- Humana (Madison, WI)
- **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
- Evolent Health (Madison, WI)
- …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
- Fresenius Medical Center (Madison, WI)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. ... leading your business, and advanced leadership. As a Clinical Manager , you may advance your career into an Area...Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and… more
- Molina Healthcare (Madison, WI)
- …performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), ... of illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Healthcare Services provides operational management and...years in one or more of the following areas: utilization management , case management , care… more
- Prime Therapeutics (Madison, WI)
- …+ 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
- Fresenius Medical Center (Madison, WI)
- …under the direction of the Facility Manager and/or Charge Registered Nurse , utilizing standard nursing techniques to assist the physician in optimum ... acting on adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other FVC administrative and… more
- Fresenius Medical Center (Fitchburg, WI)
- …accounting department. + Acts as the Facility Manager in the absence of the manager or at the direction of management . + Ensure nurses' progress notes are ... **PURPOSE AND SCOPE:** Works with the Facility Manager , facility staff and physician to coordinate the...basis in accordance with policies, procedures and training. Provides nursing support to patients and staff. Assists with staffing,… more
- SSM Health (Madison, WI)
- …opportunities for improvement in standard work. + May also be responsible for: utilization management process, ED case management process, admission process, ... and act as a case manager liaison with post acute providers (skilled ...department's Scope of Service. + As an SSM Health nurse , I will demonstrate the professional nursing … more
- Fresenius Medical Center (Madison, WI)
- …Position requires a licensed RN, 3+ years of supervisory experience in nursing preferred. **PURPOSE AND SCOPE:** Ensure the provision of quality patient care ... to ensure quality service while maintaining a high level of efficiency management . **PRINCIPAL DUTIES AND RESPONSIBILITIES:** + Manages the tactical execution of… more
- Amergis (Madison, WI)
- …regarding accessibility of services + Follows State/County mandated guidelines for the nurse case management programs + Participates in outreach activities to ... The RN Case Manager is responsible for coordinating continuum of care...of care activities for assigned patients and ensuring optimum utilization of resources, service delivery, and compliance with medical… more
- Huron Consulting Group (Madison, WI)
- …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
- Amergis (Madison, WI)
- The RN Case Manager is responsible for coordinatingcontinuum of care activities for assigned patients and ensuring optimumutilization of resources, service delivery, ... referrals for psychosocial needs + Participates in Quality Assurance and Utilization Reviewactivities, as directed + Empowers patients in decision-making for care… more
- Sharecare, Inc. (Madison, WI)
- …/ 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