• Utilization Management Nurse

    CVS Health (Springfield, IL)
    …both verbal and written **Required Qualifications** + 2+ years of experience as a Registered Nurse in adult acute care/critical care setting. + Must have active ... current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and… more
    CVS Health (05/17/25)
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  • Utilization Review Nurse

    US Tech Solutions (Chicago, IL)
    …Do you have experience with Utilization Review? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** US Tech Solutions is a global ... + 3+ years of experience as an RN + Registered Nurse in state of residence +...and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1… more
    US Tech Solutions (04/18/25)
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  • Registered Nurse Case Manager

    Health Advocates Network (North Chicago, IL)
    Health Advocates Network is seeking a ** Registered Nurse Case Manager** to work at a facility in **North Chicago, IL.** This is a registry position with our ... / hour *W2 **RESPONSIBILITIES** + Develops and implements a comprehensive Utilization Management plan/program + Performs data/metrics collection on identified… more
    Health Advocates Network (05/13/25)
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  • Case Manager, Registered Nurse

    CVS Health (Springfield, IL)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse (RN) with at least 1...in **Oncology** **.** **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
    CVS Health (05/16/25)
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  • Registered Nurse , Case Manager…

    CVS Health (Springfield, IL)
    …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... reviews. **Required Qualifications** - 5+ years' experience as a Registered Nurse (RN) with at least 1...using a keyboard. **Preferred Qualifications** - 1+ years' Case Management experience or discharge planning, nurse navigator… more
    CVS Health (05/16/25)
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  • Clinical Registered Nurse - Remote

    Sharecare (Springfield, IL)
    …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting...disease management program intervention guidelines. A Clinical Registered Nurse is supervised by an Operations… more
    Sharecare (05/10/25)
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  • Registered Nurse - Operating Room…

    Trinity Health (Melrose Park, IL)
    …Part time **Shift:** Day Shift **Description:** The Surgery OR RN, a perioperative registered nurse , provides patient care for all patients, from infants through ... Robot experience also preferred **Licensure/Certifications** : + AHA BLS card + Current Registered Nurse License State of Illinois **Benefits and perks you need… more
    Trinity Health (03/20/25)
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  • RN Registered Nurse Care Manager…

    AdventHealth (Hinsdale, IL)
    …documents avoidable days, and facilitates progression of care. **.** Collaborates with Utilization Management staff for collaboration on patient status changes ... . BSN . Health-related Master's degree or MSN . Prior Care Management / Utilization Management experience **LICENSURE, CERTIFICATION OR REGISTRATION… more
    AdventHealth (05/16/25)
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  • Utilization Review Author

    R1 RCM (Chicago, IL)
    …testing, training, and other opportunities that promote growth. **Required Skills:** + Active Registered Nurse (RN) license in your state of residence, with ... you must have experience in a clinical inpatient environment and hospital-based utilization or case management experience. Proficiency in basic computer skills… more
    R1 RCM (05/20/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Springfield, IL)
    …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
    Fresenius Medical Center (05/08/25)
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