- Cognizant (St. Paul, MN)
- …you need to have to be considered** + Educational background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …needs and may require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for ... annual performance review /*License/Certifications:*/ * Possession of a valid license as a Registered Nurse issued by the State of Minnesota. **Title:** *Staff … more
- CVS Health (St. Paul, MN)
- …both verbal and written **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active ... all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedules...will include weekends, holidays, and evening hours. * Utilizes clinical experience and skills in a collaborative process to… more
- Fresenius Medical Center (Hastings, MN)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- Veterans Affairs, Veterans Health Administration (Minneapolis, MN)
- …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... VHA and advancing national strategies for managing workflow and knowledge in clinical systems utilized by nursing staff. Responsibilities Major Duties include but… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …in confidentiality, integrity, creativity, and initiative */License/Certifications:/* * Current Registered Nurse licensure upon hire * National certification ... performing utilization management activities. The goal is to achieve clinical , financial, and utilization goals through effective management, communication,… more
- Evolent (St. Paul, MN)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals.… more
- Fairview Health Services (Maplewood, MN)
- …Three years in mental health or related setting **License/Certification/Registration** + Current Registered Nurse license in Minnesota + Basic Life Support ... Certification **Preferred** **Experience** + Outpatient experience **License/Certification/Registration** + Certified Registered Nurse **Additional Requirements (must be obtained… more
- CenterWell (Brooklyn Park, MN)
- …+ Graduate of an accredited School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's license, auto insurance ... at our** **Brooklyn Park, MN** **branch location.** The **RN Clinical Manager** coordinates and oversees all direct care patient...and reliable transportation. + Two years as a Registered Nurse with at least one-year of… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …improve provider performance and member satisfaction. Required Skills and Experience * Registered nurse or licensed behavioral health clinician (ie LICSW, LPCC, ... join us. The Impact You Will Have This job implements effective utilization management strategies including: review of appropriateness of pre and post service… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …to ensure optimal and cost-effective health outcomes. Required Skills and Experience * Registered nurse with current MN license and with no restrictions * ... effective plan of care that leads to optimal, cost-effective outcomes. Leveraging clinical expertise, strong critical thinking skills and a keen business sense, the… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …needs across the continuum of care by leveraging member partnership, pre-service clinical utilization review, case and disease management processes, skill sets ... care coordination, and transition of care between settings. Required Skills and Experience * Registered nurse with current MN license and with no restrictions. *… more
- Fairview Health Services (Minneapolis, MN)
- …**Required Qualifications** + Bachelors Degree in Nursing + 1 year RN experience + Registered Nurse **Preferred Qualifications** + Case Management Nurse + ... of care and develops, implements, monitors, and documents the utilization of resources and progress of the patient through...requirements. This position is accountable for the quality of clinical services delivered by both them and others and… more
- CVS Health (St. Paul, MN)
- …through assessment and evaluation. **Required Qualifications** + Active Registered Nurse Compact License + Minimum 3+ years clinical practical experience ... in serving our members by utilizing best-in-class operating and clinical models. You can have life-changing impact on our...experience, transitions of care and discharge planning required + Registered Nurse with active state license in… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …* Attend community events to engage with members. Required Skills and Experience * Registered nurse with current MN license and with no restrictions or ... the BCBSMN Care Management team. Behavioral Health Care Advisors will provide clinical approaches that will serve and support members from communities. The… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …coordination, and transition of care between settings. Required Skills and Experience * Registered Nurse licensure in the state of Minnesota with no ... * Receives referral and/or reaches-out to member and leverages clinical knowledge, motivational interviewing and behavioral modification techniques. * Conducts… more
- Presbyterian Homes and Services (Roseville, MN)
- …communicate at IDT + Site specific education + Key measure management Qualifications + Registered nurse with current licensure from the State Board of Nursing in ... working knowledge of the MDS process. + Experience with MDS completion, reimbursement, clinical resource utilization and/or case management. + Ability to work… more
- Highmark Health (St. Paul, MN)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
- CVS Health (St. Paul, MN)
- …conditions. + **Diabetes education experience** is required. + Current, unrestricted ** Registered Nurse (RN) license** ; multi-state licensure preferred. + ... health outcomes by engaging telephonically with individuals living with diabetes. This nurse will guide members through actionable steps to close gaps in care,… more
- Bluestone Physician Services (Eagan, MN)
- …to identify high risk patients Qualifications: Education/Certification/Experience + Social Worker, Registered Nurse , or LPN with 4-year degree or commensurate ... Home communities throughout Minnesota, Wisconsin and Florida and are supported by clinical operations and administrative colleagues who work remotely or at our… more