- CVS Health (Springfield, IL)
- …required + Must reside in Illinois + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN licensure in state of residence. + ... 5:00pm in time zone of residence **Preferred Qualifications** + Utilization Management review + Managed Care experience + Client processing experience **Education**… 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
- Prime Therapeutics (Springfield, IL)
- …education and/or relevant work experience + 5 years of work experience in case management or professional practice + Current Registered Nurse (RN) license in ... passion and drives every decision we make. **Job Posting Title** SIU Clinical Consultant **Job Description** The SIU Clinical Consultant is responsible for… more
- Highmark Health (Springfield, IL)
- …of clinical, quality , care, utilization, high-cost claim, and population health management . Must be a recognized subject matter expert (SME). + Clinical Program ... in Business or Clinical field **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse (RN) or Pharmacist (Pharm D) or Physician Assistant (PA) **Preferred** +… 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 ... work. Services and strategies, policies and programs are comprised of network management , clinical coverage, and policies. Community Care Case Manager use a… more
- Lincoln Financial (Springfield, IL)
- …you will be responsible for leading and managing a team of nurse disability consultants and behavioral health consultants. This includes partnering closely with ... medical and vocational operations and serve as a consultant to the claim operations team for complex clinical...area(s) of responsibility, assesses the impact, and collaborates with management to incorporate new trends and developments in current… more