- CVS Health (Springfield, IL)
- …personal, convenient and affordable. Position Summary This Utilization Management (UM) Nurse Consultant role is fully remote and employee can live in any ... state. CCR - Duals UM Nurse Consultant Utilizes clinical experience and skills in a...external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications - 3+… more
- Humana (Springfield, IL)
- …a part of our caring community and help us put health first** The Compliance Nurse 2 reviews utilization management activities and documentation to ensure ... prevent and detect fraud, waste, and abuse. The Compliance Nurse 2 work assignments are varied and frequently require...clinical nursing experience. + 2 years of experience in utilization management with MCG Guidelines + Ability… more
- Veterans Affairs, Veterans Health Administration (Danville, IL)
- Summary The Registered Nurse (RN), Inpatient Acute Care, supports the VAIHCS mission in caring for complex veteran populations requiring inpatient medical care ... responsibility for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care. Administers… more
- Lincoln Financial Group (Springfield, IL)
- …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for… more
- Sharecare, Inc. (Springfield, IL)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... the Family Health Advocate is an exciting and innovative remote role newly created to provide meaningful support to...+ Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex… 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 (Danville, 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
- Teleflex (Chicago, IL)
- …territory. The incumbent is responsible for the growth of overall product utilization within their accounts including, but not limited to, selling the designated ... time in the field. * Facilitate sales growth by conducting physician, nurse , and technologist training and account in-servicing of dialysis access products. *… more