- CVS Health (Springfield, IL)
- …strategic initiatives, along with a team of medical coders/nurses supporting Aetna 's Special Investigations Unit. Key Responsibilities: + Leadership: Leads a team ... of coding/ nursing professionals who conduct reviews of medical records and...prioritization. + Quality Control and Compliance: Maintains oversight of coder/ nurse reviews, ensuring compliance with ICD-10, CPT and HCPCS… more
- CVS Health (Norridge, IL)
- …all with heart, each and every day. **Position Summary** This Case Manager Registered Nurse position is with Aetna 's Long-Term Services and Supports (LTSS) team ... requirements is for candidates to hold a IL Registered Nurse License, and travel 50-75% of the time to...Microsoft Office Suites experience **Education** - Associates Degree in Nursing Required - Bachelors Degree in Nursing … more
- CVS Health (Eureka, IL)
- …all with heart, each and every day. **Position Summary** This Case Manager Registered Nurse position is with Aetna 's Long-Term Services and Supports (LTSS) team ... requirements is for candidates to hold an Illinois Registered Nurse License, and travel 50-75% of the time to...- Associates Degree required - Bachelor's in Science & Nursing preferred **Anticipated Weekly Hours** 40 **Time Type** Full… more
- CVS Health (Milan, IL)
- …all with heart, each and every day. **Position Summary** This Case Manager Registered Nurse position is with Aetna 's Long-Term Services and Supports (LTSS) team ... the Rock Island County IL. The requirements is for candidates to have a IL Registered Nurse Licensee and travel 50-75% of the time to meet with members face to face.… more
- CVS Health (Bartonville, IL)
- …And we do it all with heart, each and every day. This Case Manager Registered Nurse position is with Aetna 's Long-Term Services and Supports (LTSS) team and is a ... IL or Surrounding Areas. The requirements is for candidates to hold an IL Registered Nurse License, and travel 50-75% of the time to meet with members face to face.… more
- US Tech Solutions (Chicago, IL)
- …required to contact the providers of record, vendors, or internal Aetna departments to obtain additional information. + Evaluates documentation/information to ... 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior...Utilization Review? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** US Tech Solutions… more
- CVS Health (Springfield, IL)
- …plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. + Applies clinical judgment to the incorporation of ... (CCM) certification + Experience with ATV/ASD **Education** + Associates Degree in Nursing required + BSN preferred **Anticipated Weekly Hours** 40 **Time Type**… more
- CVS Health (Springfield, IL)
- …eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. -Applies clinical judgment to the incorporation of ... Case Manager (CCM) certification -Experience with ATV/ASD **Education** Associates Degree Nursing minimum BSN preferred **Anticipated Weekly Hours** 40 **Time Type**… more
- CVS Health (Springfield, IL)
- …system applications. Contacts the provider of record, vendors, or internal Aetna departments to obtain additional information Accurately applies review requirements ... to assure case is reviewed by a practitioner with clinical expertise for the appeal issue at hand (eg Specialty Match Review (SMR), RN, MD, etc.). Commands a comprehensive knowledge of complex delegation arrangements, coding logic, contracts (member and… more
- CVS Health (Arlington Heights, IL)
- …channels. + Build and maintain positive working relationships with the Aetna members, providers, nurse case managers, agency representatives, supervisors ... through outreach and education. By providing these services, CHW's help Aetna members attain and maintain better health outcomes, improve relationships with… more