2mo
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Utilization Review RN
Springfield, Illinois, United States
$33-$53/hr OnsiteFull Time
3+ YOERN with 3-5 years in acute care/home health/case management; IL license; associate degree; utilization review exp preferred
1w
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Utilization Review Nurse
New Lenox, Illinois, United States
$35-$45/hr HybridFull Time
Current RN licensure, current CPR, knowledge of clinical norms, strong communication and critical thinking; experience in utilization review, case management or hospital nursing preferred.
2mo
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Utilization Review RN
Springfield, Illinois, United States
$33-$53/hr OnsiteFull Time
3+ YOEAssociates Degree in Nursing; Illinois RN license; 3-5 years acute care/home health/case management experience; experience with utilization review; continuing professional development.
iCIMS, EMR
1d
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Supervisor, Utilization Management
Phoenix or Alaska or Arkansas or Arizona or Colorado or Florida or Hawaii or Iowa or Idaho or Illinois or Kansas or Louisiana or Maryland or Minnesota or Missouri or Montana or Nebraska or Nevada or New Mexico or North Carolina or North Dakota or Oklahoma or Oregon or South Carolina or South Dakota or Tennessee or Texas or Utah or Virginia or District of Columbia or Washington or Wisconsin or Wyoming
$91k-$107k/yr RemoteFull Time
3+ YOE3+ MgmtCurrent RN license, 3+ years healthcare experience, 3+ years supervisory experience, 2+ years utilization review/case management, U.S. citizenship and favorable DoD background investigation required.
InterQual, ICD, DSM, CPT, HCPCS, American Dental codes, Microsoft Office, Microsoft Word, Microsoft Outlook, TriWest Intranet
3w
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Utilization Review Manager
Chicago, Illinois, United States
OnsiteFull Time
3+ YOEMaster's degree required, 3+ years utilization review/case management/clinical documentation experience, active LCSW or LCPC preferred, proficiency in EHR and Google Office Suite, strong knowledge of payer authorization and regulatory compliance.
EHR, Google Office Suite
3d
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DIR - UTILIZATION REVIEW / MGMT
Springfield, Illinois, United States
$38-$56/hr OnsiteFull Time
5+ YOEMaster's degree and RN license required; 8–10 years inpatient psychiatric or 5–7 years utilization management experience; knowledge of DSM-V, managed care payer practices, data trend analysis, team management, and medical necessity determinations.
1mo
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UTILIZATION REVIEW NURSE-ED (PT NIGHTS)
Kankakee, Illinois, United States
$41-$54/hr OnsitePart Time
3+ YOEActive Illinois RN license, Associates Degree in Nursing required, minimum 3 years ED clinical experience, proficiency with EHR and utilization review tools (InterQual/MCG), strong clinical assessment and communication skills.
EHR, InterQual, MCG
4w
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Utilization Management Specialist (Chicago, IL, US, 60624)
Chicago, Illinois, United States
$51k-$60k/yr HybridFull Time
1+ YOEBachelor's in counseling, nursing, or related; 1+ year utilization management experience in healthcare; strong proofreading and VDT skills; ability to travel to assigned sites; daytime, hybrid schedule.
3w
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Health - Network Performance / Utilization Manager
Chicago, Illinois, United States
$80k-$294k/yr FieldFull Time
5+ YOEMinimum 5 years in network strategy/utilization analytics or healthcare market analysis; 2 years assessing providers in Medicaid- or financially stressed environments; 2 years converting claims/encounter/provider/market data into recommendations; Bachelor's degree.
Workday
5d
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Utilization Reviewer-Full Time On-Site
DeKalb, Illinois, United States
$37-$52/hr OnsiteFull Time
2+ YOEMaster's in Social Work or Psychology or BSN with RN license; 2+ years experience; knowledge of IM+CANS/IATP, documentation standards, grant and regulatory compliance.
EPIC
1mo
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ABA Utilization Review (UR) Specialist
Skokie, Illinois, United States
HybridFull Time
3+ YOE3+ years ABA/behavioral health experience preferred, superior communication, attention to detail, insurance/benefits knowledge, strong computer skills (Word, Excel), ability to obtain authorizations and document cases.
Microsoft Word, Microsoft Excel
1mo
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Utilization Management Nurse Consultant
Michigan or Mississippi or Pennsylvania or North Carolina or Maryland or Minnesota or Nebraska or Missouri or Colorado or New York or New Jersey or Arizona or Connecticut or Texas or District of Columbia or Florida or Rhode Island or Iowa or Alaska or Arkansas or South Dakota or Idaho or Illinois or Kansas or Tennessee or Virginia or Delaware or Wisconsin or Georgia or West Virginia or Oregon or Oklahoma
$29-$62/hr RemoteFull Time
3+ YOEActive unrestricted RN license in state of residence, 3+ years Med-Surg RN hospital experience, Associates in Nursing required (BSN preferred), 1+ year Microsoft Office (Outlook, Teams, Excel) experience, ability to work multiple IT platforms.
Microsoft Outlook, Microsoft Teams, Microsoft Excel
1w
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Utilization Management and Population Health Nurse
Chicago, Illinois, United States
OnsiteFull Time
Active RN licensure and bachelor\u0002s degree required; must meet health-plan licensure/certification requirements. Skills in care coordination, utilization review, patient outreach, education, and quality improvement.
2mo
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Behavioral Health Utilization Review Registered Nurse
Rockford, Illinois, United States
$57k-$62k/yr RemoteFull Time
3+ YOERN with active license; 3+ years acute clinical practice; mental health/substance abuse experience; UR nurse orientation; managed care or workers compensation helpful.
2mo
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RN Utilization Review Case Manager
Granite City, Illinois, United States
$32-$48/hr OnsiteFull Time
5+ YOERN with at least 5 years' acute care or community health experience; licensed nurse; full-time with benefits; hourly pay.
1w
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Utilization Management Behavioral Health Professional
Kentucky or Ohio or West Virginia or Virginia or Indiana or Illinois or Tennessee or Missouri
$65k-$89k/yr RemoteFull Time
3+ YOEMust reside in KY or contiguous counties, Bachelor's in nursing or Master's in Human Services plus professional license, 3+ years clinical experience, intermediate Microsoft Office skills.
Microsoft Teams, Microsoft Excel, Microsoft PowerPoint, Microsoft Outlook, Microsoft Word
2w
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Utilization Review & Quality Assurance Specialist (32449)
Rockford, Illinois, United States
$45-$52/hr RemoteFull Time
Active registered nurse license required; strong clinical knowledge, medical terminology, group health/criteria familiarity; proficiency with Microsoft Office and Outlook; ability to perform quality reviews, follow procedures, and work independently.
Microsoft Office, Microsoft Outlook
2w
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Utilization Review & Quality Assurance Specialist (32449)
Rockford, Illinois, United States
$45-$52/hr RemoteFull Time
Must hold and maintain an active RN license; strong clinical knowledge of group health/criteria sets, medical terminology, and quality standards; proficient with Microsoft Office and Outlook; ability to work independently and maintain confidentiality.
Microsoft Office Suite, Outlook
2w
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Area Manager- Effingham IL
Shumway, Illinois, United States
OnsiteFull Time
3+ YOESupervisory experience in utility locate operations, HS diploma, valid driver license, clean background, computer literate, 3+ years experience, strong communication and investigation skills.
2w
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Utilization Management Registered Nurse (RN) - Remote
Chicago, Illinois, United States
$70k-$75k/yr RemoteFull Time
3+ YOEActive Illinois RN license, 3+ years healthcare experience, knowledge of utilization review/managed care, Microsoft 365 skills, strong clinical judgment and communication, ability to meet CE requirements.
Microsoft 365, Microsoft Word, Microsoft Excel, Microsoft PowerPoint
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