- Molina Healthcare (Madison, WI)
- … and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Provides support for … more
- Fresenius Medical Center (Madison, WI)
- …Case Manager for patients with various shifts and work hours **PURPOSE AND SCOPE:** The registered professional nurse (CAP RN 1) position is an entry level ... designation into the Clinical Advancement Program for Registered Nurses. The CAP RN 1 is...years. + Minimum of 9 months experience as a Registered Nurse (preferred). + Chronic Home dialysis… more
- Fresenius Medical Center (Fitchburg, WI)
- …communicated to and implemented by the facility staff. + Maintains integrity of medical records and other FMS administrative and operational records. + Complies with ... as pertinent. **STAFF:** + Responsible for implementation of FMS staffing, and medical supply models, to provide quality patient care, and makes recommendations. +… more
- Marshfield Clinic (Beaver Dam, WI)
- …together to support the most exciting missions in the world!** **Job Title:** Registered Nurse - Home Health/Hospice **Cost Center:** 351011118 BDHos-Home Health ... be eligible for a sign-on bonus **JOB SUMMARY** The Registered Nurse - Home Health/Hospice is responsible...Care and Hospice uses a Case Manager and visit nurse model. The RN utilizes the direct… more
- Veterans Affairs, Veterans Health Administration (Madison, WI)
- …the EDRP application. Former EDRP participants ineligible to apply. Responsibilities The Registered Nurse - Emergency Department provides urgent and emergent ... care to patients with acute and/or chronic medical , surgical, and psychiatric conditions. Nursing care ranges from...demonstrated at any organizational level within a facility. The Registered Nurse - Emergency Department is responsible… more
- Cognizant (Madison, WI)
- …expectations. **What you need to have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...the medical necessity determinations to the Health Plan/ Medical Director based on the review of… more
- Molina Healthcare (Madison, WI)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...specific programs supported by the plan such as utilization review , medical claims review , long-term… more
- Humana (Madison, WI)
- …concerns.** **Use your skills to make an impact** **Required Qualifications** + **Active Registered Nurse ( RN ) Multi-state/Compact State license with no ... needs at the discretion of department leadership. The Telephonic Nurse provides medical guidance, assists with access...degree in nursing (BSN) + Previous case management, utilization review , or triage experience + Previous experience in a… more
- Molina Healthcare (Madison, WI)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Madison, WI)
- For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This role will be doing Utilization review for ... authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted… more
- Molina Healthcare (Madison, WI)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support...care unit, or in a telemetry type setting. UM medical review experience highly preferred. Work Hours:… more
- Molina Healthcare (Madison, WI)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The Care Review Clinician ( RN ) provides support for...requests within required timelines. * Refers appropriate cases to medical directors (MDs) and presents them in a consistent… more
- Molina Healthcare (Madison, WI)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **_Wisconsin RN license required_** JOB DESCRIPTION Job SummaryProvides support...JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are… more
- Molina Healthcare (Madison, WI)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
- Molina Healthcare (Madison, WI)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Humana (Madison, WI)
- …Typical work hours are Monday-Friday, 8 hours/day, 5 days/week. **Required Qualifications** + Registered Nurse ( RN ), holding an active and unrestricted ... resources, schedules and goals. The Manager, Fraud and Waste Investigator: Nurse Audit/ Review validates and interprets medical documentation to ensure… more
- Fresenius Medical Center (Fitchburg, WI)
- **PURPOSE AND SCOPE:** Functions as part of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a Staff ... Registered Nurse , to ensure provision of quality patient care on a daily basis in accordance with FMS policies, procedures, and training. Supports the FMCNA's… more
- Select Medical (Madison, WI)
- …**Director of Case Management** $10,000 Sign On Bonus **_Clinical license as a registered nurse or respiratory therapist or master's in social work and ... minimum three (3) years of medical case management or similar experience._** **Previous case mangement...of the department, including, but not limited to: Utilization Review (UR) and resource management, discharge planning, treatment plan… more
- Humana (Madison, WI)
- …an impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and… more
- Gentiva (Madison, WI)
- …Medicare, Medicaid, JCAHO, ACHC **About You** **Qualifications - What You'll Bring:** + Current Registered Nurse ( RN ) license in the state of employment + ... Hospice Care.** We are seeking a Senior Patient Care RN Manager to join our hospice team. Reporting directly...+ Coordinate and facilitate Interdisciplinary Group (IDG) meetings to review patient care plans and update clinical documentation +… more