- State of Minnesota (St. Paul, MN)
- **Working Title: State Medical Review Team County Liaison** **Job Class: Human Services Program Specialist 2** **Agency: Human Services Dept** + **Job ... This position exists to fully evaluate, screen, and develop referrals made to the State Medical Review Team (SMRT) in accordance with program policies… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …issued by the State of Minnesota. **Title:** *Staff Nurse - Utilization Review (ED)* **Location:** *MN-Minneapolis-Downtown Campus* **Requisition ID:** *251531* ... may require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for evaluating the … more
- Humana (St. Paul, MN)
- …and will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer based review of moderately complex to ... clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed… more
- Intermountain Health (St. Paul, MN)
- **Job Description:** A Medical assistant has accountability for providing care to patients in an ambulatory clinic setting. This will involve caring for patients ... with acute and chronic needs. A Medical Assistant will be responsible for communicating clearly with patients seeking care through different modalities including… more
- Highmark Health (St. Paul, MN)
- …Specialties or the American Osteopathic Association Specialty Certifying Boards + Active medical state licensure required. Additional specific state ... and improve the care of our members **ESSENTIAL RESPONSIBILITIES** + Conduct electronic review of escalated cases against medical policy criteria, which may… more
- Humana (St. Paul, MN)
- …clinical reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn North Central region state Medicaid ... will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to… more
- Evolent (St. Paul, MN)
- …by Medicare. + No history of a major disciplinary or legal action by a state medical board To ensure a secure hiring process we have implemented several ... care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular...within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure… more
- Evolent (St. Paul, MN)
- …by Medicare. + No history of a major disciplinary or legal action by a state medical board To ensure a secure hiring process we have implemented several ... within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure...in medicine or required specialty + Obtaining and maintaining medical licenses in the state you reside,… more
- Travelers Insurance Company (St. Paul, MN)
- …which can impact claim outcomes. Organize and coordinate Travelers' medical review functions. This includes interpreting Federal and State regulations and ... medical guidelines to establish medical review policies. Works in close collaboration...experience preferred + Proven ability to work in a team environment and collaborate on innovative projects + Demonstrated… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …supports the team with primary accountabilities related to quality improvement, Medical Records Review (MRR), and provider outreach and relations. This ... * Manage and implement communications processes for the annual HEDIS Medical Records Review initiative including clinic information updates, committee… more
- Evolent (St. Paul, MN)
- …or sanctioned by Medicare. . No history of disciplinary or legal action by a state medical board To ensure a secure hiring process we have implemented several ... clinical rationale for standard and expedited appeals. . Utilizes medical /clinical review guidelines and parameters to assure...in medicine or required specialty . Obtaining and maintaining medical licenses in the state you reside,… more
- Minnesota State (St. Paul, MN)
- …**Working Title:** Director of Employee Experience **Institution:** Metropolitan State University **Classification Title:** Human Resources Specialist 3 **Bargaining ... Resources services, including consultation with supervisors and employees on Federal/ State -mandated programs and special HR initiatives. This role offers subject… more
- Humana (St. Paul, MN)
- …will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to ... clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed… more
- CenterWell (St. Paul, MN)
- …will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to ... clinical group practice management. + Utilizationmanagement experience in a medical management review organization, such as Medicare Advantage,managedMedicaid,… more
- Evolent (St. Paul, MN)
- …by Medicare. + No history of a major disciplinary or legal action by a state medical board To ensure a secure hiring process we have implemented several ... clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure...in medicine or required specialty- + Obtaining and maintaining medical licenses in the state you reside,… more
- Evolent (St. Paul, MN)
- …+ Provides clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... will be a key member of the utilization management team . We can offer you a meaningful way to...medicine or required specialty- Required + Obtaining and maintaining medical licenses in the state you reside-… more
- Humana (St. Paul, MN)
- …put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). The Medical director work ... and will understand how to operationalize this in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex… more
- Evolent (St. Paul, MN)
- …when available, within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... will be a key member of the utilization management team . We can offer you a meaningful way to...medicine or required specialty- **Required** + Obtaining and maintaining medical licenses in the state you reside… more
- State of Minnesota (St. Paul, MN)
- …: Department of Employment & Economic Development + **Division/Unit** : Paid Family & Medical Leave + **Work Shift/Work Hours** : Day Shift, 8:00AM - 4:30PM + **Days ... do is more than just a job.** At the State of Minnesota, employees play a critical role in...product practices to deliver the program. The Paid Leave team has high standards and an unrelenting commitment to… more
- Medtronic (Mounds View, MN)
- …are seeking an experienced Principal Medical Science Specialist to join the Surgical Medical Science team at an exciting time for the Surgical business. The ... will possess expertise in industry-sponsored clinical evidence, ideally at a medical device company and across multiple medical /surgical therapeutic… more