- Molina Healthcare (Madison, WI)
- **Job Description** **Job Summary** The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring ... nursing experience, including at least 1 year of utilization review , medical claims review , long-term...or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must… 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
- Veterans Affairs, Veterans Health Administration (Middleton, WI)
- Summary The Revenue Utilization Review (RUR) nurse is under the supervision of the Nurse Manager and ANM. The RUR nurse is an active member of the ... improvements in patient care through systematic evaluation and analytical review of clinical information. Responsibilities Responsibilities of the RUR...level degree in Nursing may have opportunity to become registered as a nurse with a state… 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
- CVS Health (Madison, WI)
- …Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... virtual training.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS...setting. + A Registered Nurse that holds an active, unrestricted… 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)
- …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
- SSM Health (Madison, WI)
- …Support HealthCare Provider (BLS HCP) - American Heart Association (AHA) + And + Registered Nurse ( RN ) - Missouri Division of Professional Registration + ... than a career, it's a calling** WI-SSM Health Dean Medical Group Madison North High Point **Worker Type:** Regular...Or + Registered Nurse ( RN ) Issued by… 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)
- …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
- 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
- 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
- Evolent (Madison, WI)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for performing precertification and prior approvals. Tasks are performed within the RN /LVN/LPN scope of practice, under Medical Director direction, using… more
- Veterans Affairs, Veterans Health Administration (Madison, WI)
- …patient information. Completed work should need only a general review by a registered nurse ( RN ) or physician (MD/DO) for appropriateness and conformity ... Summary The Licensed Practical Nurse (LPN) Specialty/PACT position is located in the...error. Provides safe administration of medications in accordance with Medical Center's and Nursing Service policy and monitors side… more
- Veterans Affairs, Veterans Health Administration (Madison, WI)
- …patient information. Completed work should need only a general review by a registered nurse ( RN ) or physician (MD/DO) for appropriateness and conformity ... without error. Provides safe administration of medications in accordance with Medical Center's and Nursing Service policy and monitors side effects. Continues… 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