- 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. **Title:** *Staff … more
- Humana (St. Paul, MN)
- **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 ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state)… more
- CVS Health (St. Paul, MN)
- …both verbal and written **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active ... work schedules will include weekends, holidays, and evening hours._ + Utilizes clinical experience and skills in a collaborative process to assess, plan, implement,… 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 ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult inpatient… 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)
- …+ Associates Degree in Nursing + less than 1 year nursing experience + MN Registered Nurse (RN) License + Basic Life Support (American Heart Assoc or Red ... City/State: Edina, Minnesota Categories: Nurse (RN/LPN) Shift: Ebenezer Job Status: day Req...and Advance Care Planning documents, including POLST. + Maintains clinical charts and progress notes using computerized documentation system.… 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 (Maplewood, 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
- Datavant (St. Paul, MN)
- …clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …community events to engage with members. Required Skills and Experience * Registered Nurse with Psychiatric experience or Behavioral Health Professional that ... the BCBSMN Care Management team. Behavioral Health Care Advisors will provide clinical approaches that will serve and support members from communities. The… 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
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …coordination, and transition of care between settings. Required Skills and Experience * Registered Nurse licensure in the state of Minnesota with no ... * Receives referral and/or reaches-out to member and leverages clinical knowledge, motivational interviewing and behavioral modification techniques. * Conducts… more
- Highmark Health (St. Paul, MN)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... 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
- Adecco US, Inc. (Minneapolis, MN)
- …or local law; and Holiday pay upon meeting eligibility criteria. **IMPORTANT:** This ** Registered Nurse ** role is being recruited for by Adecco's Healthcare & ... inpatient hospital setting . Experience applying benefits and criteria to clinical reviews . Utilization Management, pre-authorization, concurrent review, or… more