- ProgenyHealth (Elk Grove Village, IL)
- ProgenyHealth is a leading provider of care management solutions for premature and medically complex newborns. Our program promotes appropriate utilization , ... attaining quality outcomes for the members. The clinical care nurse serves as a nurse reviewer for...events throughout the year + Role specific - full remote work week ProgenyHealth positively recruits people from diverse… more
- CVS Health (Springfield, IL)
- …rotation per business needs Preferred Qualifications - Prior authorization & utilization management experience - Outpatient Clinical experience - Knowledge ... internal and external constituents in the coordination and administration of the utilization /benefit management function. For more information on our benefit… more
- Humana (Springfield, IL)
- …products including Word, Excel and Outlook **Preferred Qualifications** + Appeals/ Utilization Review/Quality Management experience + Previous claims experience ... community and help us put health first** The Appeals Nurse 2 resolves clinical complaints and appeals. The Appeals...programs + Bachelor's degree **Additional Information** **Work Style** : Remote **Work Days/Hours:** Monday - Friday; 8:00 am-5 pm… more
- Rush University Medical Center (Chicago, IL)
- …implement solutions for current situations. The Ambulatory RN 2 is a competent nurse who has mastered technical skills and utilizes evidence based interventions. The ... **Other information:** **Required Job Qualifications:** * Current State of Illinois Registered Nurse licensure. State of IN RN licensure required for those working… more
- ChenMed (Chicago, IL)
- …expanding and we need great people to join our team. The Registered Nurse 1, Care Line, is responsible for providing telephonic triage directional patient care ... client counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families. Providing on-call coverage, the… more
- Marriott (Springfield, IL)
- …States **Schedule** Full-Time **Located Remotely?** Y **Relocation?** N **Position Type** Management **JOB SUMMARY** The Nurse CARE Manager coordinates timely, ... **Additional Information** Nurse CARE Manager (CARE - Coordinated Action and...Claims Services + Collaborate with Claims department regarding case management . + Collaborate with UNM on utilization … more
- Abbott (Chicago, IL)
- …to support diagnostic testing which provides important information for treatment and management of diseases and other conditions. We currently have an opportunity ... for a **Technical Consultant** . This is a remote , field-based position located in the **Chicago, IL.** This position will assist Account Managers with evaluations,… more
- Centene Corporation (Burr Ridge, IL)
- …5+ years of leadership experience. Master's degree preferred. **License/Certification:** Registered Nurse . Certified Case Management (CCM). **For Illinois Plan ... Must reside in Illinois. Will direct all activities pertaining to Case Management and Care Coordination activities and monitor utilization of Enrollees'… more
- Veterans Affairs, Veterans Health Administration (Peoria, IL)
- …appropriate. Duties and responsibilities include a variety of medical care management techniques, which requires knowledge, skills, licensures, and experience as a ... adequate and comprehensive services and communicates these to staff physicians, nurse practitioners, physician assistants and other members of Ambulator Care.… more