- CVS Health (Springfield, IL)
- …verbal and written Required Qualifications + 3+ years clinical experience as a Registered Nurse + 1+ year(s) of experience with Microsoft Office applications ... and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with… more
- Humana (Springfield, IL)
- **Become a part of our caring community and help us put health first** The Compliance Utilization Management Nurse 2 reviews utilization management ... rotating schedule. (about 2 holidays per year) The Compliance Utilization Management Nurse 2 ensures...make an impact** **Required Qualifications** + Active unrestricted Licensed Registered Nurse , (RN), in your state of… 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Springfield, IL)
- …- 5+ years of clinical experience required - 2+ years of experience as a Registered Nurse - Must have active current and unrestricted RN licensure in state ... - 5:00pm in time zone of residence Preferred Qualifications - Utilization Management review - Managed Care experience - Client processing experience Education… more
- Humana (Springfield, IL)
- …projects. **Use your skills to make an impact** **Required Qualifications** + Licensed as a Registered Nurse in the State of Wisconsin or have a compact license. ... inpatient and subacute activity daily for outcomes related to readmission, utilization , quality of care and provider performance in compliance with Humana/iCare… more
- Marriott (Springfield, IL)
- …Information** Nurse CARE Manager (CARE - Coordinated Action and Response) Registered Nurse license required **Job Number** 24069165 **Job Category** Finance ... Claims Services + Collaborate with Claims department regarding case management . + Collaborate with UNM on utilization ...informed **Education or Certification** + Must be a licensed registered nurse + Certification as an occupational… more
- Evolent Health (Springfield, IL)
- …Be Doing:** As an Initial Clinical Reviewer, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... reviewers are supported by Physician clinical review staff (MDs) in the utilization management determination process. + Reviews charts and analyzes clinical… more