- Cognizant (Helena, MT)
- …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
- Humana (Helena, MT)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN)** in the (appropriate state)… more
- CVS Health (Helena, MT)
- …conditions. + **Diabetes education experience** is required. + Current, unrestricted ** Registered Nurse (RN) license** ; multi-state licensure preferred. + ... health outcomes by engaging telephonically with individuals living with diabetes. This nurse will guide members through actionable steps to close gaps in care,… more
- St. Peters Health (Helena, MT)
- …school of nursing required. LICENSE/CERTIFICATION/REGISTRY: Current Montana License as a Registered Nurse required. Current and valid American Heart Association ... principles of case management to ensure effective coordination of care and utilization of community resources. Works collaboratively with other members of the… more
- Evolent (Helena, MT)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals.… more
- Health Care Service Corporation (Helena, MT)
- …organization in delivery of services to the customer. **JOB REQUIREMENTS** **:** + Registered Nurse (RN), with current, unrestricted license to practice in state ... staff involved in a variety of behavioral health clinical operations such as Utilization Management, Case...years) at the independent practice level + If a Registered Nurse (RN): must have at least… more
- Health Care Service Corporation (Helena, MT)
- …visits to acute in-patient to out-patient office visits. **JOB REQUIREMENTS:** * Registered Nurse (RN) or Masters-level Behavioral Health Professional (LPC, ... This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity...of years) at the independent practice level *If a Registered Nurse (RN): must have at least… more
- Highmark Health (Helena, MT)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more