- Humana (Topeka, KS)
- …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...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse ( RN ) in a… more
- CVS Health (Topeka, KS)
- …+ Active and good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC ... experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal… more
- Humana (Topeka, KS)
- **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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- CVS Health (Topeka, KS)
- …active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, ... **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care...or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing… more
- Humana (Topeka, KS)
- **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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
- Cognizant (Topeka, KS)
- …have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with ... 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
- CenterWell (Topeka, KS)
- …clinical experience. + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Intelligence + ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...Experience with Home Health preferred + Previous experience in utilization management within Insurance industry a plus… more
- CVS Health (Topeka, KS)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital… more
- CVS Health (Topeka, KS)
- …is subject to change based on business needs. **Preferred Qualifications** 6+ months Case Management or Utilization Management experience Case Management ... however, it is subject to change based on business needs.** The RN Case Manager is responsible for telephonically assessing, planning, implementing, and coordinating… more
- Humana (Topeka, KS)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
- Highmark Health (Topeka, KS)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... in addressing targeted populations **LICENSES or CERTIFICATIONS** **Required** + RN license in PA or WV or DE or...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more
- AdventHealth (Shawnee, KS)
- …documents avoidable days, and facilitates progression of care. + Collaborates with Utilization Management staff for collaboration on patient status changes and ... skills + Data analysis skills + Current working knowledge of discharge planning, utilization management , care management , performance improvement and managed… more
- CVS Health (Topeka, KS)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... performing the job functions. **Required Qualifications** - 5+ years' experience as a Registered Nurse with hospital experience; preferably in the specialty. - A… more
- Highmark Health (Topeka, KS)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... data to assure appropriate level of payment and resource utilization . It is also used to identify issues which...experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder… more
- CVS Health (Topeka, KS)
- …+ 5-7 years of regulatory and/or clinical audit experience. + Experience in medical management , including Utilization Management (UM) and Case Management ... accreditation processes, and NCQA standards. + Licensed clinical professional ( RN preferred). + Excellent analytical, organizational, and communication skills. +… more
- Evolent (Topeka, KS)
- …responsible for support and assistance for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices ... in a regulatory role (preferred). **LICENSE/CERTIFICATION:** Current, unrestricted state PA or RN /NP license in medicine or required specialty. Of a PA, obtaining a… more
- Spira Care, LLC (Kansas City, KS)
- …Minimum Qualifications + Associate or bachelor's degree in nursing + Valid and active Registered Nurse ( RN ) in Kansas and Missouri or multi-state compact ... helping people achieve their health goals. The Care Guide, RN is an integral role within the Care Team...years' experience, including at least three years of Care/Case/Disease Management , Health Plan, or Utilization Review experience… more
- CenterWell (Overland Park, KS)
- …license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home care, ... on-site at our Overland Park, KS branch location.** The ** RN Clinical Manager** coordinates and oversees all direct care...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- HCA Healthcare (Overland Park, KS)
- …sites of care in 21 states and the United Kingdom. We are looking for a(an) RN Manager of Case Management for our Overland Park Regional Medical Center team ... to be an influencer in healthcare? **Apply for our RN Manager of Case Management role today!**...supporting a balance of optimal care and appropriate resource utilization . **What qualifications you will need:** * Associate Degree… more
- Elevance Health (Kansas City, KS)
- **LTSS Service Coordinator- RN Clinician (Case Manager)** **Schedule:** Monday-Friday 8am-5pm CST **Location:** Candidates must live in or near **Wyandotte or ... an accommodation is granted as required by law._ The **LTSS Service Coordinator- RN Clinician** is responsible for **face-to-face member service coordination of all… more