- CVS Health (Springfield, IL)
- …in managed care, clinical, or health care related field. - 1 year of project management experience. - Registered Nurse (RN) license in the state of their ... and industry knowledge and performance improvement best practices to quality improvement efforts. Analyzes workflow and organizational performance to evaluate… more
- CVS Health (Springfield, IL)
- …that promote high- quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. **Key ... Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care … more
- CVS Health (Springfield, IL)
- …we do it all with heart, each and every day. **Position Summary** _Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and ... other products, services and/or programs + Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and… more
- CVS Health (Springfield, IL)
- …to coordinate, document and communicate all aspects of the utilization/benefit management program. Applies critical thinking and knowledge in clinically appropriate ... constituents in the coordination and administration of the utilization/benefit management function - Gathers clinical information and applies the appropriate… more
- Fujifilm (Springfield, IL)
- …customers. + Ensure compliance with all applicable requirements of the company's quality management system. + Maintains effective communications and working ... **Position Overview** The Clinical Consultant , MI - I shall be responsible for... products and services. + Understand and apply appropriate quality management system processes. + Promote Company… more
- CVS Health (Springfield, IL)
- …to coordinate, document, and communicate all aspects of the utilization/benefit management program. + Conduct clinical reviews for adult inpatient behavioral health ... constituents in the coordination and administration of the utilization/benefit management function. + Gathers clinical information and applies the appropriate… more
- CVS Health (Springfield, IL)
- …members. Community Care is a member centric, team-delivered, community-based care management model that joins members where they are. With compassionate attention ... Services and strategies, policies and programs are comprised of network management , clinical coverage, and policies. **Position Summary/Mission** Community Care Case… more
- CVS Health (Springfield, IL)
- …and strategies, policies and programs are comprised of network management , clinical coverage, and policies. **Position** **Summary/Mission** Our Case Managers ... health needs through communication and available resources to promote quality , cost effective outcomes. **Fundamental Components & Physical** **Requirements** +… more