- Evolent (St. Paul, MN)
- …scheduled. + Determines medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all review ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks… more
- Fresenius Medical Center (Hastings, MN)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture...a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in… more
- State of Minnesota (Oak Park Heights, MN)
- …charge nurse /supervisor; maintain a system for accurate and thorough medical record keeping; provide health education; and maintain adequate inventory and ... **Working Title: RN** **Job Class: Registered Nurse ** **Agency: Corrections Dept** + **Job ID** :...security of medical supplies and equipment. **Minimum Qualifications** To be qualified… more
- CVS Health (St. Paul, MN)
- …benefit overall claim management. + Using a holistic approach, consults with clinical colleagues, supervisors, Medical Directors and/or other programs to ... in the US with virtual training.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993,… more
- Fairview Health Services (Maplewood, MN)
- …an individualized treatment plan based on age, social and cultural considerations, clinical diagnosis, level of functioning and other relevant needs. + Acts as ... individualized discharge plan based on age, social and cultural considerations, clinical diagnosis, level of functioning and other relevant needs. Facilitates… more
- Datavant (St. Paul, MN)
- …years of CDI experience + 3+ years of clinical experience in an academic medical center + Registered Nurse license, Bachelor's degree in Nursing + CCDS or ... realize our bold vision for healthcare. **What We're Looking For:** As a Clinical Documentation Quality Improvement (CDQI) Specialist, you will play a pivotal role… more
- BioLife Plasma Services (St. Paul, MN)
- …You will report to the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. BioLife ... of laboratory test results, and donor notification of unsuitable test results. The Medical Support Specialist (Plasma Center Nurse ) works under the guidance of… more
- Elevance Health (Mendota Heights, MN)
- …Group Clinical Validation Auditor** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and ... DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims. **How...an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and… more
- Fujifilm (St. Paul, MN)
- **Position Overview** The Clinical Consultant, MI - I shall be responsible for providing clinical consulting for the project, report configuration (CV), workflow ... go-live support to Synapse PACS/MI projects. In addition, provide clinical support for sales and company team members with...HCUS team to gain customer acceptance of the FUJIFILM Medical Systems solution. + Participates in teaching and training… more
- Cardinal Health (St. Paul, MN)
- …to ensure a positive and satisfactory experience for all customers. The Supervisor, Clinical Operations monitors nurse to patient contact quality and provides ... manufacturers to rethink the reach and impact of their products. The Supervisor, Clinical Operations provides management and clinical oversight to a team of… more
- St Croix Hospice (River Falls, WI)
- …during operating hours to assist clinicians as appropriate. + Reviews patient's medical diagnosis, prognosis, medications, procedures, and clinical course. + ... Manager of Clinical Services Job Details Level Management Job Location...appropriate hospice personnel to case as needed. Conferences with Medical Director or Hospice Physician regarding any questions about… more
- Surgery Care Affiliates (Eagan, MN)
- …do it. Each decision we make is rooted in seven core values: + Clinical quality + Integrity + Service excellence + Teamwork + Accountability + Continuous improvement ... package to support your health, well-being, and financial future. Our offerings include medical , dental, and vision coverage, 401k plan with company match, paid time… more
- Oracle (St. Paul, MN)
- …+ Excellent communication, stakeholder engagement, and leadership skills. **Preferred Qualifications:** + Clinical experience as a nurse or physician with a deep ... **Job Description** The Clinical Note AI Agent Product Management Leader will...Gather and analyze information to define product specifications and review design specifications. Envision and communicate product strategy and… more
- Highmark Health (St. Paul, MN)
- …over a specified panel of members that range in health status/severity and clinical needs; and assesses health management needs of the assigned member panel and ... utilizing data/analytics in conjunction with professional clinical judgement to identify the right clinical intervention for each member. The incumbent conducts… more
- BrightSpring Health Services (Forest Lake, MN)
- …Help clinicians grow professionally and create a strong team culture. As a RN Clinical Supervisor You will: + Review new patient referrals and determine care ... Lake, MN Schedule: Monday-Friday 8AM-5PM Are you a RN Clinical Supervisor looking for a new opportunity? Hospice of...and organizational goals. Benefits and Perks for You! + Medical , Dental, Vision insurance + Health Savings & Flexible… more
- CenterWell (St. Paul, MN)
- …will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review ... Compact Nursing License + A minimum of three years clinical RN experience; + Prior clinical experience,...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Blue Shield of Minnesota Position Title: Supervisor - Special Investigations Unit Clinical Location: Hybrid | Eagan, Minnesota Career Area: Legal About Blue Cross ... complex potential fraud, waste, or abuse, including pre-pay and/or post-pay medical claims reviews to determine valid cases for appropriate action; documents… more
- Fresenius Medical Center (Blaine, MN)
- …dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance ... and/or change in patient condition directly to the registered nurse or supervisor. + Observe patient and conduct machine...activities. + Enters all treatment data into the designated clinical application in an accurate and timely manner. +… more
- BioLife Plasma Services (Mounds View, MN)
- …You will report to the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. BioLife ... of laboratory test results, and donor notification of unsuitable test results. The Medical Support Specialist (Plasma Center Nurse ) works under the guidance of… more
- Datavant (St. Paul, MN)
- …Prevention Specialist is to effectively defend utilization of available health services, review of admissions for medical necessity and necessity of continued ... necessity criteria and standards of care, along with clinical knowledge and expertise successfully. Ideal candidate should be...to author appeal letter Identification of referrals to the medical director for review + Select appropriate… more