- Veterans Affairs, Veterans Health Administration (Iowa City, IA)
- Summary The Utilization Management (UM) Registered Nurse (RN) is responsible for providing competent, evidence-based practices within the position. Uses ... and continued stay criteria and best clinical documentation and utilization management practices to ensure efficient resource...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Molina Healthcare (Iowa City, IA)
- …driver's license **PREFERRED EDUCATION:** **PREFERRED EXPERIENCE:** + 3-5-year experience as a Registered Nurse and/or Nurse Practitioner, ideally in a ... **JOB DESCRIPTION** **Job Summary** The Care Connections Nurse Practitioners focus on screening and preventive primary care services delivered in the home,… more
- Molina Healthcare (Iowa City, IA)
- …and electronic medical record (EMR) experience. Preferred Qualifications * Experience as a registered nurse or nurse practitioner in a home health, ... post-discharge coordination to reduce hospital readmission rates and emergency room utilization . * Performs face-to-face in-person visits in a variety of settings… more
- Molina Healthcare (Iowa City, IA)
- …of payment decisions. * Serves as a clinical resource for utilization management , chief medical officers, physicians and member/provider inquiries/appeals. ... and/or coding experience, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in… more
- Molina Healthcare (Iowa City, IA)
- …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review. + Minimum two years of experience in… more
- UnityPoint Health (Cedar Rapids, IA)
- …evaluation of patient care on the behavioral health units under the direction of a Registered Nurse (RN) or Nurse Manager and established standards of ... the treatment plan. + Will share in the behavior management of all patients, utilizing a varied repertoire of...other health care associates under the direction of a registered nurse . + Integrates patient/family education concepts… more
- Molina Healthcare (Iowa City, IA)
- …internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
- Molina Healthcare (Iowa City, IA)
- …including design, development, implementation, and oversight of technology that drives core utilization management , care management , long-term services and ... management /leadership experience in a clinical leadership, clinical systems and/or informatics, utilization management , or care management role. *… more
- Molina Healthcare (Iowa City, IA)
- …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
- UnityPoint Health (Cedar Rapids, IA)
- …of accredited nursing program + Current licensure in good standing to practice as a Registered Nurse in [type in State]. + Must possess and maintain current ... home care. Responsible for case coordination of patients and insurance precertification/ utilization review. Patients served include adult and geriatric. St. Luke's… more
- UnityPoint Health (Cedar Rapids, IA)
- …of patient care on the behavioral health units under the direction of a registered nurse . Responsible for the delivery of patient care through a ... the progress towards goals per unit policy. + Maintains competence in the management of the patient undergoing ECT where applicable. + Is knowledgeable regarding… more
- UnityPoint Health (Iowa City, IA)
- …vehicle for work-related reasons. . Current licensure in good standing to practice as a Registered Nurse in Iowa. . Must possess and maintain current Basic Life ... consisting of patient staffing's and special care conferences. Assist with designated management duties in a leadership role. The patients served are patients of… more
- Molina Healthcare (Iowa City, IA)
- …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
- UnityPoint Health (Cedar Rapids, IA)
- …efficiency. License(s)/Certification(s): Current licensure in good standing to practice as a Registered Nurse in [type in State]. Must possess and maintain ... unit policy. . Maintains competence in performing procedures involved with the management of violent or potentially violent patients. Complies with policies for… more