• Utilization Management Nurse

    CVS Health (Springfield, IL)
    …of time, talking on the telephone, and typing on the computer. The UM Nurse Consultant utilizes clinical skills to coordinate, document and communicate all ... aspects of the utilization /benefit management program. Applies critical thinking and knowledge in clinically appropriate treatment, evidence-based care and… more
    CVS Health (07/22/25)
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  • Utilization Management 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 ... from work._ **Required Qualifications** + 1 year of varied UM ( utilization management ) experience within an **outpatient** setting, concurrent review… more
    CVS Health (07/30/25)
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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 CST zones **Education** +… more
    CVS Health (07/30/25)
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  • Utilization Management Nurse

    CVS Health (Springfield, IL)
    …procedures/services or initiate a Medical Director referral as needed. Assists management with training new nurse reviewers/business partners or vendors ... meet quality and metric expectations. **Required Qualifications** + Registered Nurse (RN) - active license. + 3+ Years of...3+ Years of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management more
    CVS Health (07/31/25)
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  • Utilization Management Clinical…

    CVS Health (Springfield, IL)
    …clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
    CVS Health (07/31/25)
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  • QM Nurse Consultant

    CVS Health (Springfield, IL)
    …Friday 8:00am - 5:00pm in time zone of residence_** **Preferred Qualifications** - Utilization Management review - Managed Care experience - Client processing ... years of clinical experience required - 2+ years of experience as a Registered Nurse - Must have active current and unrestricted RN licensure in state of residence… more
    CVS Health (07/30/25)
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