• Clinical Case Manager

    CVS Health (Springfield, IL)
    …as needed/requested by Management. Preference for candidates residing in the Chicago area. Clinical Case Manager RN is responsible for telephonically and/or ... of Care: - Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and… more
    CVS Health (05/23/25)
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  • NY Registered Nurse - Case

    Public Consulting Group (Springfield, IL)
    …. PCG is currently seeking a qualified Registered Nurse to perform as a Case Manager . The Case Manager will be responsible for assisting ... Medical Fund on behalf of a state agency. The Case Manager will be charged with helping...informed decisions by acting as their advocate regarding their clinical status and treatment options * Develops effective working… more
    Public Consulting Group (04/05/25)
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  • Case Manager , Registered

    CVS Health (Springfield, IL)
    …members. **Key Responsibilities** + This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or ... within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical… more
    CVS Health (05/16/25)
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  • Registered Nurse, Case

    CVS Health (Springfield, IL)
    …care for members. - This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or self-insured ... within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical… more
    CVS Health (05/16/25)
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  • NY Registered Nurse - Case

    Public Consulting Group (Springfield, IL)
    …that is safe, timely, effective, efficient, equitable, and client-centered + Handles case assignments, draft service plans, review case progress and determine ... to conduct periodic in person assessments + Facilitates multiple care aspects ( case coordination, information sharing, etc.) + Helps patients make informed decisions… more
    Public Consulting Group (05/24/25)
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  • Case Manager Registered

    CVS Health (Springfield, IL)
    …And we do it all with heart, each and every day. **Position Summary** This Case Manager position is with Aetna's Long-Term Services and Supports (LTSS) team and ... The requirements is for candidates to hold an Illinois Registered Nursing license, and travel 50-75% of the time...outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as… more
    CVS Health (05/03/25)
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  • Case Manager , Registered

    CVS Health (Springfield, IL)
    …of network management, clinical coverage, and policies. Community Care Case Manager use a collaborative process of assessment, planning, facilitation, ... and benefit plan eligibility and facilitates integrative functions using clinical tools and information/data. - Utilizes case ...RN licenses if needed, company will provide. - Certified Case Manager is preferred. - Additional national… more
    CVS Health (04/18/25)
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  • Case Manager Registered Nurse…

    CVS Health (Springfield, IL)
    …and more compassionate. And we do it all with heart, each and every day. This Case Manager Registered Nurse position is with Aetna's Long-Term Services and ... The requirements is for candidates to hold an IL Registered Nurse License, and travel 50-75% of the time...Friday 8:00am - 5:00pm ​ **Position Summary** Coordinating all case management activities with members to evaluate the medical… more
    CVS Health (05/15/25)
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  • Case Manager Registered Nurse…

    CVS Health (Springfield, IL)
    …And we do it all with heart, each and every day. **Position Summary** This Case Manager Registered Nurse position is with Aetna's Long-Term Services and ... The requirements is for candidates to hold an Illinois Registered Nurse License, and travel up to 75% of...Monday-Friday 8:00 am - 5:00 pm CST. Coordinating all case management activities with members to evaluate the medical… more
    CVS Health (05/01/25)
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  • Care Manager , Registered Nurse-…

    Sharecare (Springfield, IL)
    …+ Training in motivational interviewing preferred. + Minimum 3-5 years varied clinical experience with telephonic Case Management experience strongly preferred. ... 2025** **Salary:** **$85,000 annually, plus comprehensive benefits package** The Care Manager supports the implementation of the Value Based Care Management program… more
    Sharecare (04/26/25)
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  • Registered Nurse RN Home Heath PRN Weekends

    Elara Caring (Springfield, IL)
    …+ Previous experience with HomeCare HomeBase is preferred You will report to the Clinical Manager or Clinical Supervisor _This is not a comprehensive ... the Right Time, in the Right Place. **Job Description:** ** Registered Nurse Home Health PRN** We are looking for...pursuant to HIPAA Privacy Final Rule. + Assesses assigned case load of home health care patients and families… more
    Elara Caring (05/14/25)
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  • Registered Nurse RN Home Health PRN

    Elara Caring (Springfield, IL)
    …bonuses, on-call, or other performance-based compensation variables. You will report to the Clinical Manager or Clinical Supervisor Elara Caring determines ... the Right Time, in the Right Place. **Job Description:** ** Registered Nurse Home Health PRN** **Coverage 1: Jacksonville, Quincy**...pursuant to HIPAA Privacy Final Rule. + Assesses assigned case load of home health care patients and families… more
    Elara Caring (05/14/25)
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  • Registered Nurse

    Gentiva (Springfield, IL)
    …the care they need with dignity, grace, and love. **As a Hospice RN/ RN Case Manager , you will:** + Reportdirectly to the Administrator, Executive Director or ... Patient Care Manager Senior and will maintain primary control and professional...supportive care to the patient's family with a reasonable case load while providing a trusting and compassionate relationship… more
    Gentiva (04/19/25)
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  • Senior Care Manager (RN)

    Centene Corporation (Springfield, IL)
    …a fresh perspective on workplace flexibility. **On-Site RN Opportunity | Senior Care Manager - Peoria, IL** **Are you a passionate RN with a strong background ... in case management or utilization management within an inpatient setting?...where care happens.** **We're currently hiring a Senior Care Manager RN to work on-site at a hospital in… more
    Centene Corporation (04/12/25)
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  • Care Manager , Ltss (RN) Illinois

    Molina Healthcare (Clinton, IL)
    …waiver services. **Preferred License, Certification, Association** Active and unrestricted Certified Case Manager (CCM) To all current Molina employees: If ... comprehensive waiver enrollment and disenrollment processes. + Develops and implements a case management plan, including a waiver service plan, in collaboration with… more
    Molina Healthcare (04/05/25)
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  • Coding Auditor Educator

    Highmark Health (Springfield, IL)
    …Is responsible for or works with external resources to create and monitor inpatient case mix reports and the top 25 assigned DRGs/APCs in the facilities to identify ... related to special projects and providing coverage for coding manager (s). (10%) + Depending on location provides or arranges...processes as it relates to the DRG/APC and other clinical data quality management factors. With technical direction and… more
    Highmark Health (05/09/25)
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