- Veterans Affairs, Veterans Health Administration (Hines, IL)
- Summary The Utilization Management (UM) Consultant is a registered professional nurse , qualified by education and experience to work directly with ... level degree in Nursing may have opportunity to become registered as a nurse with a state...not creditable as related degrees. Preferred Experience: 1 year Utilization Management experience preferred. Reference: For more… more
- CVS Health (Springfield, IL)
- …administration of the utilization /benefit management function. Required Qualifications + Registered Nurse in state of residence. + 3+ years of Nursing ... experience. Preferred Qualifications + Prior authorization utilization management /review experience preferred Outpatient Clinical experience. + Knowledge of… more
- US Tech Solutions (Chicago, IL)
- …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 ... + 3+ years of experience as an RN + Registered Nurse in state of residence +...and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1… more
- Veterans Affairs, Veterans Health Administration (Hines, IL)
- …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... care while ensuring appropriate patient flow and responsible resource management . Requirements of the ANM role is the necessary...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Veterans Affairs, Veterans Health Administration (Bloomington, IL)
- Summary The Patient Aligned Care Team (PACT) Float Registered Nurse (RN) is responsible for providing competent, evidence-based gender-specific care to primary ... and coaching on wellness, disease prevention, and chronic care management . Assists in directing the provision of nursing education,...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- CVS Health (Springfield, IL)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... reviews **Required Qualifications** - 5+ years' experience as a Registered Nurse with at least 1 year...using a keyboard **Preferred Qualifications** - 1+ years' Case Management experience or discharge planning, nurse navigator… more
- Humana (Springfield, IL)
- …of our caring community and help us put health first** The Senior Compliance Nurse reviews utilization management activities and documentation to ensure ... your skills to make an impact** **Required Qualifications:** + Registered Nurse with a Bachelor's degree in...action + Minimum two, (2) years of experience in utilization management + Intermediate proficiency using Microsoft… more
- AdventHealth (Hinsdale, IL)
- …documents avoidable days, and facilitates progression of care. **.** Collaborates with Utilization Management staff for collaboration on patient status changes ... . BSN . Health-related Master's degree or MSN . Prior Care Management / Utilization Management experience **LICENSURE, CERTIFICATION OR REGISTRATION… more
- Trinity Health (Melrose Park, IL)
- …Part time **Shift:** Day Shift **Description:** The Surgery OR RN, a perioperative registered nurse , provides patient care for all patients, from infants through ... Robot experience also preferred **Licensure/Certifications** : + AHA BLS card + Current Registered Nurse License State of Illinois **Benefits and perks you need… more
- Humana (Springfield, IL)
- …us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral health ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work assignments… more
- Fresenius Medical Center (Springfield, IL)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- CVS Health (Chicago, IL)
- …**Position Summary** The RN Case Manager is responsible for coordinating all case management activities with members to evaluate the medical needs of the member and ... Services strategies policies and programs are comprised of network management and clinical coverage policies. **Position Responsibilities:** + Responsible for… more
- Fresenius Medical Center (Chicago, IL)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... + Preferred but not required: + 3+ years supervisory or project/program management experience. + Med/surg or ICU/CCU experience. **PHYSICAL DEMANDS AND WORKING… more
- Rush University Medical Center (Chicago, IL)
- …of each case. **Summary:** The Oncology Nurse Navigator 2 is a registered nurse (RN) who works with physician practices and multi-disciplinary teams to ... promote the effective utilization of services and coordination of care for patients...procedures. **Other information:** **Requirements:** * Current State of Illinois Registered Nurse licensure required * At least… more
- Rush University Medical Center (Chicago, IL)
- …procedures. **Other information:** **Required Job Qualifications:** *Current license in Illinois as Registered Nurse (RN). *Ability to perform all job components ... Unit: Rush Medical Center Hospital: Rush University Medical Center Department: Care Management **Work Type:** Full Time (Total FTE between 0.9 and 1.0) **Shift:**… more
- CVS Health (Springfield, IL)
- …+ 5+ years of clinical experience required + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN licensure in state ... Friday 8:00am - 5:00pm in time zone of residence **Preferred Qualifications** + Utilization Management review + Managed Care experience + Client processing… more
- Rush University Medical Center (Chicago, IL)
- …**Other information:** **Required Job Qualifications:** * Current State of Illinois Professional Registered Nurse licensure * Graduate degree in nursing * o ... may vary depending on the circumstances of each case. **Summary:** The Clinical Nurse Leader (CNL) functions as an advanced generalist providing and managing care… more
- CVS Health (Springfield, IL)
- …You can have life-changing impact on our members, who are enrolled in Care Management and present with a wide range of complex health and social challenges. With ... exciting opportunity as we grow and expand our Care Management Programs to change lives in new markets across...nursing, or rehabilitative stay. Under the direction of a Registered /Licensed RN, the TOC Coach ensures the member experiences… more
- Rush University Medical Center (Chicago, IL)
- …procedures. **Other information:** **Required Job Qualifications:** * Current State of Illinois Registered Nurse licensure. * Master's degree in Nursing from an ... of each case. **Summary:** The Clinical Specialist RN is an advanced practice nurse with knowledge in a specialized area of nursing who promotes quality patient… more
- Intermountain Health (Springfield, IL)
- …cost-effective outcomes. Provides focused support to various areas such as utilization management , emergency department, acute, ambulatory and specialty care. ... /Professional Nursing program. + Required Licensure/Certification: State licensure as a Registered Nurse (RN). Preferred Qualifications + Bachelor's degree in… more