 am - 6 pm CST The Nurse Reviewer I is responsible for conducting preauthorization, out of network and appropriateness of treatment reviews for diagnostic imaging services by utilizing appropriate policies, clinical and department guidelines. Collaborates with healthcare providers, and members to promote the most appropriate, highest quality and effective use of diagnostic imaging to ensure quality member outcomes, and to optimize member benefits. Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. Partners with more senior colleagues to complete non-routine reviews. Through work experience and mentoring learns to conduct medical necessity clinical screenings of preauthorization request to assess assessing the medical necessity of diagnostic imaging procedures, out of network services, and appropriateness of treatment. How you will make an impact: Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review. Conducts initial medical necessity review of exception preauthorization requests for services requested outside of the client health plan network. Notifies ordering physician or rendering service provider office of the preauthorization determination decision. Follows-up to obtain additional clinical information. Ensures proper documentation, provider communication, and telephone service per department standards and performance metrics. Minimum Requirements: Requires AS in nursing and minimum of 3 years of clinical nursing experience in an ambulatory or hospital setting or minimum of 1 year of prior utilization management, medical management and/or quality management, and/or call center experience; or any combination of education and experience, which would provide an equivalent background. Current unrestricted RN license in applicable state(s) required. Preferred Skills, Capabilities, and Experiences: Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed health care including HMO, PO and POS plans strongly preferred. BA/BS degree preferred. Previous utilization and/or quality management and/or call center experience preferred. Ability to work 9:30 am - 6 pm PST Ability to work weekends if necessary New grads are encouraged to apply Knowledge in Microsoft Office (Word, Excel, Visio) Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] assistance.