- Humana (Springfield, IL)
- …professional onsite, field, or remote based opportunities. The Prior Authorization, Registered Nurse , RN, Intern will utilize Humana's Medicaid training and ... the goal to put health first? The Prior Authorization, Registered Nurse , RN, Intern will review prior...to complete medical necessity reviews for requested services using clinical judgment and refers to internal stakeholders for review… more
- Lincoln Financial Group (Springfield, IL)
- …as indicated **What we're looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where the ... Carolina); Omaha, NE (Nebraska); Work from Home **Work Arrangement:** Remote : Work at home employee residing outside of...We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization.… more
- Centene Corporation (Springfield, IL)
- …and standards **Education/Experience:** Graduate from an Accredited School of Nursing ( Registered Nurse ), required Bachelor's Degree Bachelor's degree in social ... to 10%) statewide/overnight travel to provider offices for Illinois-based Registered Nurses (RN) or Licensed Clinical Social...alcohol and or substance use disorders. preferred RN - Registered Nurse - State Licensure and/or Compact… more
- CVS Health (Springfield, IL)
- …development, modeling inclusive behaviors, and proactively managing bias **Preferred Qualifications** + Registered Nurse , preferably in the state of IL + ... healthcare to our members. ** This position is fully remote . Eligible candidates can live anywhere in the US,...RFP activity. + Leading and partnering with the COO clinical program vendor implementations and maintaining an oversight relationship… more
- Sharecare (Springfield, IL)
- …within a matrix organizational design. **Qualifications:** + Current multi-state compact Registered Nurse licensure in state of residence is required, ... + Actively participate in team huddles and contribute to clinical learning. + Remain current on clinical ...to clinical learning. + Remain current on clinical knowledge via self-directed learning. **Specific Skills/ Attributes:** +… more
- Highmark Health (Springfield, IL)
- …+ Bachelor's degree in Nursing **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Case Manager (CCM) **Language ... Group **Job Description :** **JOB SUMMARY** This job is responsible for analyzing clinical data to assess potential stop loss and managed care claim liability,… more
- WelbeHealth (Springfield, IL)
- …compliance with regulatory standards **Job Requirements:** + Bachelor's degree required + Registered Nurse (RN), master's degree, or other relevant advanced ... 100% REMOTE OPPORTUNITY At WelbeHealth, each participant of our...is guided by our interdisciplinary team (IDT), composed of clinical and non- clinical members who work cohesively… more
- Humana (Springfield, IL)
- … clinical experience in behavioral health **OR** an active, unrestricted Kentucky Registered Nurse **(RN)** license with at least three years of experience ... Virginia, or West Virginia.** + An active, unrestricted Licensed Masters Clinical Social Worker **(LCSW),** Licensed Professional Clinical Counselor **(LPCC)**… more
- Humana (Springfield, IL)
- …Therapist **(LMFT)** , Licensed Professional Counselor **(LPC)** , Psychologist **(PhD)** , Registered Nurse **(RN)** or other professional license. + Three (3) ... independent determination of the appropriate courses of action. + Utilizes clinical knowledge, communication skills, and independent critical thinking skills towards… more