- Veterans Affairs, Veterans Health Administration (Fort Harrison, MT)
- Summary The Registered Nurse (RN) Quality Management (QM) Performance Measures Consultant will function as an advanced clinician and execute position ... for accreditation/external review functions, performance measures, patient safety, and quality management functions. Function as a facilitator,...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- CVS Health (Helena, MT)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... and Utilization Management . AHH delivers flexible medical management services that support cost-effective quality care...setting. + A Registered Nurse that holds an active, unrestricted… more
- Sharecare (Helena, MT)
- …within a matrix organizational design. **Qualifications:** + Current multi-state compact Registered Nurse licensure in state of residence is required, ... program in an appropriate and efficient manner by providing high- quality telephonic Case or Care Management with...by providing high- quality telephonic Case or Care Management with CareFirst members. The Care Manager partners with… more
- CVS Health (Helena, MT)
- …compassionate. And we do it all with heart, each and every day. **Position Summary** The Quality Management Nurse (QM Nurse ) supports Aetna Better Health ... compliance with regulatory and accreditation standards while driving healthcare quality initiatives. This role combines clinical expertise with ...in a healthcare setting. + 2+ years as a Registered Nurse (RN) or License Practical … more
- Humana (Helena, MT)
- …part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently… more
- Humana (Helena, MT)
- …timeframe **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) Compact license, with no disciplinary action + 3 ... community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical...need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families,… more
- Health Care Service Corporation (Helena, MT)
- …and facilitates the coordination of care for identified members. **JOB REQUIREMENTS:** ** Registered Nurse (RN) with current, valid, unrestricted license in state ... (self) education functioning in a clinical care advisory role, the primary nurse case administrator assesses members for case management , introduces members… more
- St. Peters Health (Helena, MT)
- …required. BSN preferred. LICENSE/CERTIFICATION/REGISTRY: Current Montana License as a Registered Nurse required. Current BLS certification required. Aptitudes ... a per diem position Under general administrative direction, the Pre-Anesthesia Nurse Navigator (NN) Non-Exempt shall be an entrepreneurial, enterprising, and… more
- St. Peters Health (Helena, MT)
- The Home Dialysis Registered Nurse (RN) is responsible for providing comprehensive, patient-centered care to individuals performing home hemodialysis (HHD) ... independent home dialysis operators. The role includes participation in quality improvement initiatives and taking on-call responsibilities to support after-hours… more
- Humana (Helena, MT)
- …part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently… more
- CVS Health (Helena, MT)
- …and good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... to coordinate, document, and communicate all aspects of the utilization/benefit management program. + Conduct clinical reviews for adult inpatient behavioral health… more
- CVS Health (Helena, MT)
- …physician reviewer. - Identify and address quality issues and participates in quality management activities. - Assist in the preparation of reports that ... performing the job functions. **Required Qualifications** - 5+ years' experience as a Registered Nurse with hospital experience; preferably in the specialty. - A… more
- Datavant (Helena, MT)
- …job function as delegated by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and ... expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well...documents and records + Meets or exceeds production and quality metrics + Attend all mandatory meetings and trainings… more
- Cardinal Health (Helena, MT)
- …be needed to perform your duties up to 25%. **_Qualifications_** + Current, unrestricted Registered Nurse license, required. + BA, BS or equivalent experience in ... and satisfactory experience for all customers. The Supervisor, Clinical Operations monitors nurse to patient contact quality and provides coaching as needed… more
- Humana (Helena, MT)
- …intervention **Use your skills to make an impact** **Required Qualifications** + Active Registered Nurse (RN) license with no disciplinary action. + **Hold an ... help us put health first** The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and...Our nurses are titled Care Managers, because our case management services are centered on the person rather than… more
- St. Peters Health (Helena, MT)
- …business management or business related field preferred. LICENSE/CERTIFICATION/REGISTRY: Registered Nurse required. Basic Life Support (CPR) certification ... to manage for results in key areas such as clinical quality , service excellence, people management , and financial management . *Demonstrated ability to create… more
- Oracle (Helena, MT)
- …other clinical healthcare information technology (HCIT) work experience + Professional license required: Registered Nurse - State Board + Work in accordance with ... people just as dedicated as we are to improving health equity and delivering quality care across the globe. If you're excited about making healthcare more human,… more
- CVS Health (Helena, MT)
- …conditions. + **Diabetes education experience** is required. + Current, unrestricted ** Registered Nurse (RN) license** ; multi-state licensure preferred. + ... health outcomes by engaging telephonically with individuals living with diabetes. This nurse will guide members through actionable steps to close gaps in care,… more
- Sharecare (Helena, MT)
- …of Sharecare with leadership practices. **Qualifications:** + Current licensure as a Registered Nurse is required; Compact state preferred + Bachelor's degree ... through the lens of their personal health and making high- quality care more accessible and affordable for everyone. To...the objectives and goals of the Value Based Care Management Program. The responsibilities of this role include directly… more
- Health Care Service Corporation (Helena, MT)
- …and/or facilities to support complex and specialty populations **Required Job Qualifications:** + Registered Nurse (RN) with 2 years direct clinical care to the ... responsible to provide care coordination to members via telephonic and/or field-based care management to inform and educate them on health care programs to address… more