- Evolent (St. Paul, MN)
- …mission. Stay for the culture. **What You'll Be Doing:** Job Description As a Clinical Reviewer , Nurse , you will be a key member of the utilization management ... providing better health outcomes. **Collaboration Opportunities:** As a Clinical Reviewer , Nurse , you will routinely interact with...You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases, which do not… more
- Elevance Health (Mendota Heights, MN)
- ** Nurse Reviewer I** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum ... integration, and ensures essential face-to-face onboarding and skill development. The ** Nurse Reviewer I** is responsible for conducting preauthorization, out… more
- CVS Health (St. Paul, MN)
- …Perform medical necessity reviews **Required Qualifications** - 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital setting - ... A Registered Nurse that holds an active, unrestricted license in their...levels of care - 1+ years' experience in Utilization Review - CCM and/or other URAC recognized accreditation preferred… more
- CVS Health (St. Paul, MN)
- …medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital setting. + ... A Registered Nurse that holds an active, unrestricted license in their...levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred.… more
- Sharecare (St. Paul, MN)
- …To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals and objectives of the ... manner while ensuring high quality care. The Clinical Registered Nurse coordinates with the Primary Care Provider and all...orientation and to take the pre and posttests to review competency during orientation. Yearly competency test is required… more
- BioLife Plasma Services (Mounds View, MN)
- …Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. BioLife Plasma Services is a subsidiary of ... determine donor eligibility to donate plasma, management of donor adverse events, review of laboratory test results, and donor notification of unsuitable test… more
- Fresenius Medical Center (Maplewood, MN)
- …therapy for assigned patients under the direct supervision of a registered nurse . Participates in the implementation and evaluation of patient care. Responsible for ... intravenous medication in accordance with physician orders and state nurse practice laws. + Perform and document pre, interim,...+ Perform and document pre, interim, and post treatment review of patient condition. + Initiate basic CPR measures… more
- BioLife Plasma Services (Mounds View, MN)
- …Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. BioLife Plasma Services is a subsidiary of ... determine donor eligibility to donate plasma, management of donor adverse events, review of laboratory test results, and donor notification of unsuitable test… more
- Fresenius Medical Center (Hastings, MN)
- …dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance ... significant information and/or change in patient condition directly to the registered nurse or supervisor. + Observe patient and conduct machine safety checks… more
- Surgery Care Affiliates (Woodbury, MN)
- …ideas should inspire change. If you join our team, they will. Responsibilities The Nurse Manager is responsible for the overall functioning of Preop, Postop and the ... OR. As a Registered Nurse is responsible for assessing, planning, implementing, and coordinating...with other disciplines as needed. + Participate in quality review and performance improvement projects. + Participate in the… more
- Sedgwick (St. Paul, MN)
- …Services & Insurance RN Consultant Sr - Professional Liability **Prior Legal Nurse Consulting expereince highly preferred in order to be considered.** **PRIMARY ... complex or high exposure claim issues; advises and leads Nurse Consultant - PL colleagues. + Receives requests for...hospital facilities weekly as needed. + Participates in follow-up review and investigation as directed and assists in discovery… more
- Public Consulting Group (St. Paul, MN)
- …learn more, visit www.publicconsultinggroup.com . PCG is currently seeking a qualified Registered Nurse to perform as a Case Manager. The Case Manager will be ... and client-centered * Handles case assignments, draft service plans, review case progress, and manages ongoing care needs *...Proven working experience in case management, including as a nurse , medical, mental health care manager or a related… more
- Presbyterian Homes and Services (Roseville, MN)
- …reference dates throughout the resident's stay. + Audit RUG grouper/MDS end splits, review all expedited appeals and ALJ level appeals. Perform concurrent MDS ... review to assure appropriate RUGs category is achieved through...and management for your assigned region. Qualifications + Registered nurse with current licensure the State Board of Nursing… more
- University of St. Thomas (St. Paul, MN)
- …instructors are for a pooled, adjunct faculty position for continuous recruitment. Review of candidates is typically done two times annually - spring/summer and ... MSN programs, which are focused on coursework for entry into professional Registered Nurse practice. More information about the School of Nursing can be foundhere… more
- Travelers Insurance Company (St. Paul, MN)
- …activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants nurse consultants, and fire or fraud investigators, and ... evaluation documentation tools in accordance with department guidelines. + Proactively review Claim File Analysis (CFA) for adherence to quality standards and… more
- Public Consulting Group (St. Paul, MN)
- …efficient, equitable, and client-centered + Handles case assignments, draft service plans, review case progress and determine case closure + Travels within the State ... Proven working experience in case management, including as a nurse , medical, mental health care manager or a related...+ Current license, certification or registration as a Registered Nurse or Social Worker **Working Conditions** + Office Setting… more
- Sedgwick (St. Paul, MN)
- …: Performs standard clinical evaluations on claims that require additional review based on medical condition, client requirement, and/or complexity. Consults with ... university preferred. Current Certified Rehabilitation Counselor (CRC) or Registered Nurse (RN) license required. Current license, registration and/or professional… more
- Sevita (Maplewood, MN)
- …in appropriate settings such as home, school, or community. + Review social history information, complete functional assessments, and target appropriate behavior ... from the agency by attending and presenting behavior support plan information to review committees. + Document progress and activity; review records and logs… more
- Fairview Health Services (St. Paul, MN)
- …defined by quality outcomes and frequency criteria. Evaluate and create the Annual Review and Education plan for coders and providers in partnership with corporate ... practices through financial and activity reports, as well as documentation review , to identify potential opportunities for revenue capture and recognize areas… more
- CVS Health (St. Paul, MN)
- …Manager role includes: -Collaborate with an interdisciplinary care management team ( nurse case managers, medical directors, dietitians, social workers) to support ... - Currently and on a daily basis applies clinical knowledge to review medications and resolve different disease management scenarios beyond dispensing role;… more