- Molina Healthcare (Lincoln, NE)
- **Job Description** **Job Summary** The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring ... nursing experience, including at least 1 year of utilization review , medical claims review , long-term...or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must… more
- Molina Healthcare (Lincoln, NE)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Lincoln, NE)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Molina Healthcare (Lincoln, NE)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Veterans Affairs, Veterans Health Administration (Lincoln, NE)
- …patient information. Completed work should need only a general review by a registered nurse ( RN ) or physician (MD/DO) for appropriateness and conformity ... to Veterans through in-person, video, or telephone interactions, under the supervision of a Registered Nurse ( RN ) or Provider. The Specialty Medicine Clinics… more
- Veterans Affairs, Veterans Health Administration (Lincoln, NE)
- …patient information. Completed work should need only a general review by a registered nurse ( RN ) or physician (MD/DO) for appropriateness and conformity ... NE. This LPN works under the direction of an RN as a member of a Primary Care team,...to health promotion and reinforces instructions provided by the Registered Nurse and provider. Recognize the need… more
- CenterWell (Lincoln, NE)
- …+ Graduate of an accredited School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's license, auto insurance ... on-site at our Brooklyn Park, MN branch location.** The ** RN Clinical Manager** coordinates and oversees all direct care...and reliable transportation. + Two years as a Registered Nurse with at least one-year of… more
- Evolent (Lincoln, NE)
- …the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... are performed within the ** RN /LVN/LPN** scope of practice, under the Medical ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate,… more
- Humana (Lincoln, NE)
- …an impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and… more
- Humana (Lincoln, NE)
- …each day between 6AM and 9AM in their home time zone. **Required Qualifications** + Active Registered Nurse ( RN ) license in the state they reside. + Minimum ... independent determination of the appropriate courses of action. The Nurse Auditor 2 validates and interprets medical ...clinical and coding experience to conduct a clinical validation review of the inpatient medical record to… more
- Cardinal Health (Lincoln, NE)
- …interactions **_Qualifications_** + 2-4 years of experience, preferred + Current, unrestricted Registered Nurse license, required + Bachelor's degree in related ... to meet the needs of an individual patient. **_Job Summary_** The Nurse , Individualized Care promotes high-quality patient care and treatment through patient… more
- Datavant (Lincoln, NE)
- …+ 3+ years of CDI experience + 3+ years of clinical experience in an academic medical center + Registered Nurse license, Bachelor's degree in Nursing + CCDS ... you will play a pivotal role in elevating the impact of our medical record documentation. You will conduct daily evaluations and engage in direct communication… more
- Highmark Health (Lincoln, NE)
- …State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC). + Delaware RN license must be obtained within ... **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria… more
- Humana (Lincoln, NE)
- …guidance where needed. Follows established guidelines/procedures. **KEY ACCOUNTABILITIES** + Review medical documentation, obtain additional information that may ... community and help us put health first** The Appeals Nurse 2 resolves clinical complaints and appeals. The Appeals...TRICARE, all HGB policies and procedures as well as medical necessity review criteria and privacy requirements… more
- Highmark Health (Lincoln, NE)
- …Preferred + Associate's or Bachelor's Degree in Nursing + 1 year performing medical record review and data abstraction for cardiovascular registries + Proficient ... **Job Description :** **GENERAL OVERVIEW:** This job performs clinical review and data abstraction of patient records to support...Minimum + High School/GED + Current State of PA RN licensure OR Current multi-state licensure through the enhanced… more
- CenterWell (Lincoln, NE)
- …community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part...to make an impact** **Required Qualifications** + Active unrestricted RN license with the ability to obtain Compact Nursing… more
- Datavant (Lincoln, NE)
- …with clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... is to effectively defend utilization of available health services, review of admissions for medical necessity and...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
- Highmark Health (Lincoln, NE)
- …+ 1-3 years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related ... claims review basis. Review process includes a review of medical documentation, itemized bills, and claims data to assure appropriate level of… more
- Fujifilm (Lincoln, NE)
- …Nuclear Medicine Technologist experience in: + MPI + MUGA + PET + (CV) Registered Nurse Cardiac experience in: + Cath, Peripheral Angiography, Electrophysiology ... HCUS team to gain customer acceptance of the FUJIFILM Medical Systems solution. + Participates in teaching and training...industry, experience in Cardiology or Radiology discipline preferred. + (CV) Registered in one or more of the following: +… more
- Catholic Health Initiatives (Lincoln, NE)
- …is a full-time Electrophysiology Cardiology opportunity. Individuals with previous Cardiology RN or clinical/hospital experience are encouraged to apply. + Enjoy ... medications and treatments and writes prescriptions, providing refills as appropriate* Review 's treatment and therapy plans with the patient and appropriate family… more