- 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
- ChenMed (Chicago, IL)
- …I, Care Line is responsible for diagnostic patient care primarily through virtual, remote consultation via video conference or telephone. The incumbent in this role ... trends in patient conditions and develops, documents and implements a patient management plan based on interpretation of findings. Aids in the development of… more
- Veterans Affairs, Veterans Health Administration (Danville, IL)
- …Control (IPC) Registered Nurse (RN) collaborates with the Chief of Quality Management along with other health care professionals to ensure that all services are ... Summary The Infection Prevention and Control (IPC) Registered Nurse (RN) is responsible and accountable for the planning, designing, integrating, implementing, and… more
- Elevance Health (Chicago, IL)
- ** Nurse Audit Lead** **Supports the Carelon Payment Integrity line of business** _Location: This position will work a hybrid model ( remote and office). The ideal ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Nurse Audit Lead** is responsible for leading a team of clinicians… more
- Kepro (IL)
- …reports for clients. + Identify patterns and trends in clinical case and utilization management performance. + Maintain the Department's Quality Management ... public sector. Acentra seeks a Quality Manager - RN ( Remote , preferred within Illinois) to join our growing team....+ Master's degree in nursing. + 1+ years of utilization management experience. + Formal training or… more
- ChenMed (Chicago, IL)
- …PRN is responsible for diagnostic patient care primarily through virtual, remote consultation via video conference or telephone. Providing on-call coverage, the ... trends in patient conditions and develops, documents and implements a patient management plan based on interpretation of findings. Aids in the development of… 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
- Rush University Medical Center (Chicago, IL)
- …**Shift:** **Shift 1** **Work Schedule:** 8 Hr (8:30:00 AM - 5:00:00 PM) (1 day Remote OR 4 - 10 hour Shifts!) **Summary:** The Ambulatory RN 2 identifies patterns ... current situations. The Ambulatory RN 2 is a competent nurse who has mastered technical skills and utilizes evidence...the teaching- learning process to meet the learning and self- management needs of patients and families. 11. Assesses patient… 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