Current jobs related to Clinical Review Nurse Consultant - Springfield, Illinois - CVS Health
-
Clinical Utilization Review Specialist
4 weeks ago
Springfield, Illinois, United States Trinity Health Full timeJob Summary:Trinity Health is seeking a skilled Registered Nurse to fill the role of Clinical Utilization Review Specialist. This position will be responsible for performing utilization review with payers, assisting physicians with level of care determinations, and promoting improvements in work processes within the department, hospital, and community.Key...
-
Clinical Utilization Review Specialist
4 weeks ago
Springfield, Illinois, United States Trinity Health Full timeJob SummaryWe are seeking a skilled Registered Nurse to join our team as a Utilization Review Specialist. In this role, you will be responsible for performing utilization review with payers, assisting physicians with level of care determinations, and coordinating patient care to ensure optimal outcomes.Key ResponsibilitiesPerform utilization review and payer...
-
Clinical Nurse Consultant
3 weeks ago
Springfield, Illinois, United States ICU Medical Full timeAbout the Role:The Clinical Nurse Consultant will be part of a cross-functional team and will be responsible for providing training and consultation on ICU Medical\'s clinical products/software and clinical services programs.Key Responsibilities:Collaborate with internal and external teams to provide clinical expertise and support.Assess current state...
-
Nurse Reviewer II Position
4 weeks ago
Springfield, Illinois, United States Health Services Advisory Group Full timeNurse Reviewer II Job SummaryThis position is responsible for coordinating and conducting various review activities as defined by HSAG's contract with the State of Hawaii, Department of Human Services MedQUEST Division (DHS/MQD).The Nurse Reviewer II will use professional judgment to apply established screening criteria to conduct long-term care level of...
-
Clinical Nurse Consultant
4 weeks ago
Springfield, Illinois, United States CVS Health Full timeJob SummaryCVS Health is seeking a skilled Clinical Nurse Consultant to join our team. As a Utilization Management RN Specialist, you will play a critical role in assessing, planning, implementing, coordinating, monitoring, and evaluating options to facilitate appropriate healthcare services and benefits for members.Key Responsibilities* Utilize clinical...
-
Clinical Nurse Consultant
4 weeks ago
Springfield, Illinois, United States ICU Medical Full timeJob Summary:The Clinical Nurse Consultant at ICU Medical provides expert training and consultation on clinical products and services. This role involves collaboration with cross-functional teams to deliver high-quality results.Key Responsibilities: Lead clinical nursing initiatives and collaborate with internal and external teams Assess and improve clinical...
-
Clinical Nurse Consultant
4 weeks ago
Springfield, Illinois, United States ICU Medical Full timeJob Summary:The Clinical Nurse Consultant at ICU Medical provides expert training and consultation on our clinical products and services. This role involves working with a cross-functional team to deliver high-quality solutions to our customers.Key Responsibilities: Participate in the development and implementation of clinical training programs Collaborate...
-
Urology Physician Clinical Reviewer
4 weeks ago
Springfield, Illinois, United States Evolent Health Full timeTransforming Healthcare TogetherEvolent Health partners with health plans and providers to deliver better health outcomes for individuals with complex and costly health conditions. As a key member of our utilization management team, you will play a vital role in ensuring patients receive the same level of care and compassion we would want for our loved...
-
Medical Review Officer
4 weeks ago
Springfield, Illinois, United States QTC Company Full timeJob SummaryWe are seeking a highly skilled Medical Review Officer to join our team at QTC Company. As a Medical Review Officer, you will be responsible for providing clinical leadership and expertise in the review of medical examination results.The selected candidate will have a strong clinical background, with a minimum of five years of out-patient clinical...
-
Nursing Consultant
4 weeks ago
Springfield, Illinois, United States SIU Medicine Full timeJob Title: Nursing ConsultantSIU Medicine is seeking a skilled Nursing Consultant to join our team. As a key member of our Ambulatory Clinic, you will provide high-quality patient care and support our healthcare professionals in delivering exceptional patient outcomes.Key Responsibilities:Provide primary support for the Division of Gastroenterology care...
-
Nurse Consultant
4 weeks ago
Springfield, Illinois, United States Inova Full timeInova Fair Oaks Hospital seeks a full-time Inpatient Lactation Consultant RN to join our team. Current IBCLC certification is strongly preferred.This is a part-time position with day and evening hours, 24 hours/week.Inova Fair Oaks Hospital is a top-ranked 182-bed acute care community hospital, delivering around 3,200 newborns per year, that serves the...
-
Occupational Therapist
4 weeks ago
Springfield, Illinois, United States Amazing Staffing Consultant Full timeJob DescriptionAt Amazing Staffing Consultant, we are seeking a skilled Occupational Therapist to join our team. As an Occupational Therapist, you will play a vital role in helping patients achieve independence and improve their physical and cognitive functioning.Key ResponsibilitiesConduct thorough assessments of patient functioning levels and develop...
-
Clinical Utilization Management Specialist
4 weeks ago
Springfield, Illinois, United States CVS Health Full timeJob SummaryCVS Health is seeking a skilled Clinical Utilization Management Specialist to join our team. As a Utilization Management Nurse Consultant, you will play a critical role in coordinating and documenting all aspects of the utilization/benefit management program.You will utilize your clinical expertise to ensure members receive the appropriate care at...
-
Healthcare Consultant
4 weeks ago
Springfield, Illinois, United States Walker Healthforce Full timeJob Title: Healthcare ConsultantJob Summary:Walker Healthforce is a leading healthcare consulting firm that provides end-to-end healthcare IT and clinical solutions to hospitals, health systems, and payer organizations. As a certified WMBE, we deliver precision, expertise, and integrity in the healthcare consulting community.Responsibilities:- Provide...
-
Neonatal Nurse Practitioner
4 weeks ago
Springfield, Illinois, United States SIU Medicine Full timeJob SummaryWe are seeking a highly skilled Neonatal Nurse Practitioner to join our team at SIU Medicine. The successful candidate will possess strong clinical expertise and a passion for teaching and consultation.Key ResponsibilitiesProvide high-quality patient care in a busy level III NICU and several level II special care nurseries.Develop and maintain a...
-
Clinical Therapist
2 weeks ago
Springfield, Illinois, United States PGS NH Care Full timeJob Title: Clinical TherapistWe are seeking a skilled Clinical Therapist to provide psychotherapy services at our partner facilities. This role offers a meaningful and flexible work environment where you can make a significant impact on the lives of seniors in our community.Responsibilities:Provide individual and family counseling to clients in nursing...
-
Senior Consultant
4 weeks ago
Springfield, Illinois, United States ECS Full timeSenior Consultant Job DescriptionECS is seeking a highly skilled Senior Consultant to join our team in supporting the Veterans Health Administration's (VHA) Office of Healthcare Innovation and Learning (OHIL).This role provides client delivery services while leading client delivery of communications tasks, consistently demonstrating advanced general...
-
Clinical Travel Nurse Position Available
3 weeks ago
Springfield, Illinois, United States Planet Healthcare Full timePlanet Healthcare is seeking a clinical travel nurse to fill an Intermediate Care position.Job Description & RequirementsSpecialty: Intermediate CareDiscipline: RN36 hours per weekShift: 12 hours, nightsEmployment Type: TravelAbout Planet HealthcareWe deliver vital healthcare talent to clients worldwide.Planet Healthcare is a leading clinical staffing firm...
-
RN Clinical Director
4 weeks ago
Springfield, Illinois, United States Erickson Senior Living Full timeClinical Leadership OpportunityAt Erickson Senior Living, we are seeking a skilled RN Clinical Manager to join our team. As a key member of our clinical leadership team, you will be responsible for the assessment, coordination, implementation, and evaluation of safe and effective person-centered care in our 36-bed Long-term Care neighborhood. This role...
-
Neonatal Nurse Practitioner
4 weeks ago
Springfield, Illinois, United States Southern Illinois University School of Medicine Full timeJob SummaryWe are seeking a highly skilled Neonatal Nurse Practitioner to join our team at Southern Illinois University School of Medicine. The successful candidate will possess excellent clinical expertise, teaching, and consultation skills, with a strong commitment to delivering comprehensive, family-centered healthcare.Key ResponsibilitiesProvide direct...
Clinical Review Nurse Consultant
1 month ago
CVS Health is seeking a skilled Clinical Review Nurse Consultant to join our team. As a key member of our clinical review team, you will play a critical role in ensuring the quality and accuracy of our clinical information and documentation.
Key Responsibilities- Review and evaluate clinical information and documentation to ensure compliance with regulatory and accreditation requirements.
- Interpret data obtained from clinical records or systems and apply clinical decision-making to apply appropriate clinical criteria and policies.
- Independently coordinate clinical resolution with clinician/MD support as required.
- Act as a resource for customer service and claims processing areas.
- 5+ years of clinical experience required.
- 2+ years of experience as a Registered Nurse with current unrestricted state licensure in state of residence.
- Preferred qualifications include utilization management review, managed care experience, client processing experience, and education.
CVS Health offers a comprehensive benefits package, including medical, dental, and vision benefits, 401(k) retirement savings plan, and employee stock purchase plan. We also provide a fully-paid term life insurance plan, short-term and long-term disability benefits, and numerous well-being programs.
Join Our TeamCVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
