• Staff Nurse - Utilization

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …Some positions may require specialized certifications(s). **Title:** * Staff Nurse - Utilization Review (Float)* **Location:** *MN-Minneapolis-Downtown ... *_SUMMARY:_* We are currently seeking a* Staff Nurse *to join our Utilization...may require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse more
    Minnesota Visiting Nurse Agency (10/02/25)
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  • Manager - Utilization Review

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    review functions. Oversees daily operations, which include supervising staff performing utilization management activities. The goal is to achieve ... *_SUMMARY:_* We are currently seeking a* Utilization Review Manager* to join ourTransitional...utilization and denial management. Liaises with provider office staff and facilitates meetings with payers, as appropriate *… more
    Minnesota Visiting Nurse Agency (09/30/25)
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  • RN - UM / Medical Management Nurse

    Elevance Health (Mendota Heights, MN)
    …or case management experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any combination of education ... RN - Utilization / Medical Management Nurse /...6pm PST. Rotating Weekends and holidays. The **Medical Management Nurse ** is responsible for review of the… more
    Elevance Health (10/22/25)
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  • Clinical Reviewer, Nurse -9am -6pm PST

    Evolent (St. Paul, MN)
    …quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are… more
    Evolent (10/21/25)
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  • Appeals Nurse

    Evolent (St. Paul, MN)
    …focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and procedures ... work with a group of nurses, providing appeal intake review for one dedicated client. They interact with coordinators...Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company… more
    Evolent (10/11/25)
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  • Dialysis Clinical Manager Registered Nurse

    Fresenius Medical Center (Hastings, MN)
    …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
    Fresenius Medical Center (10/24/25)
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  • Care Management Coordinator

    Highmark Health (St. Paul, MN)
    …timeframes and notification requirements are met. + Communicate effectively with Utilization Management Staff , providers, other internal and external customers ... requirements. Documents, processes and routes requests for services to the nurse reviewer and other departments based on documentation procedures, including … more
    Highmark Health (10/16/25)
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