- State of Minnesota (St. Paul, MN)
- **Working Title: Case Mix Reviewer ** **Job Class: Nursing ... review (CMR) audit process. Working as a Case Mix Reviewer you will: + ... of Health (MDH) + **Division/Unit** : Health Regulation / Case Mix Review + **Work...and development opportunities. Elevate your career and use your nursing knowledge and expertise to be part of a… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …an accurate reflection of the patient condition in the associated MS-DRG assignments, case - mix index, severity of illness and risk of mortality profiling and ... CDI activities /*License/Certifications:*/ * Maintain current licensure by the Minnesota Board of Nursing as a Registered Nurse (RN) -OR- * Registration as a… more
- CVS Health (St. Paul, MN)
- …Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or ... Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers...**Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …You Will Have This job implements effective utilization management strategies including: review of appropriateness of pre and post service health care services, ... ensure appropriate resource utilization, identification of referrals to a Health Coach/ case management, and identification and resolution of quality issues. Monitors… more
- CVS Health (St. Paul, MN)
- …Manager role includes: -Collaborate with an interdisciplinary care management team ( nurse case managers, medical directors, dietitians, social workers) to ... for pharmacy benefit and precertification related issues. -Participates in case conferences, grand rounds, and plan sponsor requested formal clinical… more