• Clinical Registered Nurse

    Cognizant (St. Paul, MN)
    …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
    Cognizant (11/15/25)
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  • Staff Nurse - Utilization Review…

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …needs and may require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for ... annual performance review /*License/Certifications:*/ * Possession of a valid license as a Registered Nurse issued by the State of Minnesota. **Title:** *Staff … more
    Minnesota Visiting Nurse Agency (11/04/25)
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  • Utilization Management Appeals Nurse

    Humana (St. Paul, MN)
    **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 ... SRO **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action… more
    Humana (11/12/25)
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  • Utilization Management Nurse

    Humana (St. Paul, MN)
    **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) Compact license, with no… more
    Humana (11/13/25)
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  • Utilization Management Nurse

    Humana (St. Paul, MN)
    …make an impact** **Required Qualifications** + Associate's Degree or higher + Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary ... health first** This is an opportunity to use your clinical knowledge and research skills to support the coordination,...an 8.5-hour shift between 7:00am - 5:00pm CST. The Utilization Management Nurse 2 uses knowledge, communication,… more
    Humana (11/12/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Shakopee, MN)
    **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
    Fresenius Medical Center (08/28/25)
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  • Manager - Utilization Review

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …in confidentiality, integrity, creativity, and initiative */License/Certifications:/* * Current Registered Nurse licensure upon hire * National certification ... performing utilization management activities. The goal is to achieve clinical , financial, and utilization goals through effective management, communication,… more
    Minnesota Visiting Nurse Agency (09/30/25)
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  • Registered Nurse

    Ebenezer (Edina, MN)
    …+ Associates Degree in Nursing + less than 1 year nursing experience + MN Registered Nurse (RN) License + Basic Life Support (American Heart Assoc or Red ... City/State: Edina, Minnesota Categories: Nurse (RN/LPN) Shift: Ebenezer Job Status: day Req...and Advance Care Planning documents, including POLST. + Maintains clinical charts and progress notes using computerized documentation system.… more
    Ebenezer (11/11/25)
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  • Clinical UM Nurse

    CenterWell (St. Paul, MN)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... an impact** **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no...Lung or Critical Care Nursing experience required + Prior clinical experience preferably in an acute care, skilled or… more
    CenterWell (11/12/25)
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  • UM Behavioral Health Nurse

    Humana (St. Paul, MN)
    …help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation ... Facilities to obtain sufficient clinical information. The Utilization Management Behavioral Health Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) Compact license, with no… more
    Humana (11/15/25)
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  • Disease Management Nurse - Remote

    Sharecare (St. Paul, MN)
    …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
    Sharecare (10/22/25)
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  • Nurse Liaison

    Fairview Health Services (Maplewood, MN)
    …Three years in mental health or related setting **License/Certification/Registration** + Current Registered Nurse license in Minnesota + Basic Life Support ... Certification **Preferred** **Experience** + Outpatient experience **License/Certification/Registration** + Certified Registered Nurse **Additional Requirements (must be obtained… more
    Fairview Health Services (10/15/25)
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  • FV Partners Nurse (RN) Care Coordinator

    Fairview Health Services (Edina, MN)
    …electronic medical record systems; excellent written and verbal communication skills + MN Registered Nurse (RN) License in good standing + Drivers License in ... in a variety of care settings throughout the 11-county metro area. The FVP Nurse (RN) Care Coordinator provides coordination across all settings of care and performs… more
    Fairview Health Services (11/15/25)
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  • Case Manager PreService & Retrospective…

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …improve provider performance and member satisfaction. Required Skills and Experience * Registered nurse or licensed behavioral health clinician (ie LICSW, LPCC, ... join us. The Impact You Will Have This job implements effective utilization management strategies including: review of appropriateness of pre and post service… more
    Blue Cross and Blue Shield of Minnesota (10/23/25)
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  • Denials Prevention Specialist, Clinician PRN

    Datavant (St. Paul, MN)
    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
    Datavant (11/12/25)
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  • Behavioral Health Care Advisor - Substance Use…

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …mental health challenges by providing culturally sensitive support. This role requires a Registered Nurse (RN) licensed in the state of Minnesota with ... community events to engage with members. Required Skills and Experiences * Registered Nurse with Psychiatric experience or Behavioral Health Professional that… more
    Blue Cross and Blue Shield of Minnesota (09/10/25)
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  • Behavioral Health Care Advisor- Substance Use…

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …community events to engage with members. Required Skills and Experience * Registered Nurse with Psychiatric experience or Behavioral Health Professional that ... the BCBSMN Care Management team. Behavioral Health Care Advisors will provide clinical approaches that will serve and support members from communities. The… more
    Blue Cross and Blue Shield of Minnesota (11/05/25)
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  • RN Specialist Complex Case Manager - Oncology

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …to ensure optimal and cost-effective health outcomes. Required Skills and Experiences * Registered nurse with current MN license and with no restrictions. All ... effective plan of care that leads to optimal, cost-effective outcomes. Leveraging clinical expertise, strong critical thinking skills and a keen business sense, the… more
    Blue Cross and Blue Shield of Minnesota (09/10/25)
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  • Care Advocacy Case Manager RN - Bilingual Spanish

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …needs across the continuum of care by leveraging member partnership, pre-service clinical utilization review, case and disease management processes, skill sets ... care coordination, and transition of care between settings. Required Skills and Experience * Registered nurse with current MN license and with no restrictions. *… more
    Blue Cross and Blue Shield of Minnesota (10/21/25)
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  • Lead RAI Director

    Presbyterian Homes and Services (Roseville, MN)
    …sites by directing the other RAI Directors on the approved plan. Qualifications + Registered nurse with current licensure the State Board of Nursing in states ... similar position within the SNF setting. + Experience with MDS completion, reimbursement, clinical resource utilization and/or case management + Ability to work… more
    Presbyterian Homes and Services (11/15/25)
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