- Catholic Health Initiatives (Omaha, NE)
- … Review experience.** Medical Coding experience is a plus! As our Utilization Review RN , you will be responsible for conducting comprehensive ... **Responsibilities** Are you a skilled and experienced Utilization Review Specialist looking for a rewarding opportunity to impact patient care and optimize… more
- Molina Healthcare (NE)
- **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States who has a compact, multi-state license. This team reviews the prior ... for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of… more
- Molina Healthcare (Kearney, NE)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied… more
- Sharecare (Lincoln, NE)
- …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals and… more
- Sedgwick (Lincoln, NE)
- …to ensure efficient, cost effective, and high quality delivery of case management and utilization review services to clients for multiple business lines; and to ... provide expertise in client specific case management and utilization review requirements and ensure customer satisfaction through the provision of these… more
- Highmark Health (Lincoln, NE)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective ** utilization management** strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management,… more
- Lincoln Financial (Lincoln, NE)
- …as indicated **What we're looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where the ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's it like… more
- Insight Global (Omaha, NE)
- …Worker's Compensation . Prior Experience with Case Management Cost Containment Background - utilization review or managed care null We are a company committed ... we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ . Skills… more
- Banner Health (Ogallala, NE)
- …This position provides nursing care under the direction and supervision of a registered nurse and/or licensed physician, and is accountable for the quality ... 2. Contributes to plan of care under direction of registered nurse , including the discharge plan, utilizing...Reviews audit results and presents summary information for management utilization and review . 7. May coordinate the… more
- Healthfirst (NE)
- …as assigned **Minimum Qualifications:** + Associates degree + New York State Registered Nurse + Work experience demonstrating verbal and written communication ... **Duties/Responsibilities:** + Oversees utilization management functions which include timely authorizations related to pre-certification, concurrent review ,… more
- Pine Acres Rehabilitation & Care Center (Nebraska City, NE)
- …to Administrator Reporting to this position: None Job Classification: Registered nurse with administrative duties/management Position Purpose: Conducts ... Required Qualifications Must possess a current, unencumbered, active license to practice as a registered nurse in Nebraska. Must have 3 years' experience as a … more
- Omaha Children's Hospital (Omaha, NE)
- …skills, motivation, problem-solving, autonomy and supporting the team. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or ... with surgical needs. Plays an active role in the administration and review of children's surgical care across the continuum, from admission through discharge.… more
- Omaha Children's Hospital (Omaha, NE)
- …fiscal reports. + Skills in negotiation and problem solving. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State ... operational or financial plan. + Assure efficiencies in staffing and resource utilization by comparison with internal and external benchmarks as measured by… more