- Cognizant (Des Moines, IA)
- …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
- CVS Health (Des Moines, IA)
- …we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** utilizes ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- George C. Grape Community Hospital (Hamburg, IA)
- …control, and payers to resolve care coordination issues. Qualifications: * Education: Registered Nurse (RN) license required; BSN preferred. * Experience: o ... Quality/ Utilization Review Nurse Position Summary: The...infection control outcomes. * Education & Collaboration: o Educate clinical staff on documentation requirements, utilization management… more
- Fresenius Medical Center (Dubuque, IA)
- **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
- Great River Health (West Burlington, IA)
- …shifts with on call requirements. Job Description: This position requires that the nurse work providing patient care on a regular basis and possesses strong ... disciplines. Facilitator responsibilities include but not limited to: effective and efficient utilization of resources and day to day operations of the surgical… more
- CVS Health (Des Moines, IA)
- …+ 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
- Avera (Sioux Center, IA)
- …Surg Unit, Emergency Department, and Obstetrics Unit._** **Summary** + The LPN assists the registered nurse in the management and care of their assigned patients ... Med Surg: ACLS, BLS **Essential Functions** + Assists the registered nurse in the management and care...and following through with them. Records and documents all clinical and patient data. Assists RN with discharges and… more
- Avera (Hartley, IA)
- …eligible for a $6000 sign on bonus Mileage reimbursement **Student Loan Repayment:** This Registered Nurse (RN) position may be eligible for Avera's Student Loan ... hardship to the employer. **Required Education, License/Certification, or Work Experience:** + Registered Nurse (RN) - Board of Nursing Upon Hire **Preferred… more
- Trinity Health (Davenport, IA)
- …ACLS; Basic Life Support. Training Preferred: Baccalaureate degree in nursing or clinical certification Licensure/Registration: Registered Nurse in Iowa; ... and performance improvement activities; promoting evidence-based practice through research utilization or conduct of practice research. Report To: Manager… more
- Alight (IA)
- …Alight to support the company's operational and financial goals. **Requirements** + Be a Registered Nurse with a BSN and equivalent experience required. + Have ... responsible for informing and supporting participants to seek the best clinical outcomes. **Responsibilities** + Assessing and identifying opportunities to support… more
- Trinity Health (Davenport, IA)
- …communities of Eastern Iowa and Western Illinois. But when it comes to clinical capabilities and quality, we exceed those geographical limits. We have earned ... unit or department during the assigned shift. + Responsible for resolving clinical issues, and serving as a liaison between nurses, physicians, and administrative… more
- Evolent (Des Moines, IA)
- …+ 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
- Molina Healthcare (Sioux City, IA)
- …and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse (RN). License must be active and unrestricted in ... for denial or modification of payment decisions. + Serves as a clinical resource for utilization management, CMOs, physicians and member/provider… more
- Molina Healthcare (Des Moines, IA)
- …and electronic medical record (EMR) experience. Preferred Qualifications * Experience as a registered nurse or nurse practitioner in a home health, ... primary care and medical care services to members - primarily in non- clinical settings where members feel most comfortable, including in-home, community and nursing… more
- CenterWell (Hiawatha, IA)
- …+ Graduate of an accredited School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's license, auto insurance ... position comes with a $10K sign-on bonus.** + The ** Clinical Manager** coordinates and oversees all direct care patient...and reliable transportation. + Two years as a Registered Nurse in a home care, with… more
- Access Dubuque (Dubuque, IA)
- …hours with weekend, holiday, and call rotations + **Job ID:** 168637 **Overview** ** Clinical Nurse Preceptor** **Dubuque Finley Home Care** **Part Time Benefits ... competency and proficiency in case management for provision of care, clinical expertise, documentation, utilization effectiveness, patient experience and quality… more
- UnityPoint Health (Dubuque, IA)
- …daytime hours with weekend, holiday, and call rotations + Job ID: 168637 Overview Clinical Nurse Preceptor Dubuque Finley Home Care Part Time Benefits 0.5 FTE ... competency and proficiency in case management for provision of care, clinical expertise, documentation, utilization effectiveness, patient experience and quality… more
- Molina Healthcare (Cedar Rapids, IA)
- …and experience. * At least 5 years health care management/leadership required. * Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical ... * Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Registered Nurse (RN). License must be active and unrestricted… more
- Molina Healthcare (Iowa City, IA)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for...to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications *… more
- UnityPoint Health (Anamosa, IA)
- …to provide continuity of care. + Functions under all accountabilities of the Registered Nurse position. + Works with patients/families to identify their goals ... career and make a difference with UnityPoint Health. Responsibilities Clinical Excellence/Patient Care + Assesses the needs of patients...Current licensure in good standing to practice as a Registered Nurse in Iowa. + Must possess… more