- Humana (Springfield, IL)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Highmark Health (Springfield, IL)
- …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
- Sharecare (Springfield, IL)
- …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... and their Primary Care Provider according to the disease management program intervention guidelines. An RN is...orientation and to take the pre and posttests to review competency during orientation. Yearly competency test is required… more
- Highmark Health (Springfield, IL)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES:** + Implement care management review processes that are consistent with established… 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 ... + Case Management experience in the insurance industry + Compact RN licensure + Certified Case Manager + Telephonic Nursing experience + Home Health… more
- Humana (Springfield, IL)
- …Family Therapist **(LMFT)** , Licensed Professional Counselor **(LPC)** , Psychologist **(PhD)** , Registered Nurse **( RN )** or other professional license. + ... us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral health… more
- CVS Health (Springfield, IL)
- …current licensure in the state of Illinois - 3+ years of clinical experience as a Registered Nurse - 2+ Case Management experience - 1+ year of Discharge ... office-based meetings and/or trainings in Downers Grove IL as needed/requested by Management .** Preference for candidates residing in the Chicago, Cook County area. … more
- Guardian Life (Springfield, IL)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… more
- CVS Health (Springfield, IL)
- …functions, as well as be the health plan's subject matter expert in medical management operations, including Utilization Management , Care Management , ... development, modeling inclusive behaviors, and proactively managing bias **Preferred Qualifications** + Registered Nurse , preferably in the state of IL +… more