- CVS Health (Springfield, IL)
- …+ Active and good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC ... experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal… more
- CVS Health (Springfield, IL)
- …active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, ... **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care...or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing… more
- Humana (Springfield, IL)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
- Cognizant (Springfield, IL)
- …have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- CenterWell (Springfield, IL)
- …clinical experience. + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Intelligence + ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...Experience with Home Health preferred + Previous experience in utilization management within Insurance industry a plus… more
- US Tech Solutions (Chicago, IL)
- …and implementation of QM Work Plan Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior ... and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1...Utilization Review? + Do you have an Active Registered Nurse License? **About US Tech Solutions:**… more
- AdventHealth (Hinsdale, IL)
- …. BSN . Health-related Master's degree or MSN . Prior Care Management / Utilization Management experience **LICENSURE, CERTIFICATION OR REGISTRATION ... satisfaction, patient safety, readmission prevention and length of stay management . The RN Care Manager communicates daily...REQUIRED:** . State of Illinois registered nurse license **LICENSURE, CERTIFICATION OR REGISTRATION… more
- CVS Health (Springfield, IL)
- …is subject to change based on business needs. **Preferred Qualifications** 6+ months Case Management or Utilization Management experience Case Management ... however, it is subject to change based on business needs.** The RN Case Manager is responsible for telephonically assessing, planning, implementing, and coordinating… more
- Trinity Health (Silvis, IL)
- …As One! (http://www.genesishealth.com/) Join the MercyOne Family! We are looking to hire a Registered Nurse ! A dedicated Charge Nurse is a registered ... compliance with staffing plan. + Oversees daily operations, staff management , and coordination of interdepartmental activities within the unit...+ Bachelor of Science in Nursing (BSN) preferred + Registered Nurse in Illinois, Registered … more
- Prime Healthcare (Evanston, IL)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/227652/nursing-manager registered - nurse - rn ... IL 60201 Responsibilities + 24-hour administrative responsibility for the management of all nursing service functions in assigned units....have a current and valid state license as a Registered Nurse . 2. BLS upon hire and… more
- AdventHealth (Glendale Heights, IL)
- …+ EKG (based on patient population; see document EKG and Advanced Life Support Requirements) + Registered Nurse ( RN ) Required + Basic Life Support - CPR Cert ... **Location:** 701 WINTHROP AVE, Glendale Heights, 60139 **The role you'll contribute:** The Registered Professional Nurse ( RN ) is responsible for providing… more
- Select Medical (Chicago, IL)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,...**Current licensure in a clinical discipline either as a Nurse ( RN /LPN/ LVN)or a Respiratory Therapist… more
- Fresenius Medical Center (Urbana, IL)
- **PURPOSE AND SCOPE:** The Inpatient Services Charge Nurse is an additional "responsibility" assigned to the Inpatient Services RN , for a limited period of time, ... duties, as assigned by the Program Manager. The Inpatient Services Charge Nurse ensures appropriate provision of Acute Dialysis Services and treatments within… more
- Fresenius Medical Center (Decatur, IL)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Fresenius Medical Center (Chicago, IL)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... of education and experience. + Graduate of an accredited School of Nursing ( RN ). + Current appropriate state licensure. **EXPERIENCE AND SKILLS:** + Required: + 6+… more
- BJC HealthCare (Belleville, IL)
- …labor & delivery, nursery, medical and surgical services plus critical care. Care Management includes Utilization Management ( Utilization Review), ... to identify and resolve issues. Performs and provides consultation regarding Utilization Management and Performance Improvement programs in order to… more
- BJC HealthCare (Alton, IL)
- …to identify and resolve issues. Performs and provides consultation regarding Utilization Management and Performance Improvement programs in order to ... at this time **Additional Preferred Requirements** + At least 5 years of hospital-based RN experience + Prior Case Management experience + Proficient in EPIC… more
- Veterans Affairs, Veterans Health Administration (Hines, IL)
- …and other formats to build nursing knowledge. Responsibilities The function of the Registered Nurse Evidence Base Practice Coordinator (EBPC) is to serve as ... the context for problem identification, and action by the utilization of EBP. (a) Leading and organizing delivery of...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Carle Health (Champaign, IL)
- …miles) for nurses with 1 or more years experience - External Applicants Only** Hybrid Option The Registered Nurse ( RN ) who serves in the role of System Case ... are pivotal to the success of the incumbent. Qualifications **License/Certifications:** Licensed Registered Professional Nurse ( RN ) - Illinois Department of… more
- Highmark Health (Springfield, IL)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... in addressing targeted populations **LICENSES or CERTIFICATIONS** **Required** + RN license in PA or WV or DE or...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more