- Adecco US, Inc. (Minneapolis, MN)
- …**Pay** : $40.00 - $43.25 per hour based on experience **Responsibilities of the Utilization Management Nurse ** : . Responsible for reviewing proposed ... benefit determination. . Generally work is self-directed and not prescribed. . The Utilization Management Nurse works under the direct supervision of an RN… more
- CVS Health (St. Paul, MN)
- …Must have active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include ... med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in MST or CST zone.… more
- Sharecare (St. Paul, MN)
- …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
- CVS Health (St. Paul, MN)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... or Specialty Pharmacy Advocacy** **.** **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Elevance Health (Mendota Heights, MN)
- …criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Location: Virtual: This role...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- Elevance Health (Mendota Heights, MN)
- …with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires ... **Telephonic Nurse Case Manager I** **Location: Virtual: This role... Case Manager I** is responsible for performing care management within the scope of licensure for members with… more
- United Therapeutics (St. Paul, MN)
- …for which transplant is not currently an option. Who you are You are experienced nurse and an expert in all things PAH. You love providing mentorship, coaching and ... make a difference. The Regional Field Director, RNS Program Management serves as a director of all clinical field...+ Plan, collaborate, create and produce the yearly Clinical Nurse Summit meeting for HCPS across the United States… more
- Fairview Health Services (Minneapolis, MN)
- …services, bringing the very newest ideas in patient care. The Patient Care Management Coordinator will be working on the Acute Rehab Center and the Transitional ... is eligible for benefits. **About this Position:** This Patient Care Management Coordinator provides comprehensive care coordination of patients as assigned. The… more
- Highmark Health (St. Paul, MN)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... Care **LICENSES or CERTIFICATIONS** **Required** + United States Registered Nurse (RN) license + Delaware RN license must be...is part of the compact **Preferred** + Certification in Utilization Management or a related field **SKILLS**… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- *_SUMMARY:_* We are currently seeking a*Teen and Family Case Management Assistant*to join our Aqui Para Ti team. This part-time role will work 40 hours within a two ... delivery of cost-effective health care and identify the appropriate utilization of resources. Coaches patients and parents/caregivers in developmentally appropriate… more
- Bluestone Physician Services (Plymouth, MN)
- …with primary care teams to ensure high quality team-based care + Use utilization management tools to facilitate appropriate transitional care management ... as to acute settings with the goal of reducing utilization and unnecessary costs + Work to increase coordination...Nurse + 3-5 years of experience in case/care management or care coordination + Experience working directly with… more
- Sharecare (St. Paul, MN)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
- Fairview Health Services (Minneapolis, MN)
- …and strategic planning activities for complex clinical technology projects like nurse call, clinical communications, cardiac monitoring, and others. This leader ... facilitate the conduction of risk assessments and evaluation of the adoption and utilization of various technologies and provide plans to mitigate issues with the… more
- Presbyterian Homes and Services (Roseville, MN)
- …development and management for your assigned region. Qualifications + Registered nurse with current licensure the State Board of Nursing in state(s) in which ... of the RAI process + Experience with MDS completion, reimbursement, clinical resource utilization and/or case management + Ability to work flexible work hours… more
- Fairview Health Services (Minneapolis, MN)
- …and resources. + Serves as liaison with physicians to implement medical management of condition changes, diagnostic test results, lab results, based on knowledge ... and age specific competencies + Provides patient, MD, community and professional nurse education. + Coordinates and participates in patient, staff, MD and community… more
- Fairview Health Services (Minneapolis, MN)
- …rehabilitation centers, home health care services, counseling, pharmacies and benefit management services **Apply today to join our 34,000+ employees and 5,000+ ... Resolves conflict in a respectful manner. Demonstrates effective time management . Demonstrates personal growth and development. Contributes to department goals… more
- Fairview Health Services (Maple Grove, MN)
- …leadership to the physicians and advanced practice providers aside from the certified nurse midwives at the sites they support. Assists in development of short term ... and organizational strategies. **Job Expectations:** FTE: .1 + Implementation and ongoing management of the following for Women's Care: Pertinent policies related to… more
- Bluestone Physician Services (Minneapolis, MN)
- …medical care teams to ensure health care quality measures are met and use utilization management tools to meet value-based goals + Supporting members during ... grads encouraged to apply) + OR Current Minnesota Registered Nurse license + One or more years of experience...of experience working with the geriatric population in case management /care coordination, Home Care, Nursing Home, TCU or Assisted… more
- Bluestone Physician Services (Minneapolis, MN)
- …teams to ensure health care quality measures are met and use utilization management tools to meet value-based goals Qualifications : ... grads encouraged to apply) + OR Current Minnesota Registered Nurse license + One or more years of experience...with the geriatric or certified disabled population in case management /care coordination, Home Care, Group Homes, Nursing Homes, TCU… more
- Surgery Care Affiliates (Edina, MN)
- …scrub by anticipating the needs of the physician and keeping the circulating nurse informed of any needs throughout a procedure. + Ensures all supplies, equipment, ... Responsible for ensuring all new equipment requests are appropriately analyzed based on utilization and data from the provider. + Maintain radiation safety at all… more