- CVS Health (Springfield, IL)
- …all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** utilizes ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
- CVS Health (Springfield, IL)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- CVS Health (Springfield, IL)
- …(UM) Nurse Consultant . As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, document and communicate all ... clinical records. **Key Responsibilities of the UM Nurse Consultant ** (Includes but is not limited to) + Reviews...practice experience as an RN required. + 2+ Years Utilization Management experience. + Must be willing… more
- CVS Health (Springfield, IL)
- …time is spent at a desk and on the phone collecting and reviewing clinical information from providers. Utilization Management nurses use specific criteria ... paced environment NICU experience 3+ years **Preferred Qualifications** Previous Utilization Management experience Spine Experience **Education** Associates… more
- CVS Health (Springfield, IL)
- …in research efforts, contributing to scholarly publications, and/or facilitating research utilization to improve clinical care and outcomes. - Provides ... all with heart, each and every day. **Position Summary** Applies specialized clinical and industry knowledge and performance improvement best practices to quality… more
- CVS Health (Springfield, IL)
- …in research efforts, contributing to scholarly publications, and/or facilitating research utilization to improve clinical care and outcomes. - Provides ... all with heart, each and every day. **Position Summary** Applies specialized clinical and industry knowledge and performance improvement best practices to quality… more
- Highmark Health (Springfield, IL)
- …**Job Description :** **JOB SUMMARY** Dynamic and results-oriented Pharmacy Benefit Consultant , serving as the client-facing expert, driving growth and retention of ... Consultation: Provide in-depth pharmacy benefit expertise, offering strategic guidance, clinical recommendations, and solutions tailored to individual client needs.… more
- Veterans Affairs, Veterans Health Administration (Chicago, IL)
- …therapy and as a consultant for intensive medication therapy management services. Responsibilities FUNCTIONS: Clinical - Direct Patient Care Activities ... who functions to initiate, modify or discontinue medication therapy and as a consultant for intensive medication therapy management services. This includes, but… more
- ChenMed (Berwyn, IL)
- …to ensure compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as required that ... for outcomes: The PCP demonstrates accountability for outcomes, strong clinical care, and cost-effectiveness for each patient in their...acts as a health coach, rather than just a consultant for sickness, by helping patients set short and… more
- CVS Health (Springfield, IL)
- …understand trends, and provide clients with recommendations on formulary and utilization management strategies. You will establish relationships both internally ... our custom formulary clients. CFC consultants leverage financial and clinical acumen to assist clients with custom formulary decisions....and externally, and articulate potential management strategies with a deep understanding of the rebate… more