• Utilization Management Nurse

    Humana (Springfield, IL)
    …part of our caring community and help us put health first** The SNF Utilization Management Nurse uses clinical knowledge, communication skills, and ... receives guidance where needed. Follows established guidelines and procedures. The SNF Utilization Management Nurse uses clinical knowledge, communication… more
    Humana (06/05/25)
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  • Utilization Management Nurse

    CVS Health (Springfield, IL)
    …constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications + Registered Nurse in state of ... years of Nursing experience. Preferred Qualifications + Prior authorization utilization management /review experience preferred Outpatient Clinical experience. +… more
    CVS Health (06/01/25)
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  • Utilization Management Nurse

    CVS Health (Springfield, IL)
    …Must have active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include ... med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in EST and CST zones.… more
    CVS Health (06/07/25)
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  • Registered Nurse - Utilization

    Veterans Affairs, Veterans Health Administration (Hines, IL)
    Summary The Utilization Management (UM) Consultant is a registered professional nurse , qualified by education and experience to work directly with ... clerks, social services, administrative officers, Emergency Department (ED) staff, and Bed Management . The nurse is responsible for applying clinical skills in… more
    Veterans Affairs, Veterans Health Administration (06/07/25)
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  • Utilization Review Nurse

    R1 RCM (Chicago, IL)
    …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Nurse ** , you will help our hospital ... 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 (05/23/25)
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  • Utilization Review Nurse

    US Tech Solutions (Chicago, IL)
    …HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF UTILIZATION ... 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior...in state of residence + Must have prior authorization utilization experience + Experience with Medcompass **Skills:** + MUST… more
    US Tech Solutions (04/18/25)
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  • National Utilization Management

    Humana (Springfield, IL)
    …a part of our caring community and help us put health first** The Utilization Management (UM) Director, Clinical Strategy and Practice for Medicaid builds ... of how organization capabilities interrelate across the function or segment. The Utilization Management (UM) Director, Clinical Strategy and Practice for… more
    Humana (06/06/25)
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  • AVP, Utilization Review & Pharmacy

    Zurich NA (Springfield, IL)
    …+ Experience in development and implementation of cost containment programs + Case management , utilization review, catastrophic or disability experience + 5 or ... AVP, Utilization Review & Pharmacy 123092 Zurich Insurance is...recruiting and retaining team members. + Drive the performance management process by communicating job expectations, monitoring and evaluating… more
    Zurich NA (05/22/25)
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  • Nurse Care Manager 1

    Rush University Medical Center (Chicago, IL)
    …Unit: Rush Medical Center Hospital: Rush University Medical Center Department: Care Management **Work Type:** Full Time (Total FTE between 0.9 and 1.0) **Shift:** ... depending on the circumstances of each case. **Summary:** The Nurse Care Manager 1 works with physician practices and...physician practices and inpatient teams to promote the effective utilization of services and coordination of care for adult,… more
    Rush University Medical Center (04/03/25)
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  • Oncology Nurse Navigator 2 - Cancer Rehab…

    Rush University Medical Center (Chicago, IL)
    …Offers may vary depending on the circumstances of each case. **Summary:** The Oncology Nurse Navigator 2 is a registered nurse (RN) who works with physician ... practices and multi-disciplinary teams to promote the effective utilization of services and coordination of care for patients within the Cancer Center service line.… more
    Rush University Medical Center (05/29/25)
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