- Evolent (Springfield, IL)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals.… more
- Humana (Springfield, IL)
- …teams to alignment. + Demonstrated business and financial acumen. **Preferred Qualifications** + Registered Nurse (RN). + Five (5) or more years' experience in ... to improve clinical outcomes including but not limited to ER utilization , follow up after hospitalizations and preventive screenings. **Use your skills to make… more
- CVS Health (Springfield, IL)
- …progress toward desired outcomes through assessment and evaluation. **Required Qualifications** + Active Registered Nurse IL /Compact License + Minimum 3+ years ... in serving our members by utilizing best-in-class operating and clinical models. You can have life-changing impact on our...experience, transitions of care and discharge planning required + Registered Nurse with active state license in… more
- Highmark Health (Springfield, IL)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more