- Molina Healthcare (Madison, WI)
- …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... program(s) proficiency. Preferred Experience Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review... Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual /… more
- Molina Healthcare (Madison, WI)
- …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary… more
- Molina Healthcare (Madison, WI)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
- CVS Health (Madison, WI)
- …Service/Health Services (as applicable to hiring program) or Associates degree with a Registered Nurse with Behavioral Health experience/ background with 3 years ... with behavioral health background. **Preferred Qualifications** + 3 years Managed care /utilization review experience preferred. + Crisis intervention skills and… more
- Marshfield Clinic (Beaver Dam, WI)
- …Must hold or be eligible to obtain and maintain a current State of Wisconsin Registered Nurse license or Nurse Compact License. Licenses with restrictions ... more than 350,000 unique patients each year through accessible, high quality health care , research and education. With more than 1,600 providers in 170 medical… more
- Humana (Madison, WI)
- …a part of our caring community and help us put health first** The Appeals Nurse 2 resolves clinical complaints and appeals. The Appeals Nurse 2 work assignments ... and independent determination of the appropriate courses of action. The Appeals Nurse 2 reviews documentation and interprets data obtained from clinical records to… more