• RN Utilization Management

    Humana (St. Paul, MN)
    **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
    Humana (01/07/25)
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  • Utilization Management Spec…

    Fairview Health Services (St. Paul, MN)
    …Job Description** **Job Expectations:** + Perform and document timely and accurate utilization management review to ensure compliance with all ... **Overview** **Fairview Health Services is hiring a casual** ** Utilization Management Spec RN **...**Required** + Bachelor's degree in Nursing + 3-5 years Utilization Review or Case Management more
    Fairview Health Services (01/04/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Woodbury, MN)
    …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
    Fresenius Medical Center (12/31/24)
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  • Care Manager RN - Weekends (Remote)

    Highmark Health (St. Paul, MN)
    …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
    Highmark Health (01/07/25)
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  • Care Manager Behavioral Health - Part Time…

    Highmark Health (St. Paul, MN)
    …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES:** + Implement care management review processes that are consistent with established… more
    Highmark Health (12/12/24)
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  • RN Clinical Consultant, Claims Shared…

    Guardian Life (St. Paul, MN)
    …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… more
    Guardian Life (12/20/24)
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