• Utilization Review RN

    AdventHealth (Glendale Heights, IL)
    …+ Behavioral Health RN experience strongly preferred + Experience in utilization review strongly preferred + Registered Nurse credentialed from ... health care services regarding admissions, case management, discharge planning and utilization review for Behavioral Health **The value you'll bring to… more
    AdventHealth (01/22/25)
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  • Utilization Management Behavioral

    Humana (Springfield, IL)
    …Family Therapist **(LMFT)** , Licensed Professional Counselor **(LPC)** , Psychologist **(PhD)** , Registered Nurse **( RN )** or other professional license. + ... customers and stakeholders. **Preferred Qualifications** + Experience with utilization review process. + Experience with behavioral change, health promotion,… more
    Humana (11/13/24)
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  • Care Manager Behavioral Health - Part Time…

    Highmark Health (Springfield, IL)
    …+ Licensed Marriage and Family Therapist (LMFT) + Licensed Behavior Specialist + Registered Nurse . **Preferred** + None **SKILLS** + Working knowledge of ... Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health care… more
    Highmark Health (12/12/24)
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  • Clinical Case Manager RN

    CVS Health (Springfield, IL)
    …accreditation guidelines and company policies and procedures. **Required Qualifications :** - Registered Nurse with an unrestricted current licensure in the ... thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider...Illinois - 3+ years of clinical experience as a Registered Nurse - 2+ Case Management experience… more
    CVS Health (12/05/24)
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  • Care Manager RN - Weekends (Remote)

    Highmark Health (Springfield, IL)
    …Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care ... services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management, and… more
    Highmark Health (01/07/25)
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  • Chief Health Services Officer - Aetna Better…

    CVS Health (Springfield, IL)
    …development, modeling inclusive behaviors, and proactively managing bias **Preferred Qualifications** + Registered Nurse , preferably in the state of IL + ... plan's subject matter expert in medical management operations, including Utilization Management, Care Management, Care program development and implementation, Social… more
    CVS Health (01/09/25)
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