- Humana (Helena, MT)
- **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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Helena, MT)
- **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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Helena, MT)
- **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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Cognizant (Helena, MT)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- CVS Health (Helena, MT)
- …experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal ... clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult… more
- Sharecare (Helena, MT)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- Cabinet Peaks Medical Center (Libby, MT)
- …Services, Imaging Services, Laboratory Services, Nutrition and Diabetes Education, Quality Risk Management , Utilization Review and Risk Management , Employee ... Cabinet Peaks Medical Center is looking for a Nurse House Manager to join our Nursing Administration...utilization of personnel. Experience 5+ years' experience in management and supervisory nursing role required. Experience in Obstetrics,… more
- CVS Health (Helena, MT)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Billings Clinic (Bozeman, MT)
- …Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Nurse Navigator (0.75 FTE) - REI/Fertility - ... through meeting with physicians, advanced practice providers, genetic counselors and nurse caregivers to promote the development, implementation and evaluation of… more
- Highmark Health (Helena, MT)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... within the first 6 months of employment. **Preferred** + Certification in utilization management or a related field + Certification in Case Management … more
- Evolent (Helena, MT)
- …responsible for support and assistance for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices ... is 11:30-8:00 eastern** **OTHER SKILLS and ABILITIES:** Strong clinical, management , communication, and organizational skills. Demonstrated leadership skills Analytic… more
- Fresenius Medical Center (Butte, MT)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... + Preferred but not required: + 3+ years supervisory or project/program management experience. + Med/surg or ICU/CCU experience. **PHYSICAL DEMANDS AND WORKING… more
- Bozeman Health (Bozeman, MT)
- …DNV and the hospital administrative team. Provides oversight of case management , discharge planning and utilization review. Provides leadership, direction, ... Position Summary: The System Manager of Case Management is responsible for assisting with planning, directing,...of Science in Nursing + Current Montana Licensure (Registered Nurse ) + Three (3) years leadership experience in high… more
- Cabinet Peaks Medical Center (Libby, MT)
- …operations of the emergency department, ensuring efficient patient flow and resource utilization . Management of staff: Scheduling, hires high quality personnel, ... Peaks Medical Center is looking for a Director of Emergency Services! Nurse Practitioners and Physicians Assistants are strongly encouraged to apply. The Director… more
- Intermountain Health (Butte, MT)
- …+ Case Management Certification + Demonstrated experience in case management , utilization review, value-based care, and/or discharge planning. + Basic ... + Case Management Certification + Demonstrated experience in case management , utilization review, value-based care, and/or discharge planning. + Basic… more
- Billings Clinic (Billings, MT)
- …of co-pays. *Screens incoming telephone calls for appropriate referrals to nurse , physician and/or non-physician provider. *Orders and maintains clinical and office ... care *Refers more difficult problems to higher level medical assistant, nurse , supervisor or appropriate health care provider *Practices according to Billings… more
- Datavant (Helena, MT)
- …function as delegated by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for...expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in… more
- Billings Clinic (Billings, MT)
- …care. * Maintains respectful and professional communication skills. Insurance and Utilization Management *Maintains working knowledge of CMS requirements and ... leadership, the RN Care Manager provides services consisting of comprehensive care management , care coordination and care continuing care services. Accountable for a… more
- Highmark Health (Helena, MT)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
- Intermountain Health (Billings, MT)
- …and behaviors consistent with Employer's Framework for Excellence + Provide leadership, management and coaching for providers toward the attainment of the clinical, ... functional, integrated Medical Group + Assist in hiring of Physicians, Nurse Practitioners and Physician Assistants in collaboration with market Associate Chief… more