- Veterans Affairs, Veterans Health Administration (Milwaukee, WI)
- Summary The Utilization Management (UM) Registered Nurse (RN) is responsible and accountable for all elements of the nursing process when providing ... along the care continuum. Responsibilities The Utilization Management (UM) Registered Nurse (RN) executes position responsibilities that demonstrate… more
- Veterans Affairs, Veterans Health Administration (Milwaukee, WI)
- Summary The Registered Nurse (RN) - Pain Clinic provides specialized care in the assessment, planning, implementing and evaluation of care throughout the peri ... level degree in Nursing may have opportunity to become registered as a nurse with a state...responsibilities that demonstrate leadership, experience and creative approaches to management of complex client care beyond the immediate practice… more
- Veterans Affairs, Veterans Health Administration (Milwaukee, WI)
- …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 ... Summary The Community Care Services Nurse Manager position is in the Medical Information...areas of focus include staffing effectiveness, clinical documentation, consult management , and fiscal management . Responsibilities Coordinate and… more
- Elevance Health (Milwaukee, WI)
- …communities. The **LTSS Service Coordinator-RN Clinician** is responsible for overall management of member's case within the scope of licensure, develops, monitors, ... face-to-face functional assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health,… more
- Fresenius Medical Center (Milwaukee, WI)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... + Preferred but not required: + 3+ years supervisory or project/program management experience. + Med/surg or ICU/CCU experience. **PHYSICAL DEMANDS AND WORKING… more
- Lakeview NeuroRehabilitation Center (Waterford, WI)
- …plan for the patient. + Has overall accountability for care coordination, utilization management , and discharge planning for patients within the assigned ... for services in any phase of treatment. Participates in Utilization Management meetings to promote sharing of...staff, patients, and families of varied backgrounds. + Education: Registered Nurse , ADN or BSN. + Licensure:… more
- Molina Healthcare (Milwaukee, WI)
- …ensure appropriate reimbursement to providers. + Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) ... modification of payment decisions. + Serves as a clinical resource for utilization management , CMOs, physicians and member/provider inquiries/appeals. + Provides… more
- Molina Healthcare (Milwaukee, WI)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At ... or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active...emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management … more
- Molina Healthcare (Milwaukee, WI)
- …at least 3 or more years in one or more of the following areas: utilization management , care management , care transitions, behavioral health, or equivalent ... external vendors. * Focuses on process improvement, organizational change management , program management and other processes relative...combination of relevant education and experience. * Registered Nurse (RN), Licensed Vocational … more
- Molina Healthcare (Milwaukee, WI)
- …and cost-effective member care. We are seeking candidates with a RN licensure, Utilization Management knowledge and Medicare Appeals is strongly preferred. Work ... to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. **Required...or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active… more
- Molina Healthcare (Milwaukee, WI)
- For this position we are seeking a (RN) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity of ... to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required...or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active… more
- Gentiva (Milwaukee, WI)
- …Director to join our leadership team. This role is ideal for a licensed Registered Nurse (RN) with strong leadership experience in hospice care, home health, ... budgeting while driving branch revenue growth through census development, referral management , and efficient resource utilization + Maintain strong relationships… more
- Molina Healthcare (Milwaukee, WI)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At ... authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in… more
- Humana (Milwaukee, WI)
- …teams to alignment. + Demonstrated business and financial acumen. **Preferred Qualifications** + Registered Nurse (RN). + Five (5) or more years' experience in ... across such areas as, incentive programs, quality and clinical management , population health, data sharing, connectivity, documentation and coding, HEDIS… more
- Wellpath (Franklin, WI)
- …Surgical experience preferred Licenses/Certifications + Have and maintain current licensure as a Registered Nurse within the state of employment. + Obtain and ... the organization's Code of Conduct. + Demonstrates knowledge of risk management , clinical precautions, infection control, fall prevention, utilization of… more