- Humana (Jefferson City, MO)
- **Become a part of our caring community and help us put health first** The Manager , Utilization Management Nursing utilizes clinical nursing skills ... communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing...to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in IL, WI, MN, SD, ND, IA,… more
- Prime Therapeutics (Jefferson City, MO)
- …+ Clinical and Quality oversight for this program is provided by the Manager , Patient Programs. **Responsibilities** + Registered Nurse (RN). + 5 years ... post-degree clinical experience. + Experience in managed care, specialty drugs, care management and utilization review. + Meets Magellan Credentialing criteria.… more
- SSM Health (Jefferson City, MO)
- …opportunities for improvement in standard work. + May also be responsible for: utilization management process, ED case management process, admission process, ... and act as a case manager liaison with post acute providers (skilled ...department's Scope of Service. + As an SSM Health nurse , I will demonstrate the professional nursing … more
- Huron Consulting Group (Jefferson City, MO)
- …it promotes a culture of respect, unity, collaboration, and personal achievement. As a Manager , you will have the unique ability to specialize in certain areas that ... talent, training, supervising, coaching/mentoring, and providing feedback through performance management + Facilitate communication and collaboration between all key… more
- Sharecare, Inc. (Jefferson City, MO)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...Patient Care Technician (PCT) + Physical Therapy Assistant + Nursing Assistant + Medical Secretary/Clinic Manager +… more