- Humana (Jefferson City, MO)
- …documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ... community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the coordination,… more
- Centene Corporation (Jefferson City, MO)
- …KS or other states. Ideal candidate will have experience in utilization management , provider and payor side with 2 -5 years of leadership experience.** ... experience. 2 + years supervisory experience preferred. Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered… more
- Humana (Jefferson City, MO)
- …of our caring community and help us put health first** The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, ... communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within specific guidelines and… more
- Centene Corporation (Jefferson City, MO)
- …either CST or EST time zone with experience in mental health settings and utilization management / review. **Position Purpose:** Performs a clinical review and ... of an Accredited School Nursing or Bachelor's degree and 2 - 4 years of related experience. License to...required Additional Details: * Department: IL Meridian Behavioral Health Utilization Management Pay Range: $25.00 - $44.85… more
- Humana (Jefferson City, MO)
- …**Preferred Qualifications** + Registered Nurse + Experience in Medicare Utilization Management + Project Management Professional (PMP) certification ... are addressed. They will work closely with established functions inside utilization management (Medical Director, clinician decision making teams, quality… more
- Humana (Jefferson City, MO)
- …ad hoc reports in Access and/or SQL + Graduate degree + Utilization Management Review Experience + Registered Nurse (RN) Credentials + Home Health, Durable ... caring community and help us put health first** The Compliance Professional 2 ensures compliance with governmental requirements. The Compliance Professional 2 … 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, ... described in the department's Scope of Service. + As an SSM Health nurse , I will demonstrate the professional nursing standards defined in the professional practice… more