- Evolent (St. Paul, MN)
- …scheduled. + Determines medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all review ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks… more
- Adecco US, Inc. (Minneapolis, MN)
- …and clinical criteria, rendering approvals when appropriate. . You will summarize medical information for review by the Medical Director as needed, ... inpatient hospital setting . Experience applying benefits and criteria to clinical reviews . Utilization Management, pre-authorization, concurrent review , or… more
- 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 ... kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture...a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for evaluating the medical necessity, ... Nurse issued by the State of Minnesota. **Title:** *Staff Nurse - Utilization Review (ED)* **Location:** *MN-Minneapolis-Downtown Campus* **Requisition ID:**… more
- State of Minnesota (Shakopee, MN)
- **Working Title: LPN/CMA** **Job Class: Licensed Practical Nurse / Medical Assistant, Certified** **Agency: Corrections Dept** + **Job ID** : 90543 + **Location** ... position will be filled in either the Licensed Practical Nurse (LPN) or Medical Assistant, Certified (CMA)...applicants seeking consideration for this position: + Licensed Practical Nurse . + Clinical experience in a hospital,… more
- Veterans Affairs, Veterans Health Administration (Minneapolis, MN)
- …and record relevant patient information. Completed work should need only a general review by a registered nurse (RN) or physician (MD/DO) for appropriateness ... Summary The Licensed Practical Nurse - Primary Care position provides care and...to actual or potential health problems. The LPN executes medical regimens including administering medication and treatments prescribed by… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …and call prescription refills as directed by providers * Assist with tracking and review of medical records and lab results * Clean equipment and rooms. ... Jail Health Services is under contract with Hennepin County Medical Center and the Hennepin County Sheriff's Office to...Model, under the direction of providers and/or the registered nurse , the Licensed Practical Nurse assists providers… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …and call prescription refills as directed by providers * Assist with tracking and review of medical records and lab results * Clean equipment and rooms. ... are looking to fill a number of Licensed Practical Nurse (LPN) positions. We have a variety of shifts...of shifts and FTE's available. *_RESPONSIBILITIES_* * Perform assigned clinical tasks under the direction of a provider or… more
- CenterWell (Brooklyn Park, MN)
- …policies and standards. + Assesses staff education needs based on own the review of clinical documentation in addition to feedback and recommendations by ... at our** **Brooklyn Park, MN** **branch location.** The **RN Clinical Manager** coordinates and oversees all direct care patient...Utilization Review staff. Upon completion of the assessment, creates and… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …and call prescription refills as directed by providers * Assist with tracking and review of medical records and lab results * Clean equipment and rooms. ... are ineligible). ** *_SUMMARY_* With the context of the Hennepin County Medical Center Relationship-Based Care Practice Model, under the direction of providers… more
- Datavant (St. Paul, MN)
- …years of CDI experience + 3+ years of clinical experience in an academic medical center + Registered Nurse license, Bachelor's degree in Nursing + CCDS or ... realize our bold vision for healthcare. **What We're Looking For:** As a Clinical Documentation Quality Improvement (CDQI) Specialist, you will play a pivotal role… more
- BioLife Plasma Services (St. Paul, MN)
- …You will report to the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. BioLife ... of laboratory test results, and donor notification of unsuitable test results. The Medical Support Specialist (Plasma Center Nurse ) works under the guidance of… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …development specialist to develop standard work and expectations for the utilization review process, including timely medical necessity screening to ensure ... fiscal, legal, compliance, coding, and billing staff to answer clinical questions related to medical necessity and...payers, as appropriate * May participate in the Utilization Review Committee to present medical necessity data… more
- Elevance Health (Mendota Heights, MN)
- …Group Clinical Validation Auditor** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and ... DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims. **How...an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and… more
- Surgery Care Affiliates (Eagan, MN)
- …do it. Each decision we make is rooted in seven core values: + Clinical quality + Integrity + Service excellence + Teamwork + Accountability + Continuous improvement ... package to support your health, well-being, and financial future. Our offerings include medical , dental, and vision coverage, 401k plan with company match, paid time… more
- Fujifilm (St. Paul, MN)
- **Position Overview** The Clinical Consultant, MI - I shall be responsible for providing clinical consulting for the project, report configuration (CV), workflow ... go-live support to Synapse PACS/MI projects. In addition, provide clinical support for sales and company team members with...HCUS team to gain customer acceptance of the FUJIFILM Medical Systems solution. + Participates in teaching and training… more
- Cardinal Health (St. Paul, MN)
- …to ensure a positive and satisfactory experience for all customers. The Supervisor, Clinical Operations monitors nurse to patient contact quality and provides ... manufacturers to rethink the reach and impact of their products. The Supervisor, Clinical Operations provides management and clinical oversight to a team of… more
- Highmark Health (St. Paul, MN)
- …over a specified panel of members that range in health status/severity and clinical needs; and assesses health management needs of the assigned member panel and ... utilizing data/analytics in conjunction with professional clinical judgement to identify the right clinical intervention for each member. The incumbent conducts… more
- CenterWell (St. Paul, MN)
- …will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review ... Compact Nursing License + A minimum of three years clinical RN experience; + Prior clinical experience,...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Blue Shield of Minnesota Position Title: Supervisor - Special Investigations Unit Clinical Location: Hybrid | Eagan, Minnesota Career Area: Legal About Blue Cross ... complex potential fraud, waste, or abuse, including pre-pay and/or post-pay medical claims reviews to determine valid cases for appropriate action; documents… more