Case Manager RN-Utilization Review (Fully Remote)

Northwestern Medicine; Deutschland; Remote; EUR 52.000 - 76.000; Vollzeit

Benefits dieser Stelle

Tuition reimbursement

Loan forgiveness

401(k) matching

Lifecycle benefits

Zusammenfassung

Northwestern Medicine is seeking a seasoned clinical professional to develop individualized treatment plans and coordinate care conferences for patients with extended stays. The role also involves performing medical record reviews to assess admission appropriateness and ensure compliance with standards, and supporting denials management and appeals for insurance claims to secure quality care.

This position emphasizes collaborative practice, strong documentation, and adherence to high clinical

Qualifikationen

• Required: Active Registered Nursing license in Illinois, Bachelor of Science in Nursing, and 3+ years of clinical experience.
• Preferred: Master of Science in Nursing, ACM certification, and membership in a professional nursing organization.
• We offer tuition reimbursement, loan forgiveness, 401(k) matching, and lifecycle benefits.

Aufgaben

• Develop individualized treatment plans and coordinate care conferences for patients with extended stays.
• Perform medical record reviews to assess admission appropriateness and ensure compliance with standards.
• Support denials management and appeals for insurance claims to ensure quality care.

Kenntnisse

Clinical experience

Communication skills

Team-based care

Ausbildung

Bachelor of Science in Nursing

Master of Science in Nursing

Certification in Case Management (ACM)

Membership in professional nursing organization

Jobbeschreibung

• You will develop individualized treatment plans and coordinate care conferences for patients with extended stays.
• You will perform medical record reviews to assess admission appropriateness and ensure compliance with standards.
• You will support denials management and appeals for insurance claims to ensure quality care.

Qualifications:

• Required: Active Registered Nursing license in Illinois, Bachelor of Science in Nursing, and 3+ years of clinical experience.
• Preferred: Master of Science in Nursing, certification in Case Management (ACM), and membership in a professional nursing organization.
• We offer tuition reimbursement, loan forgiveness, 401(k) matching, and lifecycle benefits.
• We are an equal opportunity employer committed to a diverse and inclusive workplace.

Northwestern Medicine is a healthcare system focused on patient-first care. We offer a supportive workplace with competitive benefits and a culture of growth.