- Cognizant (Springfield, IL)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... 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
- 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 ... Communities is good for the Soul. Join Us!** The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state)… more
- CVS Health (Springfield, IL)
- …non-compact states as needed. + 5+ years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + 3+ year(s) of Appeals ... of utilization management services for assigned area + Implements clinical policies & procedures in accordance with applicable regulatory and accreditation… more
- CVS Health (Springfield, IL)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
- Humana (Springfield, IL)
- …Therapist **(LMFT)** , Licensed Professional Counselor **(LPC)** , Psychologist **(PhD)** , Registered Nurse **(RN)** or other professional license. + Three (3) ... health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional who utilizes behavioral health knowledge and… more
- Lincoln Financial (Springfield, IL)
- …**What we're looking for** Education * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where ... 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… more
- CVS Health (Springfield, IL)
- …leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members, who are ... inpatient, skilled nursing, or rehabilitative stay. Under the direction of a Registered /Licensed RN, the TOC Coach ensures the member experiences a seamless… more
- CVS Health (Springfield, IL)
- …with diverse cultural dynamics of clinical staff and patients. - Registered Nurse (RN) required. **Preferred Qualifications** - Master's degree in healthcare ... in research efforts, contributing to scholarly publications, and/or facilitating research utilization to improve clinical care and outcomes. - Provides… more
- Humana (Springfield, IL)
- …+ **Must reside in the state of Illinois** + An active, unrestricted, Registered Nurse **(RN)** license, Licensed Clinical Social Worker **(LCSW)** ... + Develop reporting tools in collaboration with leadership to identify clinical performance. + Interviews, hires, mentors, evaluates, coaches and manage performance… more