- Humana (St. Paul, MN)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (St. Paul, MN)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CenterWell (St. Paul, MN)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- Cognizant (St. Paul, MN)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- CenterWell (St. Paul, MN)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no disciplinary action and ability...volume and fast paced environment + Previous experience in utilization management + Education: BSN or bachelor's… more
- Humana (St. Paul, MN)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a*Staff Nurse *to join our Utilization Management department for the/Emergency Department / This position is a*0.8 FTE ... *Assessment:* * Collects, reviews, and documents clinical data relevant to utilization management , including patient status, treatment plans, and healthcare… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- … review functions. Oversees daily operations, which include supervising staff performing utilization management activities. The goal is to achieve clinical, ... financial, and utilization goals through effective management , communication, and...to 5) years of professional leadership experience (ie, charge nurse , team leader, preceptor, committee chair, etc.) * Five… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a*Case Management Assistant* to join our Utilization Management team. This position works on campus, part-time, .6 (48 ... IMM is in the medical record * Assist UR nurse with clerical support (faxing, follow-up calls) for payor...and regulations * Epic * MS Office **Title:** *Case Management Assistant- Utilization Management * **Location:**… more
- Sharecare (St. Paul, MN)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- Veterans Affairs, Veterans Health Administration (Minneapolis, MN)
- Summary The Nurse Recruiter is a Registered Nurse who is responsible for all recruitment and retention of nursing workforce. The Nurse Recruiter provides ... recruitment, onboarding, and retention of the nursing workforce. Responsibilities The Nurse Recruiter uses their leadership and expertise of nursing practice,… more
- Veterans Affairs, Veterans Health Administration (St. Cloud, MN)
- …VA Health Care System as a Surgical and Specialty Care Referral Coordination Registered Nurse , where you'll play a key role in connecting Veterans with the right ... Veteran deserves. Responsibilities The Surgical and Specialty Care Referral Coordination Registered Nurse plays a vital role in connecting Veterans to the care they… more
- Veterans Affairs, Veterans Health Administration (St. Cloud, MN)
- …providers, and community partners to promote seamless, coordinated care. Apply utilization review criteria and evidence-based standards to ensure safe, efficient, ... and high-quality outcomes. Identify Veterans requiring disease management and connect them to appropriate internal or external resources. Communicate effectively… more
- Fairview Health Services (Edina, MN)
- …not limited to: assessment, care planning, service coordination and referral, transition management , utilization management and quality assurance. The care ... Medicaid benefits and senior care industry + Public Health Nurse + Certification in case management +...Public Health Nurse + Certification in case management + gerontological nursing **Benefit Overview** Fairview offers a… more
- Mayo Clinic (Rochester, MN)
- …a dedicated professional to join our team as Infection Preventionist/Quality Assurance (IPQA) Nurse . As IPQA Nurse , you will be collaborating with leadership to ... educational and clinical training programs. + Developing policies for risk management systems to protect residents, visitors, and employees. + Computer hardware,… more
- Fairview Health Services (Maplewood, MN)
- …for services provided + Completes the requirements of various payers and utilization management reviewers to obtain authorization for treatment. Demonstrates the ... as an interdisciplinary team member. Responsible, as assigned, for the management of caseload. **Job Expectations:** Works collaboratively with the physician and… more
- Mille Lacs Health System (Onamia, MN)
- …with an asterisk (*) at the end of the bullet point. + Perform Nurse visits* Facilitate process and work flows to augment quality initiatives (meaningful use, PCRS, ... (eg medications, medical equipment, home care etc.)* + Assist in development and management of anticoagulant program (TBD) + Create and promote adherence to a care… more
- Mille Lacs Health System (Onamia, MN)
- …comprehensive patient and family health education.* + Monitors and enforces utilization of proper nursing techniques and procedures.* + Enacts the counseling ... role of the nurse . + Attends multi-disciplinary treatment staffing's. + Attends monthly...expected to report unsafe conditions to a member of management . Required Education and Experience + Graduate of accredited… more
- Highmark Health (St. Paul, MN)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... within the first 6 months of employment. **Preferred** + Certification in utilization management or a related field + Certification in Case Management … more
- Mayo Clinic (Rochester, MN)
- …multi-disciplinary teams. Major Functions of the RN Case Manager include: Utilization Review, including concurrent admission status and continued stay clinical ... terminology and disease processes. Knowledge of CPT coding, resource management systems, electronic medical record and personal computers beneficial. Demonstrated… more