- Catholic Health Initiatives (Omaha, NE)
- **Overview** Utilization Review RN is responsible for the review of medical records for appropriate admission status and continued hospitalization. Works ... admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the...with physicians, payers, Care Coordinators and other stakeholders regarding review outcomes. 5. Collaborates with facility RN … more
- Public Consulting Group (Council Bluffs, IA)
- …and/or healthcare and fraud investigations. + 2-5 years of experience as a utilization review manager conducting, directing, or leading medical necessity reviews ... for coordinating program integrity-related reviews with the medical necessity review team responsible for conducting medical necessity reviews, ensuring services… more
- Catholic Health Initiatives (Omaha, NE)
- …pertaining to their practice. 13. Performs other duties as assigned including utilization review as necessary. **Qualifications** **Required** + Graduate of an ... **Overview** The RN Care Coordinator is responsible for overseeing the...will be on care coordination, communication and collaboration with utilization management, nursing, physicians, ancillary departments, insurers and post… more
- Lincoln Financial Group (Omaha, NE)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred ... looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license...in a career at Lincoln, we encourage you to review our current openings and apply on our website.… more
- Molina Healthcare (Omaha, NE)
- **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse who resides in and is licensed in the state of Nebraska. This position supports ... our Inpatient Medical review process with our Nebraska Medicaid Health Plan. Strong...care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
- Catholic Health Initiatives (Omaha, NE)
- …as assigned by the manager. **Qualifications** **Required:** + Minimumthree (3)yearsclinical experience as Registered Nurse ( RN ) required. + RN license ... resolution strategy based on individual payer policies. 4. Implements strategies, such as RN reconsideration and peer to peer physician review . 5. Escalates… more
- Elevance Health (Omaha, NE)
- **Wound Care UM RN ** **Location:** Remote, within 50 miles of a pulse point **Hours:** An 8 hour shift Monday - Friday between the hours of 8 am - 7 pm CST. A proud ... of care for the people we serve. The **Wound Care UM RN ** is responsible for performing pre-certification certification and/or authorization activities for Home… more
- Amergis (Omaha, NE)
- The RN Case Manager is responsible for coordinatingcontinuum of care activities for assigned patients and ensuring optimumutilization of resources, service delivery, ... + Documents patient case information within a database system + Performs chart review /audits monthly or as needed + Participates in monthly case conferences by… more