- Elevance Health (Omaha, NE)
- …send you a check, or ask you for payment as part of consideration for employment. ** Utilization Management Rep II** + Job Family: CUS > Care Support + Type: Full ... + Ohio + Missouri + Kentucky + Florida **Description** ** Utilization Management Rep II** **Location: This is...given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. +… more
- Catholic Health Initiatives (Omaha, NE)
- …Collaborate effectively with multiple stakeholders Professional communication skills. Understand how utilization management and case management programs ... hospital clinical experience or a Masters degree in Case Management or Nursing field in lieu of...hospital Ability to pass annual Inter-rater reliability test for Utilization Review product(s) used. **Preferred** Certified Case Manager… 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 ... staff, anticipating needs, monitoring performance, and making recommendations to senior management . + Develops and oversees staff training and capacity building… more
- Catholic Health Initiatives (Omaha, NE)
- …and accurate information to payors. The role integrates and coordinates utilization management , care facilitation and discharge planning functions. Additional ... delivery of care in the appropriate setting. + Completes Utilization Management and screening for assigned patients....practice in our state + Graduate of an accredited nursing program + Experience as a Registered Nurse… more
- Catholic Health Initiatives (Council Bluffs, IA)
- …and accurate information to payors. The role integrates and coordinates utilization management , care facilitation and discharge planning functions. Additional ... delivery of care in the appropriate setting. + Completes Utilization Management and screening for assigned patients....practice in our state + Graduate of an accredited nursing program + Experience as a Registered Nurse… more
- Catholic Health Initiatives (Omaha, NE)
- …appropriate admit status for concurrently denied hospital stays, using utilization management guidelines, medical necessity criteria, critical thinking ... . Recommends and provides education in collaboration with their manager . The Denials RN follows a standardized approach to...of RN experience preferred. + Minimum Three (3) years utilization management experience preferred + Denials … more
- ConvaTec (Omaha, NE)
- …global medical products and technologies company, focused on solutions for the management of chronic conditions, with leading positions in advanced wound care, ... It and Do What's Right. **About the Role:** Reporting to the Regional Sales Manager , you will be responsible for driving the commercial success of the Advanced Wound… more
- Catholic Health Initiatives (Omaha, NE)
- …emphasis will be on care coordination, communication and collaboration with utilization management , nursing , physicians, ancillary departments, insurers ... healthcare field. + At least five (5) years of nursing experience. + Certified Case Manager (CCM),...multiple stakeholders + Professional communication skills. + Understand how utilization management and case management … more