- Humana (Jefferson City, MO)
- …documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are ... a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the… more
- Centene Corporation (Jefferson City, MO)
- …in either CST or EST time zone with experience in mental health settings and utilization management / review . **Position Purpose:** Performs a clinical ... and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and… more
- Lincoln Financial Group (Jefferson City, MO)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for… more
- Centene Corporation (Jefferson City, MO)
- …care, provider interactions, and facilitates operations within utilization management . + Manages prior authorization, concurrent review , and retrospective ... with applicable guidelines, policies, and procedures + Reviews and analyzes utilization management activities, operations, costs, and forecasted data to… 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
- Humana (Jefferson City, MO)
- …and ad hoc reports in Access and/or SQL + Graduate degree + Utilization Management Review Experience + Registered Nurse (RN) Credentials + Home Health, ... Durable Medical Equipment, and/or Skilled Nursing Facility Experience **Additional Information** **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week)… 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
- Elevance Health (Jefferson City, MO)
- …equivalent and a minimum of 3 years acute care clinical experience or case management , utilization management or managed care experience; or any combination ... **Anticipated End Date:** 2024-12-27 **Position Title:** Nurse Medical Management II **Job Description:** **Location** : This position can be located anywhere… more
- Cardinal Health (Jefferson City, MO)
- …for physician leaders and physician board regarding all areas of practice management and operations. This leader has primary responsibility to manage and drive ... will be needed in the following areas: practice operations, revenue cycle management , patient growth and practice marketing, value-based care, payor relations, EHR,… more