- Cognizant (Lincoln, NE)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Humana (Lincoln, NE)
- …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 assignments are...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in a compact state… more
- Humana (Lincoln, NE)
- **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 ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state)… more
- Humana (Lincoln, NE)
- **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 ... 7pm EST approximately 3-4 Thursday and Friday's annually. The Utilization Management Nurse 2 uses clinical...Qualifications** + Minimum of an Associate's degree + Licensed Registered Nurse (RN) with no disciplinary action… more
- Humana (Lincoln, NE)
- **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 ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN)** in the (appropriate state)… more
- Veterans Affairs, Veterans Health Administration (Papillion, NE)
- …to apply. Responsibilities The Community Living Center (CLC) Restorative Coordinator Registered Nurse (RN) is responsible for providing competent, evidence-based ... equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion… more
- Molina Healthcare (Omaha, NE)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support...hearings as may be required. * Serves as a clinical resource for utilization management, chief medical… more
- Sharecare (Lincoln, NE)
- …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… more
- Molina Healthcare (Lincoln, NE)
- …and electronic medical record (EMR) experience. Preferred Qualifications * Experience as a registered nurse or nurse practitioner in a home health, ... primary care and medical care services to members - primarily in non- clinical settings where members feel most comfortable, including in-home, community and nursing… more
- CenterWell (Omaha, NE)
- …+ Graduate of an accredited School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's license, auto insurance ... on-site at our** **Omaha, NE** **branch location.** The **RN Clinical Manager** coordinates and oversees all direct care patient...and reliable transportation. + Two years as a Registered Nurse with at least one-year of… more
- Molina Healthcare (Omaha, NE)
- …behavioral health, or equivalent combination of relevant education and experience. + Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed ... **Required Qualifications** + At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more years in one or more of… more
- Molina Healthcare (Omaha, NE)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for...to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications *… more
- Molina Healthcare (Omaha, NE)
- For this position we are seeking a (RN) Registered Nurse who must be licensed for the state they reside This role will be doing Utilization review for our ... Ohio Medicaid population, looking for clinicians with strong inpatient clinical experience WORK SCHEDULE: Tuesday to Saturday - 8...or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active… more
- Molina Healthcare (Omaha, NE)
- …internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital ... compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical… more
- Datavant (Lincoln, NE)
- …clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
- Molina Healthcare (Omaha, NE)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... **Job Summary** The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for verifying that services… more
- Molina Healthcare (Omaha, NE)
- …behavioral health, or equivalent combination of relevant education and experience. * Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed ... Required Qualifications * At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more years in one or more of the… more
- Good Samaritan (Omaha, NE)
- …working to provide the best care in the homes of our clients. We are looking for a Registered Nurse looking to work 32 hours a week or more. We look forward to ... intervention. Seeks to evaluate outcomes based on an integration among established clinical , financial and utilization data. Functions in structured and… more
- Molina Healthcare (Omaha, NE)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for...to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications *… more
- Molina Healthcare (Omaha, NE)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... **Job Summary** The Care Review Clinician (RN) provides support for clinical member services review assessment processes. Responsible for verifying that services… more