Utilization Review Nurse jobs at ICONMA - 309 jobs

Alden Management Services - TITLE: Nurse Clinical Liaison REPORTS TO: Director Central Intake Build new and maintain current relationships with the facility's referral sources. Assist facility marketing team with developing and executing Census Development plan in order to achieve overall census and payer mix goals. II. QUALIFICATIONS A. Valid Registered Nurse (RN) license. B. Demonstrated success in external marketing to physicians, social workers discharge planners and other healthcare referral sources preferred. C. Must be knowledgeable of Long Term care practices and procedures, as well as some familiarity with laws, regulations and guidelines pertaining to long-term care. A minimum of 2 years of experience in long term care (preferably marketing and/or nursing) D. Must be able to read, write, and speak the English language in an understandable manner. E. Must possess the ability to deal tactfully with hospitals, physicians, patients, family members, visitors, personnel, government agencies/personnel and the general public. F. Must have patience, tact, cheerful disposition and enthusiasm. G. Must be proficient with data tracking, trending and report writing. III. PHYSICAL REQUIREMENTS A. Must be able to move intermittently throughout the workday. B. Must be able to cope with the mental and emotional stress of the position. C. Must possess sight/ hearing senses or use prosthetics that will enable these senses to function adequately so that the requirements of this position can be fully met. D. Must be in good general health and demonstrate emotional stability. E. Must be able to relate well and work with the ill, disabled, elderly, emotionally upset and at times hostile people within the facility. F. Prolonged standing/walking is required. G. May be required to lift, push, pull, and move equipment, supplies, etc., throughout the day. H. Is subject to exposure to infectious waste, diseases, conditions, etc., including exposure to the (HIV) AIDS and Hepatitis B viruses. IV. ESSENTIAL FUNCTIONS A. Majority of time is spent solidifying relationships primarily with physicians, hospital discharge planners, case managers and other healthcare referral sources. B. Provision of Alden Network information to potential and actual referral sources. Information shall include facility brochures, service-related flyers, metrics flyers, continuing education events. C. Manage the referrals: a. Ensure that referrals have a completed on-site assessments also meet with families when available (share DVD of Alden, complete Introduction to Alden- what they can expect (what differentiates Alden). b. Gather and review referrals information (from case managers/discharge planners) c. Make decisions regarding admissions D. Communicate admissions decisions to the facility: a. Planned/scheduled admission date b. Financial verification needs c. Equipment needs d. Unusual and/or costly medication negotiations E. Verify admission process is in place: (Coordinate with Administrator and Assistant Administrator) a. Room readiness b. Greeting patient/family upon arrival to explain what they can expect c. Verifying that customer delights are in place and ensuring the IDT is aware d. Ensuring family courtesy calls are made and discussed daily for the first 72 hours then weekly thereafter. e. Ensuring the completion and analysis of Customer Service Surveys f. Analysis of admissions process data F. Responsible for preparation and participation in census development in order to discuss marketing opportunities and strategies to meet the metrics in place for each facility. Frequency of calls will be determined based on each facility need. G. Ensure the completion of daily rounds on patients that are in the hospital a. Meet with nurse/case manager/discharge planner regarding discharge from the hospital. b. Identify other potential referrals. c. Relay information to facility admissions director or MOD (if on the weekend) H. Complete follow up (Thank You) visits with case managers/discharge planners and provide them with key metrics related to the specific patients that have been admitted from the individual hospital (customer care survey results, success with therapy, etc.) I. Coordinate with facilities on Community marketing events and ensure follow up from these events. J. Coordinate with Vice President of Network Services and Vice President of Public Relations in order to develop and improve the reputation of the network which includes but not limited to community outreach. K. Provide updates to Director Central Intake and VP of Network Services L. Develop and maintain new referral sources for the facility and Alden in general. M. Perform other duties as assigned. V. JOB DUTIES A. Review the assigned facilities/ hospital market place to ensure facilities are able to maximize all business development opportunities to meet census objectives. B. Coordinate and develop relationships with key referral sources in community to promote the success and growth of key facility metrics to demonstrate on how facility is the one of choice. C. Coordinate and develop relationships will physicians in market to successfully gain support and educate them in order to build census both directly and indirectly through the success of the buildings.

Introduction At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it's our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people's lives. It takes empathy, precision, and a strong sense of partnership-and that's exactly what you'll find here. We're a team of fast-paced fixers, empathetic experts, and outcomes drivers - people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you'll play a vital role in helping businesses and individuals move forward with confidence. Here, you'll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you're here, you're part of something bigger. You're part of a team that shows up, stands together, and leads with purpose. Overview Provides medical management to workers compensation injured employees, performing case management through telephonic and in-person contact with injured workers and medical providers. Coordinates with employers and claims professionals to manage medical care in order to return injured employee to work. This position will cover the Chicago area with a travel radius of up to 2 hours. How you'll make an impact Key Responsibilities: Coordinating medical evaluation and treatment Meeting with physician and injured worker to collaborate on treatment plan and to discuss goals for return to work Keeping employer and referral source updated regarding medical treatment and work status Coordinating ancillary services, e.g. home health, durable medical equipment, and physical therapy. Communicates with employers to determine job requirements and to explore modified or alternate employment. Discusses and evaluates results of treatment plan with physician and injured worker using Evidence Based Guidelines to ensure effective outcome. Documents case management observations, assessment, and plan. Generates reports for referral source to communicate case status and recommendations. Generates ongoing correspondence to referral source, employer, medical providers, injured worker, and other participants involved in the injured worker's treatment plan. May participate in telephonic case conferences. Maintains a minimum caseload of 35 files, and 150 monthly billable hours, with minimum 95% quality compliance. About You Required Nursing or medical degree from an accredited institution with an active Registered Nursing license or medical license within the state of practice or states in which case management is performed. 2-4 years of work experience. Responsible for completing required and applicable training, in order to maintain proficiency and licensing requirements. Able to travel to appointments within approximately a 2 hour radius. Intermediate to advanced computer skills; Microsoft Office, Outlook, etc. Desired: Bachelor's degree preferred. Worker's Compensation experience is preferred. Certification in related field preferred. 1-3 years of clinical experience preferred. Work Traits: Demonstrates adequate knowledge of managed care with emphasis on use of criteria, guidelines and national standards of practice. Advanced written and oral communication skills, along with organizational and leadership skills. Self-directed and proactively manage assigned case files. Demonstrates strong time management skills. #LI-CW1 Compensation and benefits We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. Below are the minimum core benefits you'll get, depending on your job level these benefits may improve: Medical/dental/vision plans, which start from day one! Life and accident insurance 401(K) and Roth options Tax-advantaged accounts (HSA, FSA) Educational expense reimbursement Paid parental leave Other benefits include: Digital mental health services (Talkspace) Flexible work hours (availability varies by office and job function) Training programs Gallagher Thrive program - elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing Charitable matching gift program And more... The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process. We value inclusion and diversity Click Here to review our U.S. Eligibility Requirements Inclusion and diversity (I&D) is a core part of our business, and it's embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees' diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as "protected characteristics") by applicable federal, state, or local laws. Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.

Introduction At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it's our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people's lives. It takes empathy, precision, and a strong sense of partnership-and that's exactly what you'll find here. We're a team of fast-paced fixers, empathetic experts, and outcomes drivers - people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you'll play a vital role in helping businesses and individuals move forward with confidence. Here, you'll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you're here, you're part of something bigger. You're part of a team that shows up, stands together, and leads with purpose. Overview Provides medical management to workers compensation injured employees, performing case management through telephonic and in-person contact with injured workers and medical providers. Coordinates with employers and claims professionals to manage medical care in order to return injured employee to work. This position will cover the Chicago area with a travel radius of up to 2 hours. How you'll make an impact Key Responsibilities: Coordinating medical evaluation and treatment Meeting with physician and injured worker to collaborate on treatment plan and to discuss goals for return to work Keeping employer and referral source updated regarding medical treatment and work status Coordinating ancillary services, e.g. home health, durable medical equipment, and physical therapy. Communicates with employers to determine job requirements and to explore modified or alternate employment. Discusses and evaluates results of treatment plan with physician and injured worker using Evidence Based Guidelines to ensure effective outcome. Documents case management observations, assessment, and plan. Generates reports for referral source to communicate case status and recommendations. Generates ongoing correspondence to referral source, employer, medical providers, injured worker, and other participants involved in the injured worker's treatment plan. May participate in telephonic case conferences. Maintains a minimum caseload of 35 files, and 150 monthly billable hours, with minimum 95% quality compliance. About You Required Nursing or medical degree from an accredited institution with an active Registered Nursing license or medical license within the state of practice or states in which case management is performed. 2-4 years of work experience. Responsible for completing required and applicable training, in order to maintain proficiency and licensing requirements. Able to travel to appointments within approximately a 2 hour radius. Intermediate to advanced computer skills; Microsoft Office, Outlook, etc. Desired: Bachelor's degree preferred. Worker's Compensation experience is preferred. Certification in related field preferred. 1-3 years of clinical experience preferred. Work Traits: Demonstrates adequate knowledge of managed care with emphasis on use of criteria, guidelines and national standards of practice. Advanced written and oral communication skills, along with organizational and leadership skills. Self-directed and proactively manage assigned case files. Demonstrates strong time management skills. #LI-CW1 Compensation and benefits We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. Below are the minimum core benefits you'll get, depending on your job level these benefits may improve: Medical/dental/vision plans, which start from day one! Life and accident insurance 401(K) and Roth options Tax-advantaged accounts (HSA, FSA) Educational expense reimbursement Paid parental leave Other benefits include: Digital mental health services (Talkspace) Flexible work hours (availability varies by office and job function) Training programs Gallagher Thrive program - elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing Charitable matching gift program And more... The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process. We value inclusion and diversity Click Here to review our U.S. Eligibility Requirements Inclusion and diversity (I&D) is a core part of our business, and it's embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees' diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as "protected characteristics") by applicable federal, state, or local laws. Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.

Coordinating medical evaluation and treatment Meeting with physician and injured worker to collaborate on treatment plan and to discuss goals for return to work Keeping employer and referral source updated regarding medical treatment and work status Case Manager, Nurse, Manager, Field, Benefits, Medical Equipment, Insurance, Healthcare

Liberty Cares With Compassion At Liberty Healthcare and Rehabilitation Services, we promote a challenging, but rewarding opportunity in a caring environment. We are currently seeking an experienced: SUPPORT NURSE - LPN Job Description: Assist in assuring the best patient care possible by assisting nursing personnel (including charge nurse and Director of Nursing) on a specified unit during their assigned work hours. May be required to take call for staffing coverage. Assist in providing resident care, in accordance with the Nursing Practice Act, and under the supervision of a Registered Nurse. Delegates duties to non-licensed nursing personnel and monitoring performance under the supervision of a Registered Nurse and assists in preparation of a work schedule as needed. Assist in Quality Assurance data collection for analysis and corrective action implementation by the Quality Assurance Nurse. Assist with infection control for unit. Adheres to all regulations pertaining to cleanliness, infection control and Standard Precaution. Assist with records, orders, and assessment of new admissions to the unit. Assist with assuring the initial nursing assessment is completed. Completed assigned resident assessments as assigned by MDS Nurse or Director of Nursing. Attends Nurse Department meetings as scheduled. Assist with monitoring and measuring decubiti weekly and completing integument watch assessment forms accurately and works with other departments to implement needs for the unit and needs of patients on the unit. Reports any possible performance issues by employees within the facility to the RN for determination if disciplinary action is required. May be asked by the RN to send an employee home for the remainder of the shift if the RN determines that further investigation is needed. May document the performance concern on the appropriate form for review and use by the RN in the disciplinary process. Assist with lab request as ordered per facility policy using appropriate techniques. Responsible for reposting lab work as ordered on unit, reviewing results and notifying attending MD per established policies, protocols, and physician orders. Assist with emergencies arising while on duty. Performs CPR if needed. Assist with emergencies on other units if needed. Assist with notifying attending MD of any change or illness of patients in the unit. Notifies attending physician of emergencies and death of patients in the unit. Implement order of changes in orders as instructed or ordered by MD. Assist with other general duties which include rounds with doctors; checking MD orders, including update of orders; verification of completeness of nursing summaries timely and verification that all nursing records are complete and timely. May be asked to provide hall coverage as needed. Assist with coordinating the health care team including the rehab aides duties and assignments. Other duties as assigned by Director of Nursing in accordance to NC Board Of Nursing Practice Acts. Job Requirements: Must be a high school graduate Must be a Licensed Practical Nurse (LPN) graduated from an accredited School of Nursing, with a current, valid license as a Licensed Practical Nurse in North Carolina and submit proof of license renewal. Must provide quality-nursing care to patients, follow doctor's orders, and have a genuine interest in geriatric nursing. Must be CPR certified yearly and attend in-service training and other staff meetings as required. Must have ability to make decisions regarding nursing and unit problems realizing that errors and incompetence may have serious consequences for patients and/or staff. Must be able to work well under pressure, problem solve, and perform various jobs. Must read, know and follow personnel, department and facility policies and procedures and adhere to local, state and federal requirements. Must be able to maneuver medication carts, treatment carts and other nursing equipment. Visit ********************************* for more information. Background checks/drug-free workplace. EOE. PI7b93cd8c752f-37***********9

Our client, a Global Fortune 50 organization and one of world's largest distributors of healthcare systems, medical supplies & Pharmaceutical products, seeks an accomplished Telehealth Nurse Job Title: Telehealth Nurse Location: Hybrid [1800 Weston Parkway, Cary, NC 27513] Duration: 3-5 months assignment with possible extension Work Schedule: (Mon to Fri), 9:00 AM - 6:00 PM EST || One Saturday per quarter (overtime allowed) This will be a Hybrid role || In-office 2 days per week after orientation Standard 8-hour days, 40 hours per week Job Description: The Telehealth Nurse (RN) provides clinical education, counseling, and support to patients receiving specialty drug therapies. This role is responsible for ensuring treatment adherence, documenting patient interactions, monitoring side effects, and reporting adverse events in compliance with regulatory standards. The nurse will interact with patients via telehealth platforms while working in a hybrid model from the Biologics by McKesson site. Responsibilities: Counsel and educate new and existing patients on specialty drug therapies and FDA REMS-mandated medications. Read required FDA statements verbatim during patient counseling sessions. Ensure medication adherence, coordinate refill deliveries, and collect copays as applicable. Maintain complete, compliant, and accurate documentation following industry standards. Discuss treatment side effects, alternatives, and adherence support. Identify and report Adverse Events (AEs) and Product Complaints (PCs) to relevant authorities (manufacturer, FDA, etc.). Serve as a liaison between patients, providers, and pharmacists for ongoing therapy management. Follow HIPAA regulations and maintain strict patient confidentiality. Collaborate with Pharmacy Support and Care Teams to ensure timely drug delivery and refill coordination. Minimum Qualifications: Associate's, Bachelor's, or higher degree in Nursing. Registered Nurse (RN) with current unrestricted compact license or primary NC licensure. 5+ years of nursing experience (minimum 1 year acute/inpatient care preferred). 3-5+ years post-graduate experience in pharmacy operations, clinical oversight, or patient care. Must have experience in clinical documentation, compliance, or regulatory reporting. Strong computer skills (e-mail, Word, spreadsheets, web-based systems). Ability to read, analyze, and interpret clinical practice standards and professional guidelines. Background in specialty pharmacy or telehealth environments. Recruiter Contact Info Jatin Rattan E-mail: ********************************* ************************ I'd love to talk to you if you think this position is right up your alley, and assure prompt communication, whichever direction. If you're looking for rewarding employment and a company that puts its employees first, we'd like to work with you. Company Overview: Amerit Consulting is an extremely fast-growing staffing and consulting firm. Amerit Consulting was founded in 2002 to provide consulting, temporary staffing, direct hire, and payrolling services to Fortune 500 companies nationally; as well as small to mid-sized organizations on a local & regional level. Currently, Amerit has over 2,000 employees in 47 states. We develop and implement solutions that help our clients operate more efficiently, deliver greater customer satisfaction, and see a positive impact on their bottom line. We create value by bringing together the right people to achieve results. Our clients and employees say they choose to work with Amerit because of how we work with them - with service that exceeds their expectations and a personal commitment to their success. Our deep expertise in human capital management has fueled our expansion into direct hire placements, temporary staffing, contract placements, and additional staffing and consulting services that propel our clients' businesses forward. Amerit Consulting provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Applicants, with criminal histories, are considered in a manner that is consistent with local, state and federal laws.

Brookhaven National Laboratory is committed to employee success and we believe that a comprehensive employee benefits program is an important and meaningful part of the compensation employees receive. Review more information at BNL | Benefits Program The National Synchrotron Light Source II (NSLS-II) is one of DOE's premier user facilities. Users come to NSLS-II to take advantage of its high brightness and resolution in pursuit of their scientific goals. Position Description The candidate will serve as an Experiment Review Coordinator to advocate and provide technical resources on matters of environment, health and safety. Primary responsibilities include providing professional knowledge and expertise in the administration, support and implementation of environmental, health and safety programs to assure compliance with regulatory agency guidelines, consensus standards and BNL policies. This hands-on position involves partnering with line management representatives, employees, senior staff, subject matter experts, and NSLS-II Users. Fieldwork venues include: laboratories (chemical, biological, physical, nanomaterials, etc.); construction sites; physical plants (infrastructure and maintenance) and large experimental equipment. The Experimental Review Coordinator supports the NSLS-II, one of the newest, most advanced synchrotron light sources in the world. NSLS-II enables its growing research community to study materials with nanoscale resolution and exquisite sensitivity by providing cutting-edge imaging capabilities. Essential Duties and Responsibilities: Reporting to the NSLS-II Environment Safety, Health and Quality Manager this safety engineer will have the responsibility to: Conduct Experimental Safety Reviews for NSLSII, inclusive of review and approval of experimenter's documentation, identification of hazards and controls, and ensuring the safety of staff and users during the performance of the experiments through the implementation of controls. Identifies higher risk experiments (highly toxic, energetics, radioactive, biological, etc.) and notifies the ESH Manager of the need for an extended safety review. Provide Field ESH oversight expertise during routine work activities. Serve as Liaison with the user community regarding pending experiments and raise concerns to management as needed. Assist NSLSII with the identification of hazards associated with all facets of NSLS-II operations, provide recommendations on controls and compliance requirements and communicate to workers and safety staff. Develop local policy (for NSLSII) regarding use of biologicals and radioactive materials capturing safety requirements that are in compliance with OSHA, DOT, DOE and other regulatory requirements. Conduct/participate in audits, assessments, and surveillances of safety and health programs. Respond to issues, events, and safety concerns, and provide support to the incident commander and NSLS-II managers to ensure that hazards are identified and controlled. As assigned, participate and/or lead investigations of accidents, events, incidents, illnesses, and injuries. Participate in design reviews of equipment and facilities for environmental, safety, and health to ensure compliance with laboratory requirements. Participate/lead Readiness Reviews including Beneficial Occupancy Readiness Reviews, Operational Readiness Reviews, and Internal Readiness Reviews. Prepare reports, conduct causal analyses and identify corrective actions to address findings, as well as following actions to closure. Be familiar with Environmental and Occupational Safety and Health Management Systems. Required Knowledge, Skills, and Abilities: Bachelor's degree in Engineering, Chemistry or related health and safety field and a minimum of 3 years' progressively responsible related work experience which demonstrates advanced capabilities and use of sophisticated engineering approaches. Knowledge of OSHA/ACGIH regulations with IH impacts Demonstrated proficiency in Microsoft Office Possession of a valid driver's license and satisfactory driving record Willingness to obtain and maintain related professional certifications such as ASP, CSP, CIH. Must demonstrate the ability to present ideas and concepts orally and in writing in a clear and concise manner to communicate technical information and interact with individuals with diverse backgrounds and levels of understanding including senior management, engineers, scientists, and trade workers. Willingness and aptitude to learn from our current Safety staff and to be a team player Solid safety-based reasoning skills Strong interpersonal and time management skills Preferred Knowledge, Skills, and Abilities: Master's degree in an Engineering, Scientific, or Environment, Safety, and Health (ESH) discipline is preferred. 5 years' work experience as a mechanical, project, or safety engineer/manager, in an industrial, construction, or scientific setting. Working knowledge of 10CFR851 Working knowledge of DOE Order 420.2D Knowledge of ACGIH controls and recommendations Safety Professional (ASP/CSP) or Engineering (PE) credentials, or the ability to obtain those credentials in a short period of time, is highly desirable. Other relevant safety or professional certifications will be valued. Previous work experience in a Department of Energy accelerator facility Environmental, Health & Safety Requirements: Person should be capable of wearing a respirator. Person will work around magnetic fields > 5 gauss Brookhaven National Laboratory is committed to providing fair, equitable and competitive compensation. This is a multi-level role and the full salary range for this position is $92,000.00 - $148,000.00 / year. You will be placed at the level and salary commensurate with your experience. Salary offers will be commensurate with the final candidate's qualification, education and experience and considered with the internal peer group. Brookhaven National Laboratory requires all non-badged personnel including visitors to produce a REAL-ID or REAL-ID compliant documentation to access Brookhaven National Laboratory - view more information at ******************** This is due to nationwide identification requirements for federal site access as required by the federal REAL ID Act. Those not in possession of a REAL ID-compliant document will not be permitted to access the site which includes access to the Laboratory for interviews. About Us Brookhaven National Laboratory (************ delivers discovery science and transformative technology to power and secure the nation's future. Brookhaven Lab is a multidisciplinary laboratory with seven Nobel Prize-winning discoveries, 37 R&D 100 Awards, and more than 70 years of pioneering research. The Lab is primarily supported by the U.S. Department of Energy's (DOE) Office of Science. Brookhaven Science Associates (BSA) operates and manages the Laboratory for DOE. BSA is a partnership between Battelle and The Research Foundation for the State University of New York on behalf of Stony Brook University. BSA salutes our veterans and active military members with careers that leverage the skills and unique experience they gained while serving our country, learn more at BNL | Opportunities for Veterans at Brookhaven National Laboratory. Equal Opportunity/Affirmative Action Employer Guided by our core values of integrity, responsibility, innovation, respect, and teamwork, Brookhaven Science Associates is an Equal Employment Opportunity Employer-Vets/Disabled. We are committed to fostering a respectful and collaborative environment that fuels scientific discovery. We consider all qualified applicants without regard to any characteristic protected by law. All qualified individuals are encouraged to apply. We ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation. *VEVRAA Federal Contractor BSA employees are subject to restrictions related to participation in Foreign Government Talent Recruitment Programs, as defined and detailed in United States Department of Energy Order 486.1A. You will be asked to disclose any such participation at the time of hire for review by Brookhaven. The full text of the Order may be found at: ********************************************************************************************

Discharge planning. Educate providers on utilization and medical management. Provide clinical knowledge. Perform onsite review of emergent/urgent and continued stay requests Qualifications 2+ years of clinical nursing experience in an acute care. Current state's RN license. Additional Information All your information will be kept confidential according to EEO guidelines.

Discharge planning. Educate providers on utilization and medical management. Provide clinical knowledge. Perform onsite review of emergent/urgent and continued stay requests Qualifications 2+ years of clinical nursing experience in an acute care. Current state's RN license. Additional Information All your information will be kept confidential according to EEO guidelines.

Alden Lincoln Park Rehabilitation and Health Care Center - Responsible to provide direct nursing care to the customer, and to supervise the day-to- day nursing activities performed by the nursing assistants. Such supervision must be in accordance with current Federal, State, and local standards, guidelines and regulations, facility policies. The objective is to ensure the highest degree of quality care is maintained at all times. QUALIFICATIONS Must possess a current, unencumbered license to practice as a RN or LPN in the State of Illinois and/or Wisconsin. Must possess current CPR certificate or become certified within two weeks of employment. Must be knowledgeable of nursing and medical practices and procedures. Demonstrates interest and/or knowledge in care of the aged. Must be able to read, write, and speak the English language in an understandable manner. Must possess the ability to make independent decisions when circumstances warrant such action. Must possess the ability to deal tactfully with customers, family members, visitors, personnel, government agencies/personnel, and the general public. Must possess leadership and supervisory ability and willingness to work harmoniously with other personnel. Must be personable, enthusiastic, and resourceful. PHYSICAL REQUIREMENTS Must be able to move intermittently throughout the workday. Must be able to cope with the mental and emotional stress of the position. Must possess sight/hearing senses or use prosthetics that will enable these senses to function adequately so that the requirements of this position can be fully met. Must function independently, have flexibility, personal integrity, and the ability to work effectively with customers, family members, personnel, and support agencies. Must be in good general health and demonstrate emotional stability. Must be able to relate to and work with the ill, disabled, elderly, emotionally upset, and at times hostile people. May be required to lift, push, pull and move equipment, supplies, and customers in excess of fifty (50) pounds throughout the day. Is subject to exposure to infectious waste, diseases, conditions, etc., including exposure to the (HIV) AIDS and Hepatitis B viruses. Morning: 7am-3pm Evening- 3pm-11pm Night- 11pm-7am

Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Must be located in the state of California Schedule: 9:30am-6:00pm PST, ability to work weekends if necessary. New Grads are encouraged to apply! The Nurse Reviewer I will be 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: * 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. * Knowledge in Microsoft office. For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $31.54/hr - $56.77/hr Locations: California In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. 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. 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 and Influenza. 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 ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Must be located in the state of California Schedule: 9:30am-6:00pm PST, ability to work weekends if necessary. New Grads are encouraged to apply! The Nurse Reviewer I will be 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: * 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. * Knowledge in Microsoft office. For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $31.54/hr - $56.77/hr Locations: California In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. 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. 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 and Influenza. 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 ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Work Schedule: Monday through Friday: 11:30 AM - 8:00 PM, CST or PST (local time). Alternating weekends: 8:00am - 12:00pm, CST/PST (local time) and some holidays included. A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, formerly AIM Specialty Health, is a benefit-management leader in Illinois. Our platform delivers significant cost-of-care savings across an expanding set of clinical domains, including radiology, cardiology and oncology. The Appeals 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. How you will make an impact: * Validating appeal requests. * Manage Appeal requests that come via email, fax, mailed in letters, or live live. * Opening and closing appeal requests following established appeal processes to maintain quality, turnaround time, and compliance requirements. * Outreach to providers with appeal process instructions. * Clinical review for the RBM and Surgical solution on a client specific basis. * Notifying providers and/or members of appeal decisions. * Maintain personal log all appeal requests assigned to ensure completion, as needed. * Other duties as assigned. 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. * A current unrestricted RN license in applicable state(s) required. Preferred Experience, Skills, and Capabilities: * Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed health care including HMO, PPO and POS plans strongly preferred. * BA/BS degree preferred. * Previous utilization and/or quality management and/or call center experience preferred. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $34.69 to $54.41. Locations: California, Illinois. In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. 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. 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 and Influenza. 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 ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. Job Description: We are seeking a UR RN to work full time, M-F 8-5pm. This is a direct placement opportunity. Job purpose: RN is responsible to provide Utilization Review and approval during the admission process and to provide clinical information as required to Insurance Companies at admission and during stay. This position will work closely with Revenue Cycle staff and Discharge Planning to assist in the review and acceptance into the sub-acute rehab program. RN will coordinate the Quality Improvement monthly meetings and subsequent reports. RN will also coordinate the Risk Management process. Qualifications Qualifications Registered Nurse with current NYS License Preferred experience with QI/Risk Management/Utilization Review/Infection Control BSN Preferred Familiar with agency support availability PRI certification or within six months of employment Position Urgency: Quick Start Shifts: Working Mon-Fri, 8a-5p. No wends, no call Additional Information Regards, Riya Khem Life Science Recruiter Integrated Resources, Inc. IT Life Sciences Allied Healthcare CRO (Direct) 732-844-8721 | (W) 732-549-2030 x 311 | (F) 732-549-5549 “INC 5 0 0 0 's FASTEST GROWING, PRIVATELY HELD COMPANIES” (8th Year in a Row)

Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Work Schedule: Monday through Friday: 11:30 AM - 8:00 PM, CST or PST (local time). Alternating weekends: 8:00am - 12:00pm, CST/PST (local time) and some holidays included. A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, formerly AIM Specialty Health, is a benefit-management leader in Illinois. Our platform delivers significant cost-of-care savings across an expanding set of clinical domains, including radiology, cardiology and oncology. The Appeals 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. How you will make an impact: * Validating appeal requests. * Manage Appeal requests that come via email, fax, mailed in letters, or live live. * Opening and closing appeal requests following established appeal processes to maintain quality, turnaround time, and compliance requirements. * Outreach to providers with appeal process instructions. * Clinical review for the RBM and Surgical solution on a client specific basis. * Notifying providers and/or members of appeal decisions. * Maintain personal log all appeal requests assigned to ensure completion, as needed. * Other duties as assigned. 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. * A current unrestricted RN license in applicable state(s) required. Preferred Experience, Skills, and Capabilities: * Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed health care including HMO, PPO and POS plans strongly preferred. * BA/BS degree preferred. * Previous utilization and/or quality management and/or call center experience preferred. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $34.69 to $54.41. Locations: California, Illinois. In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. 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. 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 and Influenza. 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 ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. Job Description Job Title: Utilization Management Nurse Consultant Duration: 6 months (Possible ext) Location: Downers Grove, IL Responsibilities: · Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities. · Develops, implements and supports Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work. · Services and strategies, policies and programs are comprised of network management, clinical coverage, and policies. · Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. Requires an RN (consideration for LCSW) with unrestricted active license. · Fundamental Components & Physical Requirements include but are not limited to · (* denotes essential functions) · Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members · Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care · Communicates with providers and other parties to facilitate care/treatment · Identifies members for referral opportunities to integrate with other products, services and/or programs · Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization · Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function · Background/Experience Desired · Managed Care experience preferred · 3-5 years of clinical experience required · Education and Certification Requirements · RN consideration for LCSW) with current unrestricted state license required. · Additional Information (situational competencies, skills, work location requirements, etc.) · Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding · Effective communication skills, both verbal and written. · Ability to multitask, prioritize and effectively adapt to a fast paced changing environment · Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer. · Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor. · Typical office working environment with productivity and quality expectations · Additional for Behavioral Health: · Experience in Behavioral Health required · Managed Care experience preferred. · Onsite location will be Downers Grove. · Work hours from 8:00 am until 5:00 pm with weekend rotation among the team of clinicians (approximated to rotate once every 1 & ½ to 2 months). · The ability to create and process clinical for Behavioral Health cases on a live phone queue, create and process clinical to of a determination to the provider. Additional Job Details: · Required to have computer skills. · Work with-toggle between up to 5-6 applications/systems at a time. · Travel Required: No Qualifications n/a Additional Information Kind Regards Sumit Agarwal 732-902-2125

A Few Words About Us - Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. Job Description · The incumbent must possess medical management/clinical decision-making skills and sound skills in assessing, planning and managing member care. · Advanced assessment and teaching skills. · Problem solving skills. · Familiarity with legal terminology and liability issues and ability to handle ethical or risk management issues. · Utilization and Quality Management/Outcomes experience preferred. · Previous work experience with a managed care organization or provider is also preferred. · Prior experience in case management, home health, discharge planning, or Concurrent review. Qualifications · RN Diploma, RN Associate's degree or Bachelors of Science in Nursing (BSN) degree. · Minimum of 3 years clinical experience in an acute medical or acute surgical setting. · Proficiency with a Microsoft Windows operating system. · Must have valid license to practice nursing within the US and have started application for NC nursing license. Additional Information With Regards, Kavita Kumari Allied Healthcare Recruiter Integrated Resources, Inc IT REHAB CLINICAL NURSING Inc. 5000 - 2007-2014 (8th Year) Certified MBE I GSA - Schedule 66 I GSA - Schedule 621I I GSA - Schedule 70 Tel: 732-549-2030 x208 Fax: 732-549-5549 Direct: 732-549-5302

A Few Words About Us - Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. Job Description · The incumbent must possess medical management/clinical decision-making skills and sound skills in assessing, planning and managing member care. · Advanced assessment and teaching skills. · Problem solving skills. · Familiarity with legal terminology and liability issues and ability to handle ethical or risk management issues. · Utilization and Quality Management/Outcomes experience preferred. · Previous work experience with a managed care organization or provider is also preferred. · Prior experience in case management, home health, discharge planning, or Concurrent review. Qualifications · RN Diploma, RN Associate's degree or Bachelors of Science in Nursing (BSN) degree. · Minimum of 3 years clinical experience in an acute medical or acute surgical setting. · Proficiency with a Microsoft Windows operating system. · Must have valid license to practice nursing within the US and have started application for NC nursing license. Additional Information With Regards, Kavita Kumari Allied Healthcare Recruiter Integrated Resources, Inc IT REHAB CLINICAL NURSING Inc. 5000 - 2007-2014 (8th Year) Certified MBE I GSA - Schedule 66 I GSA - Schedule 621I I GSA - Schedule 70 Tel: 732-549-2030 x208 Fax: 732-549-5549 Direct: 732-549-5302

+ Participates in the development and ongoing implementation of QM Work Plan activities. + Improve quality products and services, by using measurement and analysis to process, evaluate and make recommendations to meet QM objectives **Responsibilities:** + Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations. + Considers all documented system information as well as any additional records/data presented to develop a determination or recommendation. + Data gathering requires navigation through multiple system applications. + Staff may be required to contact the providers of record, vendors, or internal Aetna departments to obtain additional information. + Evaluates documentation/information to determine compliance with clinical policy, regulatory and accreditation guidelines. + Responsible for the review and evaluation of clinical information and documentation. + Reviews documentation and interprets data obtained form clinical records or systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and/or provider issues. + Works Potential Quality of Care cases across all lines of business (Commercial and Medicare). + Independently coordinates the clinical resolution with internal/external clinician support as required. + Processes and evaluates complex data and information sets -Converts the results of data analysis into meaningful business information and reaches conclusions about the data + Prepares and completes QM documents based on interpretation and application of business requirements + Documents QM activities to demonstrate compliance with business, regulatory, and accreditation requirements + Assists in the development and implementation of QM projects and activities + Accountable for completing and implementation of QM Work Plan Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior authorization utilization experience + Experience with Medcompass **Skills:** + MUST HAVE MEDCOMPASS or ASSURECARE exp. + MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. + MUST HAVE 6 months of Prior Authorization. **Education:** + Active and unrestricted RN licensure in state of residence **Questionnaire:** + Do you have experience with Medcompass? + Do you have experience with Prior Authorization? + Do you have experience with Utilization Review? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit *********************** (********************************** . US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.