- CVS Health (Springfield, IL)
- …that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. **Key ... listening, and use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed,… more
- 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 (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 (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 (Springfield, IL)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Utilizes clinical experience and skills in a… more
- CVS Health (Springfield, IL)
- …and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years of ... it all with heart, each and every day. _Utilization Management is a 24/7 operation and work schedule may...to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal… more
- 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 (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 (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
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