- Elevance Health (Mendota Heights, MN)
- RN - Utilization / Medical Management Nurse / InPatient (JR171072) **Work Hours** : 8 hour shift within 8am - 6pm PST. Rotating Weekends and holidays. ... 8am - 6pm PST. Rotating Weekends and holidays. The ** Medical Management Nurse ** is responsible...an equivalent background. + Current active, valid and **unrestricted RN license** to practice as a health professional within… more
- Highmark Health (St. Paul, MN)
- … UM /CM/QA/Managed Care **LICENSES AND CERTIFICATIONS** **Required** + Current RN state licensure required. Additional specific state licensure(s) may be required ... **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health care services,… more
- CVS Health (St. Paul, MN)
- … Management ( UM ) Nurse Consultant. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and ... includes reviewing written clinical records. **Key Responsibilities of the UM Nurse Consultant** (Includes but is not...of Healthcare Services and benefit utilization. **Required Qualifications** + Registered Nurse ( RN ) with current… 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, ... precertification and prior approvals. Tasks are performed within the RN /LVN/LPN scope of practice, under Medical Director...care + Minimum of one year of experience with medical management activities in a managed care… 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 ... in utilization management or a related field. * Experience in UM /CM/QA/Managed Care. * Knowledge of state and/or federal regulatory policies and/or provider… more
- Humana (St. Paul, MN)
- …**Required Qualifications** + Bachelor's degree in Nurse (BSN). + Valid and unrestricted Registered Nurse ( RN ) license in the (appropriate state) with no ... achieve desired clinical outcomes and to enhance quality of medical care. The **Telephonic Nurse Case Manager**...behavioral health spectrum. They will also coordinate with other Medical Management programs (DM/PN) as needed, in… more
- Highmark Health (St. Paul, MN)
- …:** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides oversight over a ... in health status/severity and clinical needs; and assesses health management needs of the assigned member panel and utilizing...in a clinical setting **Preferred** + 5 years in UM /CM/QA/Managed Care + 1 year in advanced training and… more