- Cognizant (St. Paul, MN)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... 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
- CVS Health (St. Paul, MN)
- …we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** utilizes ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …needs and may require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for ... annual performance review /*License/Certifications:*/ * Possession of a valid license as a Registered Nurse issued by the State of Minnesota. Some positions may… more
- CVS Health (St. Paul, MN)
- …Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization . **Required Qualifications** + Registered Nurse (RN) ... CVS Health Aetna has an opportunity for a full-time Utilization Management (UM) Nurse Consultant. As a...Nurse Consultant. As a Utilization Management Nurse Consultant, you will utilize clinical skills… more
- CVS Health (St. Paul, MN)
- …good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… 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 ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …in confidentiality, integrity, creativity, and initiative */License/Certifications:/* * Current Registered Nurse licensure upon hire * National certification ... performing utilization management activities. The goal is to achieve clinical , financial, and utilization goals through effective management, communication,… more
- CVS Health (St. Paul, MN)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
- Ebenezer (Edina, MN)
- …155490 Pay Range: Ebenezer **Job Overview** Ebenezer is looking for a **Float RN - Registered Nurse ** to join our float team with the Ebenezer Corporate Office! ... and Advance Care Planning documents, including POLST. + Maintains clinical charts and progress notes using computerized documentation system....year previous experience in Assisted Living as a Staff Nurse + RN Licensure/ Registered with the MN… more
- CVS Health (St. Paul, MN)
- …through assessment and evaluation. **Required Qualifications** + Active Registered Nurse Compact License + Minimum 3+ years clinical practical experience ... in serving our members by utilizing best-in-class operating and clinical models. You can have life-changing impact on our...experience, transitions of care and discharge planning required + Registered Nurse with active state license in… more
- CVS Health (St. Paul, MN)
- …Service/Health Services (as applicable to hiring program) or Associates degree with a Registered Nurse with Behavioral Health experience/ background with 3 years ... we do it all with heart, each and every day. **Position Summary** Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization… more
- Good Samaritan (Inver Grove Heights, MN)
- …with a weekend on-call rotation shared with the other supervisory staff. MN Registered Nurse , RN required. Prior MDS experience preferred. $15,000 Bonus ... team. Seeks to evaluate outcomes based on an integration among established clinical , financial and utilization data. Functions in structured and unstructured… more
- Evolent (St. Paul, MN)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... 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
- Sharecare (St. Paul, MN)
- …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… more
- Fairview Health Services (Crystal, MN)
- …Three years in mental health or related setting **License/Certification/Registration** + Current Registered Nurse license in Minnesota + Basic Life Support ... Certification **Preferred** **Experience** + Outpatient experience **License/Certification/Registration** + Certified Registered Nurse **Additional Requirements (must be obtained… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …to improve provider performance and member satisfaction. Required Skills and Experience * Registered nurse with current MN license and no existing or pending ... join us. The Impact You Will Have This job implements effective utilization management strategies including: review of appropriateness of pre and post service… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …mental health challenges by providing culturally sensitive support. This role requires a Registered Nurse (RN) licensed in the state of Minnesota with ... community events to engage with members. Required Skills and Experiences * Registered Nurse with Psychiatric experience or Behavioral Health Professional that… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …to ensure optimal and cost-effective health outcomes. Required Skills and Experience * Registered nurse with current MN license and with no restrictions * ... effective plan of care that leads to optimal, cost-effective outcomes. Leveraging clinical expertise, strong critical thinking skills and a keen business sense, the… more
- Fairview Health Services (Minneapolis, MN)
- …**Required Qualifications** + Bachelors Degree in Nursing + 1 year RN experience + Registered Nurse **Preferred Qualifications** + Case Management Nurse + ... of care and develops, implements, monitors, and documents the utilization of resources and progress of the patient through...requirements. This position is accountable for the quality of clinical services delivered by both them and others and… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …needs across the continuum of care by leveraging member partnership, pre-service clinical utilization review, case and disease management processes, skill sets ... care coordination, and transition of care between settings. Required Skills and Experience * Registered nurse with current MN license and with no restrictions. *… more