- Humana (Springfield, IL)
- …a part of our caring community and help us put health first** The Weekend Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Springfield, IL)
- …+ **M** anaged care experience + Discharge planning experience + Utilization Management experience **Education** ASN Required, BSN Preferred **Anticipated ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and knowledge in… more
- CVS Health (Springfield, IL)
- …and on the phone collecting and reviewing clinical information from providers. Utilization Management nurses use specific criteria to authorize inpatient ... paced environment NICU experience 3+ years **Preferred Qualifications** Previous Utilization Management experience Spine Experience **Education** Associates… more
- Cognizant (Springfield, IL)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Lincoln Financial (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
- US Tech Solutions (Chicago, IL)
- …HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF UTILIZATION ... 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior...in state of residence + Must have prior authorization utilization experience + Experience with Medcompass **Skills:** + MUST… more
- CVS Health (Springfield, IL)
- …+ 5+ years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + 3+ year(s) of Appeals experience in Utilization ... members. **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the… more
- Humana (Springfield, IL)
- …put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional who utilizes behavioral health ... communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional work assignments are… more
- Trinity Health (Maywood, IL)
- …in collaboration with attending physicians. + Actively participates in the Utilization Management committee. + Additional responsibilities as needed. **We ... Loyola campus. Position is hybrid, must reside in Illinois. The **Regional Utilization Review Documentation Specialist** nurse works with the multidisciplinary… more
- ICW Group (Lisle, IL)
- …AND SKILLS** Understanding of Workers' Compensation, Workers' Compensation Managed Care processes, Utilization Review, Telephonic Nurse Case Management , and ... **ESSENTIAL DUTIES AND RESPONSIBILITIES** Provides oversight for all vended Nurse Case Management (NCM) products, including Field... management issues related to bill review, case management and utilization review. + Works closely… more
- Veterans Affairs, Veterans Health Administration (Hines, IL)
- …responsibility for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care. Core elements ... customer service programs. Responsibilities The Outpatient Mental Health (MH) Registered Nurse (RN) is responsible for providing competent, evidence-based care to… more
- Veterans Affairs, Veterans Health Administration (North Chicago, IL)
- …James A. Lovell Federal Health Care Center (FHCC) is seeking a Registered Nurse (RN), Bed Transfer Coordinator for Nursing Services. This position is located within ... common goal: to serve our nation's Veterans. The Bed Transfer Coordinator Registered Nurse (RN) is responsible and accountable for all elements of the nursing… more
- Rush University Medical Center (Chicago, IL)
- …Offers may vary depending on the circumstances 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 within the Cancer Center service line.… more
- CVS Health (Springfield, IL)
- …in research efforts, contributing to scholarly publications, and/or facilitating research utilization to improve clinical care and outcomes. - Provides training and ... with diverse cultural dynamics of clinical staff and patients. - Registered Nurse (RN) required. **Preferred Qualifications** - Master's degree in healthcare related… 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 ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Veterans Affairs, Veterans Health Administration (North Chicago, IL)
- …Health Care Center (FHCC) is seeking a Branch Health Clinic (BHC) Registered Nurse (RN) for Fleet Medicine Directorate. Responsibilities VISN 12 is committed to ... within a 12-state region. The Branch Health Clinic RN serves as a clinical nurse advisor to the Department Head, Medical Readiness Department on all issues related… more
- Trinity Health (Silvis, IL)
- …One! (http://www.genesishealth.com/) Join the MercyOne Family! We are looking to hire a Registered Nurse ! A dedicated Charge Nurse is a registered nurse ... allocation, and collaboration with the interdisciplinary healthcare team. The Charge Nurse ensures adherence to established policies, promotes a collaborative work… more
- Rush University Medical Center (Chicago, IL)
- …may vary depending on the circumstances of each case. **Summary:** The Clinical Nurse Leader (CNL) functions as an advanced generalist providing and managing care ... for the improvement of patient care outcomes, and resource in the management of clinically complex patients. The CNL provides insight regarding the microsystem… 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...timelines. - Utilizes weekly and daily reporting to identify utilization for the purpose of reducing Emergency Department … more
- AdventHealth (Glendale Heights, IL)
- …AVE, Glendale Heights, 60139 **The role you'll contribute:** The Registered Professional Nurse (RN) is responsible for providing and supervising direct and indirect ... abiding to compassion and image standards and fostering excellent nurse -patient relationships through effective/therapeutic communication with the patient, family,… more