- Humana (Topeka, KS)
- **Become a part of our caring community and help us put health first** The Manager , Utilization Management Nursing utilizes clinical nursing skills ... medical services and/or benefit administration of post-acute determinations. The Manager , Utilization Management Nursing...to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in IL, WI, MN, SD, ND, IA,… more
- Elevance Health (Topeka, KS)
- …willing to obtain a compact nursing license for this position. + Utilization Management experience for prior authorizations is strongly preferred. + Previous ... **: Monday through Friday, 10:30 am - 7:00 pm EST** The **Licensed Utilization Review II** responsible for working primarily with healthcare providers to help ensure… more
- Evolent Health (Topeka, KS)
- …others. **Collaboration Opportunities** : The Lead Nurse of Utilization Management is responsible for assisting the UM Manager in supervising the ... operational productivity of the Utilization Management nurses by implementing and maintaining an efficient and...department. The UM Lead, in collaboration with the UM Manager and Director, ensures compliance with all regulatory standards… more
- Elevance Health (Topeka, KS)
- ** Utilization Management Representative I** **Location** : This is a remote position. Ideal candidates will live within 50 miles of an Elevance Health PulsePoint ... Schedule : Monday - Friday 8am - 5pm The ** Utilization Management Representative I** is responsible for...requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data… more
- Elevance Health (Topeka, KS)
- ** Utilization Management Rep I** **Location:** This position will work a hybrid model (remote and office). Candidates must reside in Olathe, KS, Topeka, KS, or ... Overland Park, KS. The ** Utilization Management Rep I** is responsible for...requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data… more
- Prime Therapeutics (Topeka, KS)
- …+ Clinical and Quality oversight for this program is provided by the Manager , Patient Programs. **Responsibilities** + Registered Nurse (RN). + 5 years ... post-degree clinical experience. + Experience in managed care, specialty drugs, care management and utilization review. + Meets Magellan Credentialing criteria.… more
- ZOLL Medical Corporation (Topeka, KS)
- …patients suffering from serious cardiopulmonary and respiratory conditions.ZOLL Cardiac Management Solutions offers a unique portfolio of novel technologies designed ... patients at risk of sudden cardiac death. + HFMS (https://cardiacdiagnostics.zoll.com/products/heart-failure-arrhythmia- management -system/) (Heart Failure Management system) is a… more
- Elevance Health (Topeka, KS)
- …supervision. **Preferred Skills, Capabilities, and Experiences:** + Previous experience in case management / utilization management with a broad range of ... **JR129977** **Behavioral Health Care Manager I** The Behavioral Health Care Manager...a related behavioral health field or a degree in nursing , and minimum of 3 years of experience with… more
- Elevance Health (Topeka, KS)
- …supervision. **Preferred Skills, Capabilities and Experiences:** + Previous experience in case management / utilization management with a broad range of ... **Behavioral Health Care Manager I** **Location:** This position will work a...a related behavioral health field or a degree in nursing , and minimum of 3 years of experience with… more
- Huron Consulting Group (Topeka, KS)
- …it promotes a culture of respect, unity, collaboration, and personal achievement. As a Manager , you will have the unique ability to specialize in certain areas that ... talent, training, supervising, coaching/mentoring, and providing feedback through performance management + Facilitate communication and collaboration between all key… more
- Sharecare, Inc. (Topeka, KS)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...Patient Care Technician (PCT) + Physical Therapy Assistant + Nursing Assistant + Medical Secretary/Clinic Manager +… more
- Elevance Health (Topeka, KS)
- …The **LTSS SERVICE COORDINATOR - RN CLINICIAN** is responsible for overall management of member's case within the scope of licensure; provides supervision and ... face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health,… more
- Elevance Health (Topeka, KS)
- …participates in cross-functional corporate teams which design and implement new care/case/ utilization management programs. + Develops and implements process and ... include, but are not limited to: + Ensures appropriate utilization and administration and/or delivery of EAP or Behavioral...with state and federal regulations. + Collaborates with Care Management partners to resolve issues or find solutions. +… more
- Elevance Health (Topeka, KS)
- …documents to convey the determination. + Responsibilities exclude conducting any utilization or medical management review activities which require the ... records to either approve or summarize and route to nursing and/or medical staff for review. + The grievance...a liaison between grievances & appeals and /or medical management , legal, and/or service operations and other internal departments.… more
- Fresenius Medical Center (Topeka, KS)
- …dialysis clinic. You will collaborate with the Medical Director and the Charge Nurse regarding the provision of quality patient care in the dialysis clinic. ... Quality, and Technical Services departments. + Collaborates with the Home Therapies Manager to oversee the facility's Home Therapies Program. + Maintains integrity… more