- Adecco US, Inc. (Minneapolis, MN)
- …**Pay** : $40.00 - $43.25 per hour based on experience **Responsibilities of the Utilization Management Nurse ** : . Responsible for reviewing proposed ... benefit determination. . Generally work is self-directed and not prescribed. . The Utilization Management Nurse works under the direct supervision of an RN… more
- CVS Health (St. Paul, MN)
- …Must have active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include ... med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in MST or CST zone.… 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
- Mayo Clinic (Rochester, MN)
- …patient plan of care throughout the continuum of care by ensuring appropriate utilization management , care coordination, resource utilization , and clinical ... outcomes. The RN Case Manager provides leadership through education on case management / utilization management concepts, committee work, research, and… more
- CVS Health (St. Paul, MN)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Oncology or Specialty Pharmacy.** **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or … more
- Veterans Affairs, Veterans Health Administration (St. Cloud, MN)
- …Cloud VA Health Care System (HCS) is looking to hire an Advanced Practice Nurse (APN) for Neurology. The Neurology APN functions directly to support the activities ... modifying, and evaluating the effectiveness of Veteran's care. Responsibilities The Advanced Practice Nurse (APN) is a Registered Nurse who has a master's,… more
- Indian Health Service (Red Lake, MN)
- Summary This position is a Supervisory Nurse (Inpatient) located at the PHS Hospital Facility in Red Lake, MN. The Clinic and Emergency Room provide ambulatory ... qualities improved plans, methods, procedures, documentation, and follow-up with maximum utilization of staff and resources. Maintains current inpatient care manuals… 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
- Good Samaritan (Inver Grove Heights, MN)
- …This full-time 40 hours per week MDS Coordinator will be a part of our management team. Primary responsibilities will be MDS duties for the facility. 40 hours per ... a weekend on-call rotation shared with the other supervisory staff. MN Registered Nurse , RN required. Prior MDS experience preferred. **Job Summary** The RN Case… more
- Essentia Health (Fosston, MN)
- …timely and accurate information to payers. The role integrates and coordinates utilization management , care facilitation and discharge planning functions. This ... order to meet patient needs, manage length of stay, and promote efficient utilization of resources for a designated caseload. **Education Qualifications:** + BSN or… more
- Fresenius Medical Center (Lakeville, MN)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... + Preferred but not required: + 3+ years supervisory or project/program management experience. + Med/surg or ICU/CCU experience. **PHYSICAL DEMANDS AND WORKING… more
- Humana (St. Paul, MN)
- …will be a key enterprise leader, with responsibility for evolving Humana's Utilization Management of medical review by physician or nurse , with a focus on ... members. The Director, Physician leadership will lead Medical Directors performing utilization management for Medicare inpatient and behavioral medicine case… more
- United Therapeutics (St. Paul, MN)
- …which transplant is not currently an option. Who you are You are experienced nurse who loves providing mentorship, coaching and motivational support to your team and ... make a difference. The Regional Field Director, RNS Program Management serves as a director of all clinical field...+ Plan, collaborate, create and produce the yearly Clinical Nurse Summit meeting for HCPS across the United States… more
- Humana (St. Paul, MN)
- …**Key Functions:** **Strategic Planning and Implementation:** + Develop and implement utilization management strategies that align with organizational goals. + ... care. **Cost Containment:** + Identify opportunities for cost savings through effective utilization management practices. + Monitor and analyze utilization … more
- Highmark Health (St. Paul, MN)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... Care **LICENSES or CERTIFICATIONS** **Required** + United States Registered Nurse (RN) license + Delaware RN license must be...is part of the compact **Preferred** + Certification in Utilization Management or a related field **SKILLS**… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a*Teen and Family Case Management Assistant*to join our Aqui Para Ti team. This part-time role will work 40 hours within a two ... delivery of cost-effective health care and identify the appropriate utilization of resources. Coaches patients and parents/caregivers in developmentally appropriate… more
- Bluestone Physician Services (St. Paul, MN)
- …with primary care teams to ensure high quality team-based care + Use utilization management tools to facilitate appropriate transitional care management ... their unique needs. Using an evidence-based approach focused on quality care management and data-driven medical decisions, Bluestone care teams collaborate to manage… more
- Sharecare (St. Paul, MN)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… 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
- Fairview Health Services (Minneapolis, MN)
- …and strategic planning activities for complex clinical technology projects like nurse call, clinical communications, cardiac monitoring, and others. This leader ... facilitate the conduction of risk assessments and evaluation of the adoption and utilization of various technologies and provide plans to mitigate issues with the… more