- Humana (Madison, WI)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied… more
- Humana (Madison, WI)
- …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
- Humana (Madison, WI)
- …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 (Madison, WI)
- …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
- Prime Therapeutics (Madison, WI)
- …company achieving revenue goals and operational objectives. Responsible for executing utilization management programs on behalf of health plan/payor customers, ... clinical reviewer. + Practices and maintains the principles of utilization management by adhering to the company...cardholders, and pharmacies. + Escalates medical exception requests to nurse , pharmacist or physician on the utilization … 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, ... 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
- Meriter-UnityPoint Health (Madison, WI)
- …from the hospital to the community. The RN CM collaborates with the Enterprise Utilization Management (UM) RNs and Coordinators to communicate the plan for ... utilization of health care resources. Why UnityPoint Health? + Commitment...+ 1- 2 years of home care + 1- 2 years of experience in case management or… more