• Utilization Review Nurse

    US Tech Solutions (Chicago, IL)
    …+ Do you have experience with Prior Authorization? + Do you have experience with Utilization Review ? + Do you have an Active Registered Nurse License? ... 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior...and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review . + MUST HAVE 1… more
    US Tech Solutions (07/18/25)
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  • Utilization Management Nurse

    CVS Health (Springfield, IL)
    …UM ( utilization management) experience within an **outpatient** setting, concurrent review or prior authorization. + 5 years of a variety clinical experience ... a high-volume clinical call center environment. + 1 year of varied UM ( utilization management) experience within an inpatient, concurrent review or prior… more
    CVS Health (07/30/25)
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  • Utilization Management Nurse

    CenterWell (Springfield, IL)
    …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work… more
    CenterWell (08/08/25)
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  • Utilization Management Nurse

    CenterWell (Springfield, IL)
    …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to… more
    CenterWell (08/02/25)
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  • Utilization Review Intake RN…

    AdventHealth (Glendale Heights, IL)
    …reviews within 24 hours of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines, on a continuing basis. + ... 60139 **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is...to the Physician Advisor or designated leader for additional review as determined by department standards. Additionally, the UM… more
    AdventHealth (08/07/25)
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  • Clinical Review Nurse - Concurrent…

    Centene Corporation (Springfield, IL)
    …discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in ... health management systems according to utilization management policies and guidelines + Works with healthcare...or provide recommendations based on requested services and concurrent review findings + Assists with providing education to providers… more
    Centene Corporation (08/08/25)
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  • Nurse Care Manager 1

    Rush University Medical Center (Chicago, IL)
    …Offers may vary depending on the circumstances of each case. **Summary:** The Nurse Care Manager 1 works with physician practices and inpatient teams to promote ... the effective utilization of services and coordination of care for adult,...for adult, geriatric, neonate, pediatric and adolescent patients. The Nurse Care Manager 1 contributes to the team's effectiveness… more
    Rush University Medical Center (07/03/25)
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  • Registered Nurse Acute Care 58-2

    Veterans Affairs, Veterans Health Administration (Danville, IL)
    …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... of nursing education/orientation/competencies and providing quality improvement and outcomes utilization consultation. * Other duties as assigned. VA offers a… more
    Veterans Affairs, Veterans Health Administration (08/03/25)
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  • Associate Nurse Manager (RN)

    Blessing Hospital (Quincy, IL)
    …and procedures + I CARE standards of behavior + Collaborates with the nurse manager in budget development, utilization , evaluation, and adjustment + Maintenance ... FROM BLESSING HEALTH SYSTEM COMPETITIVE BENEFITS Click here (https://www.blessinghealth.org/benefits) to review our complete Total Rewards Guide. + 403b + matching +… more
    Blessing Hospital (07/20/25)
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  • Associate Nurse Manager (RN)

    Blessing Hospital (Quincy, IL)
    …and procedures + I CARE standards of behavior + Collaborates with the nurse manager in budget development, utilization , evaluation, and adjustment + Maintenance ... BASED ON RELEVANT EXPERIENCE COMPETITIVE BENEFITS Click here (https://www.blessinghealth.org/benefits) to review our complete Total Rewards Guide. + 403b + matching… more
    Blessing Hospital (07/19/25)
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