- CVS Health (Springfield, IL)
- …all with heart, each and every day. **Position Summary** This is a fully remote Quality Management Nurse Consultant opportunity. The schedule is Monday ... all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit… more
- CVS Health (Springfield, IL)
- …required + Must reside in Illinois + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN licensure in state of residence. + ... 5:00pm in time zone of residence **Preferred Qualifications** + Utilization Management review + Managed Care experience + Client processing experience **Education**… more
- CVS Health (Springfield, IL)
- …we do it all with heart, each and every day. **Position Summary** _Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and ... other products, services and/or programs. + Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization. + Consults and… more
- CVS Health (Springfield, IL)
- …external constituents in the coordination and administration of the utilization/benefit management function. Required Qualifications + Registered Nurse in state ... compassionate. And we do it all with heart, each and every day. _Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and… more
- Prime Therapeutics (Springfield, IL)
- …education and/or relevant work experience + 5 years of work experience in case management or professional practice + Current Registered Nurse (RN) license in ... passion and drives every decision we make. **Job Posting Title** SIU Clinical Consultant **Job Description** The SIU Clinical Consultant is responsible for… more
- Highmark Health (Springfield, IL)
- …of clinical, quality , care, utilization, high-cost claim, and population health management . Must be a recognized subject matter expert (SME). + Clinical Program ... in Business or Clinical field **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse (RN) or Pharmacist (Pharm D) or Physician Assistant (PA) **Preferred** +… more
- CVS Health (Springfield, IL)
- …do it all with heart, each and every day. This Case Manager, Registered Nurse position is a field-based position with <10% travel. Candidates from Illinois are ... welcome to apply, requirement is for candidates to hold a Registered Nurse (RN) License in Illinois. **Position** **Summary** Help us elevate our patient care to a… more
- CVS Health (Springfield, IL)
- …health needs through communication and available resources to promote quality , cost effective outcomes. Additional responsibilities include but not limited ... healthcare personnel as appropriate. - Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients… more
- CVS Health (Springfield, IL)
- …members. Community Care is a member centric, team-delivered, community-based care management model that joins members where they are. With compassionate attention ... work. Services and strategies, policies and programs are comprised of network management , clinical coverage, and policies. Community Care Case Manager use a… more
- CVS Health (Springfield, IL)
- …placement into custodial care. Responsible for implementing and coordinating all case management , psychosocial, and quality of life activities relating to cases ... caring health care professionals drives the delivery of high quality , cost effective products and services. They make it...across the continuum of care including consultant referrals, home care visits, use of community resources… more
- Lincoln Financial (Springfield, IL)
- …you will be responsible for leading and managing a team of nurse disability consultants and behavioral health consultants. This includes partnering closely with ... medical and vocational operations and serve as a consultant to the claim operations team for complex clinical...area(s) of responsibility, assesses the impact, and collaborates with management to incorporate new trends and developments in current… more