- Fresenius Medical Center (Hastings, 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
- Evolent (St. Paul, MN)
- …+ 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
- Fairview Health Services (Maplewood, 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
- CVS Health (St. Paul, MN)
- …in state of residence - 3+ years of acute experience as a Registered Nurse - 1+ years of Utilization Management experience - Must have experience using MS ... Works closely with functional area management to ensure consistency in clinical interventions supporting our members. Accountable for meeting the financial,… 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
- Minnesota State (White Bear Lake, MN)
- …+ Two full-time years (or equivalent) of verified related paid work experience as a registered nurse at the professional level. + As a registered ... the last five years. **Professional Requirement** + Current unencumbered licensure as a registered nurse (RN) with current registration in Minnesota. + **Other… 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
- 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
- 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
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …* Attend community events to engage with members. Required Skills and Experience * Registered nurse with current MN license and with no restrictions or ... the BCBSMN Care Management team. Behavioral Health Care Advisors will provide clinical approaches that will serve and support members from communities. The… more
- Highmark Health (St. Paul, MN)
- …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
- Presbyterian Homes and Services (Roseville, MN)
- …communicate at IDT + Site specific education + Key measure management Qualifications + Registered nurse with current licensure from the State Board of Nursing in ... working knowledge of the MDS process. + Experience with MDS completion, reimbursement, clinical resource utilization and/or case management. + Ability to work… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …coordination, and transition of care between settings. Required Skills and Experience * Registered Nurse licensure in the state of Minnesota with no ... * Receives referral and/or reaches-out to member and leverages clinical knowledge, motivational interviewing and behavioral modification techniques. * Conducts… more
- Bluestone Physician Services (Eagan, MN)
- …to identify high risk patients Qualifications: Education/Certification/Experience + Social Worker, Registered Nurse , or LPN with 4-year degree or commensurate ... Home communities throughout Minnesota, Wisconsin and Florida and are supported by clinical operations and administrative colleagues who work remotely or at our… more