- 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
- 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