Utilization Review Coordinator Job at Illinois Department of Public Health (IDPH) (Chester)

Utilization Management Physician Reviewer

Full-time role responsible for provisioning accurate and timely coverage determi...

Location

United States , Remote

Salary:

174070.00 - 374920.00 USD / Year

CVS Health

Expiration Date

August 21, 2026

Requirements

At least one year experience providing Utilization Management services to a Medicare and/or Medicaid line of business
Excellent verbal and written communication skills
A current, clinical, unrestricted license to practice medicine in the United States
Graduate of an accredited medical school with M.D. or D.O. Degree
3-5 years of clinical practice in a primary care setting
Deep understanding of managed care, risk arrangements, capitation, peer review, performance profiling, outcome management, care coordination, and pharmacy management
Strong record of continuing education activities
Demonstrated understanding of culturally responsive care
Proven organizational and detail-orientation skills
US work authorization

Job Responsibility

Review service requests and document the rationale for the decision
Use evidence-based criteria and clinical reasoning to make UM determinations
Work collaboratively with the Oak Street Health Transitional Care and PCP care teams
Maintain knowledge of current CMS and MCG evidence-based guidelines
Maintain compliance with legal, regulatory and accreditation requirements
Participate in initiatives to achieve and improve UM imperatives
Assist in formal responses to health plan regarding UM process
Adhere to regulatory and accreditation requirements of payor partners
Participate in rounding and patient panel management discussions
Fulfill on-call requirement

What we offer

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
Wellness screenings
Tobacco cessation and weight management programs
Confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources

Fulltime

Behavioral Health Medical Director

The Behavioral Health (BH) Medical Director leverages clinical expertise to prov...

Location

United States

Salary:

189600.00 - 237000.00 USD / Year

Personify Health

Expiration Date

Until further notice

Requirements

MD or DO degree and 5+ years of direct clinical patient care experience post residency or fellowship including behavioral health environments
Current and ongoing Board Certification in psychiatry by the American Board of Psychiatry and Neurology (ABPN) required
Additional Board Certification in Child and Adolescent Psychiatry or Addiction Medicine
A current and unrestricted license in the state of California and willing to obtain additional license(s)
No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements
Minimum 5 years of Utilization Review or Hospital experience required
Minimum 3 years of compliance related experience preferred
Managed Care experience preferred in utilization review and case management
Expertise in behavioral health case management, utilization review and telehealth delivery
Ability to design and evaluate behavioral health programs, integrating evidence-based practices and holistic wellbeing approaches

Job Responsibility

Oversee and participate in behavioral health case management, including utilization review, telephonic care, and urgent response coordination for behavioral health and substance use disorder needs
Conduct reviews for medical necessity for prior authorization, continued stay, and post-service claims, applying medical policy, guidelines, and current research
Integrate behavioral health screening and interventions within physical health case management programs, utilizing standardized tools (e.g., PHQ2, PHQ9) and ensuring appropriate referrals
Support and monitor virtual behavioral health services, ensuring access, privacy, and continuity of care for all age groups, including children, teens, and adults
Supervise and provide clinical oversight for residential and outpatient behavioral health programs, including partial hospitalization and intensive outpatient services, with an emphasis on family engagement and comprehensive discharge planning
Lead the development and implementation of comprehensive behavioral health strategies, including program design, staff education, and quality improvement initiatives
Maintain compliance with national guidelines (e.g., MCG, InterQual, specialty college recommendations) and regulatory requirements (federal, state, ERISA) specific to behavioral health
Oversee the negotiation and implementation of cost management strategies to affect quality outcomes, reflecting data in monthly case management reviews
Participate in grievance and appeals processes, including escalated behavioral health issues
Collaborate with the VP of Care Management to establish work procedures and processes that support company and departmental standards, procedures, and strategic directives

What we offer

Comprehensive medical and dental coverage through our own health solutions
Mental health support and wellness programs designed by experts who get it
Flexible work arrangements that fit your life
Retirement planning support to help you build real wealth for the future
Basic Life and AD&D Insurance plus Short-Term and Long-Term Disability protection
Employee savings programs and voluntary benefits like Critical Illness and Hospital Indemnity coverage
Professional development opportunities and clear career progression paths
Mentorship from industry leaders who want to see you succeed
Learning budget to invest in skills that matter to your future
Unlimited PTO policy

Parttime

Associate Project Manager of Utility Coordination

As an Associate Project Manager within our Utility Coordination group, you will ...

Location

United States , Council Bluffs; Lincoln; Omaha

Salary:

Not provided

Olsson

Expiration Date

Until further notice

Requirements

Bachelor’s degree in engineering, construction management, or equivalent and/or related work experience
Proven experience in utility coordination or a similar role
Ability to manage multiple projects simultaneously while maintaining budgets and deadlines
Strong understanding of construction processes and utility infrastructure
Excellent client service orientation, communication, presentation, and negotiating skills
Solid interpersonal and decision-making skills and the ability to generate innovative and effective solutions to complex problems
Valid driver’s license and a good driving history
Ability to obtain E-Rail safe certification
Willingness to work a flexible schedule and travel as required
Ability to review, interpret, and understand technical plan sets and subsurface utility engineering (SUE) reports and findings

Job Responsibility

Lead and participate in a variety of project management activities that ensure the successful completion of project deliverables for complex and high-priority projects
Be embedded with an Olsson client and be directly responsible for managing utility coordination for assigned projects
Manage consultants that provide utility coordination support services to the client
Act as a liaison between our client’s utility coordination group and other project stakeholders
Participate in the reporting efforts related to project status, submittals, resolutions, and management all financial aspects related to assigned projects
Monitor progress and measure project performance, ensuring deliverable align with established scope, schedule, and budget
Coordinate with external subconsultants to complete all aspects of project deliverables
Develop and maintain professional relationships with a focus on exceptional client service to secure future work
Adhere to regulations and enforce safety standards

What we offer

Competitive 401(k) match
Tailored development paths
Possibility for flexible work arrangements
Wellness program promoting balanced lifestyles
Traditional benefits package (health care, vision, dental, paid time off, etc.)
Opportunity to participate in a bonus system that rewards performance

Fulltime

Utilization Management Assistant

Are you passionate about patient care and thrive in a fast-paced, professional e...

Location

United States , Dubuque

Salary:

Not provided

Cottingham & Butler

Expiration Date

Until further notice

Requirements

CNA, LPN, or Medical Assistant preferred
Background in patient health support or care
1+ years of experience within this field
Strong interpersonal skills
Friendly demeanor and understanding
Accuracy and attention to detail when reviewing pre-certifications and plans

Job Responsibility

Answers first level calls in Utilization Review for HealthCheck360 participants
Evaluate certification requests by reviewing the group specific requirements
Triage the call to determine if a Utilization Review Nurse is needed
Review medical records
Coordinate with healthcare providers
Ensure patients receive appropriate, cost-effective care in accordance with clinical guidelines and insurance requirements

What we offer

Medical, Dental, Vision Insurance
Flex Spending or HSA
401(k) with company match
Profit-Sharing/Defined Contribution (1-year waiting period)
PTO/Paid Holidays
Company-paid ST and LT Disability
Maternity Leave/Parental Leave
Subsidized Parking
Company-paid Term Life/Accidental Death Insurance

Fulltime

New

Technical Business Development Manager

The Technical Business Development Manager (BDM) is responsible for supporting t...

Location

United States , Waukesha; Pewaukee

Salary:

Not provided

Energy Systems

Expiration Date

Until further notice

Requirements

Bachelor’s degree in business, Marketing, Engineering or equivalent work Experience
5+ years of business development or other sales / account management experience
Previous experience establishing business to business relationships in a technically oriented industry
Prior account management experience, specifically, working within a territory and leading a region according to their organization’s growth metrics / expectations
Prior experience collaborating with cross-functional leadership teams
Prior experience managing / leading projects and tracking to timelines, costs and other key project measures
Ability to travel up to 60-70% initially with a reduction in required travel over time (down to ~25-35%)
Familiarity with utility meter technology and compliance standards
Knowledge of the residential electrical safety groups, standards and applicable requirements (e.g. NEC, UL, IAEI, IEEE, OSHA, etc.)

Job Responsibility

Partnering with electrical utilities
Building and maintaining relationships with key utilities and identifying lead contacts responsible for reviewing new products/technologies
Developing a documented library of review process/procedures for each respective utility and disseminating them to stakeholders
Preparing, entering and tracking the progress of review submissions
Working with Authority Having Jurisdictions (AHJ’s) and utility permitting process, ensuring NEC utility compliance
Coordinating technical reviews of products with internal Generac teams as and when required
Developing and maintaining project schedule for each submittal
Capturing, quantifying and assisting in prioritizing product updates/alterations that may be needed
Finalizing approvals and directing the involvement of cross-functional personnel within Energy Systems to meet performance objectives and customer expectations
Coordinating and leading the introduction of approved products with Product Management, Marketing and Sales teams

Fulltime

Director, System Care Coordination

Aspirus Health is seeking an experienced and strategic leader to oversee system-...

Location

United States , Wausau

Salary:

Not provided

Kirby Bates Associates

Expiration Date

Until further notice

Requirements

Bachelor’s in nursing and Master’s in business, healthcare administration, or nursing required
Nationally recognized certification preferred, i.e. CPHQ, CCM, CPUM, CPUR, or D-ABQAURP
Five or more years of leadership experience in care coordination, case management, or utilization review in an integrated healthcare delivery system and/or health plan
Extensive knowledge of payer mechanisms, clinical utilization management, outcome measures and patient information systems in including Pathways, HEDIS, etc.

Job Responsibility

Oversee system-wide care coordination functions, including utilization review, social work, navigation, and case management
Execute Aspirus’ care coordination strategic plan
Ensure seamless transitions of care
Drive initiatives that enhance health system and health plan goals
Lead the development and implementation of best practices, policies, and procedures across the continuum of care
Supervise a multidisciplinary team of registered nurses, social workers, and other healthcare professionals
Collaborate with business units to optimize resource utilization, improve patient outcomes, and achieve strategic objectives
Accountable for financial stewardship, program development, and regulatory compliance.

What we offer

Robust opportunities for leadership growth
Career advancement
Chance to shape the future of care coordination across an expansive health system.

Design Engineer

As a Design Engineer in Asset Adoption, you would play a key technical and coord...

Location

United Kingdom , Woolpit

Salary:

Not provided

Hedera Hiring Ltd

Expiration Date

Until further notice

Requirements

Experience in design coordination or project administration, ideally within the multi-utility sector for an IDNO or ICP
Experience with managing people
CAD Technicians are welcomed to apply who are looking to get into a Design Engineer role

Job Responsibility

Validate Utility Design Submissions: Review and approve multi-utility network designs (electricity, gas, water, etc.) for new developments submitted by contractors and partners
Technical Support: Offer ongoing design guidance to adoption partners to help them meet all necessary regulations and technical standards
Process Management: Maintain accurate design records and track submissions using internal systems and tools like AutoCAD
Stakeholder Coordination: Liaise with internal teams (legal, operations, planning) and external stakeholders to keep projects progressing and ensure alignment with regulatory and safety expectations
Customer & Partner Relations: Build strong working relationships with external contractors to encourage long-term collaboration and loyalty

What we offer

33 days of annual leave including Bank Holidays with the ability to purchase an additional 2 weeks
Pension
Employee wellbeing and support programmes
Employee Discounts
Training and development opportunities

Program Manager, F-15 Saudi FMS

Astrion has an exciting opportunity for a Senior Program Manager on the F-15 con...

Location

United States , Robins AFB, Georgia

Salary:

Not provided

Astrion

Expiration Date

Until further notice

Requirements

Must be flexible in adapting to deadlines, changing schedules, competing priorities, and unpredictable events
Possesses the advanced knowledge, experience and ability to be recognized as an expert in their field
Has the ability to perform tasks and oversee the efforts of Junior and Journeyman personnel
Familiar with and able to present data and recommendations to a large audience
Demonstrates advanced knowledge of their technical/professional discipline as well as possess a comprehensive understanding and ability to apply associated standards, procedures and practices in their area of expertise
Superb verbal and written communication skills
15 years of directly related experience with proper certifications as described in the PWS labor category performance requirements, eight (8) of which must be in the DoD
OR Bachelor’s Degree in a related field and 12 years of experience in the respective technical/professional discipline being performed, five of which must be in the DoD
OR Master’s or Doctorate Degree in a related field and ten years of experience in the respective technical/professional discipline being performed, five (5) years of which must be in the DoD

Job Responsibility

Assist with the development of documents, such as, but not limited to, Memorandum of Agreements (MOAs), Memorandum of Understandings (MOUs), Statements of Objective (SOOs), PWSs, Statements of Work (SOWs), Requests for Proposal (RFP), Mission Needs Statements, Operational Requirements Documents (ORD), Initial Capabilities Documents (ICD), Capability Development Documents (CDD), Capability Production Documents (CPD), Milestone Documentation, Analysis of Alternatives (AoA), and Rapid Fielding Requirements Documents (RFRD)
Support the review of proposals as assigned by the Government
Assist with the following coordination of documentation between functional resources, including but not limited to, financial, management, procurement, engineering, and logistics) and assist with the consolidation of their inputs into common documents, and planning for the accomplishment of various program milestones
Support key acquisition events and reviews as needed, such as: System Requirements Reviews (SRR), Preliminary Design Reviews (PDR), Critical Design Reviews (CDR), Test Readiness Reviews (TRR), Technical Coordination Meetings (TCM), Functional Configuration Audits (FCA), Physical Configuration Audits (PCA), Production Readiness Reviews (PRR), milestone documentation development, and others as applicable
Assist in producing or reviewing products for program office use that include business case analyses, trade-off studies, estimates for program office acquisition and logistics requirements, written requirements documents for planned acquisitions, and acquisition strategies and plans
Provide milestone documentation support for documents defined in DoDI 5000.02 and as tailored by the program office and milestone decision authority
Provide a program assessment for integration of documentation to ensure consistency with program strategy and consistency across all milestone documentation
Provide inputs, draft, coordinate (with the appropriate F-15 Division programs and other Government agencies), adjudicate comments, and produce final versions of coordinated milestone documents and assessments
Develop and collect technical data and inputs for staff summary packages to support coordination and signature of all associated documents for milestone approval
Support the development of contract strategies, Work Breakdown Structures (WBS) and the completion of a program risk assessment to document issues impinging on milestone execution

What we offer

Competitive salaries
Continuing education assistance
Professional development
Multiple healthcare benefits package options
401K with employer matching
Competitive time off policy along with a federally recognized holiday schedule

Fulltime

Utilization Review Coordinator

Illinois Department of Public Health (IDPH)

Location:
United States , Chester

Category:
Nursing

Contract Type:
Employment contract

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
February 21, 2026

Expiration:
March 05, 2026

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