- Humana (Madison, WI)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… more
- Humana (Madison, WI)
- **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
- Sharecare (Madison, WI)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...minimum. + This position will be based in a home office which must satisfy all HIPAA requirements. Sharecare… more
- Molina Healthcare (WI)
- …receptive including home , nursing facilities, and "pop up" clinic. The Nurse Practitioner will be required to work primarily in non-clinical settings and provide ... 3-5-year experience as a Registered Nurse and/or Nurse Practitioner, ideally in a home health,...home health as a licensed clinician, especially in management of chronic conditions + Experience with underserved populations… more
- Molina Healthcare (Green Bay, WI)
- …(EMR) experience. Preferred Qualifications * Experience as a registered nurse or nurse practitioner in a home health, community health or public health ... in home health as a licensed clinician, especially in management of chronic conditions. * Experience with underserved populations facing socioeconomic barriers… more
- CVS Health (Madison, WI)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... day. **Position Summary** **This is a remote work from home role anywhere in the US with virtual training.**...or Specialty Pharmacy. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
- Lincoln Financial (Madison, WI)
- …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... **Alternate Locations:** Work from Home **Work Arrangement:** Remote : Work at ...We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position… more
- Evolent (Madison, WI)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... Be Doing:** + Practices and maintains the principles of utilization management and appeals management ...all employees have the following technical capability at their home : High speed internet over 10 Mbps and, specifically… more
- Fresenius Medical Center (Sheboygan, WI)
- …Quality, and Technical Services departments. + Collaborates with or functions as the Home Therapies Program Manager to oversee the facility's Home Therapies ... Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. +… more
- Molina Healthcare (Milwaukee, WI)
- … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
- Essentia Health (Superior, WI)
- …Collaborates with system shared services including, but not limited to, Nursing, utilization management and infection control, for oversight on site. ... care for Nursing and Patient Care Services (including respiratory care, care management , and other patient care services as applicable) at the assigned… more
- Meriter-UnityPoint Health (Madison, WI)
- …from the hospital to the community. The RN CM collaborates with the Enterprise Utilization Management (UM) RNs and Coordinators to communicate the plan for ... utilization of health care resources. Why UnityPoint Health? At...of hospital experience in general Medical/Surgical practice + Registered Nurse in State of WI + Knowledge of discharge… more
- Gentiva (Wausau, WI)
- …licensed Registered Nurse (RN) with strong leadership experience in hospice care, home health, or clinical operations management . If you're a natural leader ... budgeting while driving branch revenue growth through census development, referral management , and efficient resource utilization + Maintain strong relationships… more