- Humana (Springfield, IL)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
- Humana (Springfield, IL)
- …guidelines/procedures. **Use your skills to make an impact** **Required Qualifications** + Active Licensed Registered Nurse ( RN ) in the state of Virginia or ... licensure + Previous Medicare/Medicaid experience a plus + Previous experience in utilization management , case management , discharge planning and/or home… more
- CVS Health (Springfield, IL)
- …Configures the case management system to organize cases dealing with disease management and utilization review ; tracks patient progress and manages ... providers. Serves as advocate for patients, ensuring effective communication, resource utilization , and continuous monitoring of their progress to promote positive… more
- Humana (Springfield, IL)
- …of our caring community and help us put health first** The Manager, Utilization Management Behavioral Health utilizes behavioral health knowledge and skills to ... of medical services and/or benefit administration determinations. The Manager, Utilization Management Behavioral Health works within specific guidelines… more
- CVS Health (Springfield, IL)
- …Word, Excel, etc.) **Preferred Qualifications** -Crisis intervention skills preferred -Managed care/ utilization review experience preferred -Case management ... and coordination of psychosocial wraparound services to promote effective utilization resources and optimal, cost-effective outcomes. Assessment of Members: -Through… more
- Sedgwick (Springfield, IL)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer RN Medicare Compliance **We are growing and looking for nurses who have their ... clinical data; to complete complex submissions revisions/updates in preparation for Medicare review and act as an internal resource regarding Centers for Medicare &… more