- Cognizant (St. Paul, MN)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- 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. Some positions may… more
- Humana (St. Paul, MN)
- …a part of our caring community and help us put health first** The Weekend Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... Communities is good for the Soul. Join Us!** The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state)… 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
- 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
- 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)
- …through assessment and evaluation. **Required Qualifications** + Active Registered Nurse Compact License + Minimum 3+ years clinical practical experience ... in serving our members by utilizing best-in-class operating and clinical models. You can have life-changing impact on our...experience, transitions of care and discharge planning required + Registered Nurse with active state license in… more
- Good Samaritan (Inver Grove Heights, MN)
- …with a weekend on-call rotation shared with the other supervisory staff. MN Registered Nurse , RN required. Prior MDS experience preferred. $15,000 Bonus ... team. Seeks to evaluate outcomes based on an integration among established clinical , financial and utilization data. Functions in structured and unstructured… more
- Fairview Health Services (Crystal, 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
- Lincoln Financial (St. Paul, MN)
- …**What we're looking for** Education * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …improve provider performance and member satisfaction. Required Skills and Experience * Registered nurse or licensed behavioral health clinician (ie LICSW, LPCC, ... join us. The Impact You Will Have This job implements effective utilization management strategies including: review of appropriateness of pre and post service… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …management. ⦁ Performs other accountabilities as assigned. Required Skills and Experience ⦁ Registered Nurse licensure in MN. ⦁ 3+ years of related professional ... state regulations and CMS guidelines. Audits capture case management, disease management, utilization management and delegate audits for clinical and non-… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …mental health challenges by providing culturally sensitive support. This role requires a Registered Nurse (RN) licensed in the state of Minnesota with ... community events to engage with members. Required Skills and Experiences * Registered Nurse with Psychiatric experience or Behavioral Health Professional that… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …to ensure optimal and cost-effective health outcomes. Required Skills and Experience * Registered nurse with current MN license and with no restrictions * ... effective plan of care that leads to optimal, cost-effective outcomes. Leveraging clinical expertise, strong critical thinking skills and a keen business sense, the… more
- Fairview Health Services (Minneapolis, MN)
- …**Required Qualifications** + Bachelors Degree in Nursing + 1 year RN experience + Registered Nurse **Preferred Qualifications** + Case Management Nurse + ... of care and develops, implements, monitors, and documents the utilization of resources and progress of the patient through...requirements. This position is accountable for the quality of clinical services delivered by both them and others and… 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)
- …and behavior, employee relations and cost control. Required Skills and Experience * Registered nurse or licensed behavioral health clinician (ie, LICSW, LPCC, ... that may encompass cross functional and strategic partners. * Acts as a clinical , care management, and business case consultant for leadership as they relate to… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …to achieve results /*License/Certifications*/ * Possession of a valid license as a Registered Nurse without restrictions issued by the State of Minnesota * ... of HHS into planning * Assures effective operation and integration of clinical and educational resources within areas of accountability. Monitors, assesses and… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …and transition of care between settings. Required Skills and Experience * Registered Nurse with Psychiatric experience or Behavioral Health Professional that ... * Receives referral and/or reaches-out to member and leverages clinical knowledge, motivational interviewing and behavioral modification techniques. * Conducts… more
- Bluestone Physician Services (Blaine, MN)
- …high risk patients Qualifications : Education/Certification/Experience + Licensed Social Worker or Registered Nurse + 3-5 years of experience in case/care ... Home communities throughout Minnesota, Wisconsin and Florida and are supported by clinical operations and administrative colleagues who work remotely or at our… more