- Adecco USA (Minneapolis, MN)
- …unrestricted LVN license in the state of California * 1+ years Utilization management experience including Prior AuthorizationBenefit offerings include medical, ... professionals, funding sources, and community resources.Responsible for the prospective review to determine the appropriateness of denial, possible alternative… more
- Lincoln Financial Group (St. Paul, MN)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for… more
- Humana (St. Paul, MN)
- …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 (St. Paul, MN)
- …and ad hoc reports in Access and/or SQL + Graduate degree + Utilization Management Review Experience + Registered Nurse (RN) Credentials + Home Health, ... Durable Medical Equipment, and/or Skilled Nursing Facility Experience **Additional Information** **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week)… more
- Kepro (Minneapolis, MN)
- …partner for health solutions in the public sector. Acentra is looking for a Utilization Management - Mental Health Clinical Reviewer to join our growing team. ... review processes, functions as the initial resource to nurse reviewers regarding all review process questions...initial resource to nurse reviewers regarding all review process questions and/or concerns. + Functions as providers'… more
- Adecco US, Inc. (Minneapolis, MN)
- …unrestricted LVN license in the state of California . 1+ years Utilization management experience including Prior Authorization Benefit offerings include medical, ... funding sources, and community resources. + Responsible for the prospective review to determine the appropriateness of denial, possible alternative treatment, and… more
- Humana (St. Paul, MN)
- …**Preferred Qualifications** + Registered Nurse + Experience in Medicare Utilization Management + Project Management Professional (PMP) certification ... are addressed. They will work closely with established functions inside utilization management (Medical Director, clinician decision making teams, quality… more
- Elevance Health (Mendota Heights, MN)
- …equivalent and a minimum of 3 years acute care clinical experience or case management , utilization management or managed care experience; or any combination ... **Anticipated End Date:** 2024-12-27 **Position Title:** Nurse Medical Management II **Job Description:** **Location** : This position can be located anywhere… more
- St Croix Hospice (Oakdale, MN)
- …nursing is preferred). + Experience with performance improvement, quality assessment, and utilization management . + Is self-directed and able to work with ... Quality Assurance Nurse (RN) Job Details Level Experienced Job Location...and methodologies. + Implements established schedule for clinical record review and data collection. + Compiles, trends and reports… more
- Fairview Health Services (Minneapolis, MN)
- …for services provided . Completes the requirements of various payers and utilization management reviewers to obtain authorization for treatment. Demonstrates the ... an interdisciplinary team member. Responsible, as assigned, for the management of caseload. **Responsibilities Job Description** Job Expectations: Works… more
- Fresenius Medical Center (Lakeville, MN)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Elevance Health (Mendota Heights, MN)
- …**How you will make an impact:** + Develops, maintains and enhances the claims review process. + Assists management with developing unit goals, policies and ... Level:** Non- Management Exempt **Workshift:** **Job Family:** MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation… more
- Fairview Health Services (St. Paul, MN)
- …hospital operations, revenue cycle leadership, information technology, medical staff, residents, utilization review , quality, risk, service lines, and other ... hiring a Manager Clinical Documentation Integrity to join our Health Information Management team. Here are the key details: **Position Details:** + **Position:**… more
- Cardinal Health (St. Paul, MN)
- …for physician leaders and physician board regarding all areas of practice management and operations. This leader has primary responsibility to manage and drive ... will be needed in the following areas: practice operations, revenue cycle management , patient growth and practice marketing, value-based care, payor relations, EHR,… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …correct patient * Assesses patient risk via patient interviews and chart review ; alerts nurses and/or physicians to possible contraindications for procedure (labs, ... allergy pre-medication) * Demonstrates extensive understanding of procurement, storage, utilization , documentation, and billing requirements for catheters, stents, and… more
- Teleflex (Minneapolis, MN)
- …territory. The incumbent is responsible for the growth of overall product utilization within their accounts including, but not limited to, selling the designated ... time in the field. * Facilitate sales growth by conducting physician, nurse , and technologist training and account in-servicing of dialysis access products. *… more
