- Humana (St. Paul, MN)
- **Become a part of our caring community and help us put health first** The Manager , Utilization Management Nursing utilizes clinical nursing skills ... communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Nursing...to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in IL, WI, MN, SD, ND, IA,… more
- Mayo Clinic (Rochester, MN)
- …by ensuring appropriate utilization management , care coordination, resource utilization , and clinical documentation. The RN Case Manager will function ... the resources you need to succeed. **Responsibilities** The Registered Nurse (RN) Case Manager works within an... Manager provides leadership through education on case management / utilization management concepts, committee work,… more
- Fresenius Medical Center (Waconia, MN)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Fresenius Medical Center (Champlin, MN)
- **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
- Select Medical (Golden Valley, MN)
- …by doing what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management ... **Overview** **Critical Illness Recovery Hospital** **Case Manager ** **$7500 Sign On Bonus** _Requires a current...the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates… more
- Elevance Health (Mendota Heights, MN)
- ** Nurse Reviewer I** **Location:** Within 50 miles of...hospital setting or minimum of 1 year of prior utilization management , medical management and/or ... state(s) required. **Preferred Skills, Capabilities, and Experiences:** + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed… more
- Fresenius Medical Center (Duluth, MN)
- …of time, and for specific additional duties, as assigned by the Program Manager . The Inpatient Services Charge Nurse ensures appropriate provision of Acute ... **PURPOSE AND SCOPE:** The Inpatient Services Charge Nurse is an additional "responsibility" assigned to the...performing Acute treatments as needed or directed by Program manager . Assumes the provision of quality patient care to… more
- Prime Therapeutics (St. Paul, MN)
- …+ 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
- Elevance Health (Gilbert, MN)
- **Telephonic Nurse Disease Management II** **$2000 Sign on Bonus** At **Federal Health Products and Services - FHPS** , a proud member of the Elevance Health, ... and Experiences:** + Must be eligible for a multi-state license. + BS in nursing preferred. + Prior case management experience is preferred. + Prior disease… more
- Fairview Health Services (St. Paul, MN)
- …**Qualifications** **Required Qualifications** + Bachelor's degree in Health Information Management , Nursing , Education or related field or equivalent ... **Overview** Fairview is hiring a Manager Clinical Documentation Integrity to join our Health...combination of Associate degree in Health Information Management , Nursing , Education, or related field and… more
- Fairview Health Services (Hibbing, MN)
- …5 years of experience in home care, hospice, or related setting. Keywords: Manager , Supervisor, Leadership, Registered Nurse , Nursing Leadership, Home Care, ... **Fairview Range is looking for a Clinical Manager to join our Hibbing Home Care and...+ Current MN RN licensure. + 5 years of nursing experience. + Management or leadership experience,… more
- Fairview Health Services (Minneapolis, MN)
- …years working as a care coordinator/case manager Active MN Registered Nurse license **Preferred** Case Management Certification BSN Basic Life Support (BLS) ... consulting with leader on any unusual situations. Internal customers include all levels of nursing management and staff, medical staff, and all other members of… more
- Fairview Health Services (Maplewood, MN)
- …resource management , quality, regulatory compliance, educational opportunities, and financial management . Serves as a nurse leader and role model to ... staff hour schedules according to pre-established parameters. Responsible for effective fiscal management of assigned area(s) to ensure proper utilization of… more
- Fairview Health Services (Maplewood, MN)
- …years working as a care coordinator/case manager Active MN Registered Nurse license **Preferred** Case Management Certification BSN Basic Life Support (BLS) ... with the leader on any unusual situations. Internal customers include all levels of nursing management and staff, medical staff, and all other members of the… more
- ConvaTec (Minneapolis, MN)
- …global medical products and technologies company, focused on solutions for the management of chronic conditions, with leading positions in advanced wound care, ... us on our journey to #ForeverCaring as a Territory Manager , Chronic, and you won't either. **About the Role:**...Identify, prioritize, pull-through, and close opportunities + Ensure effective utilization of the products by all trained HCPs within… more
- Essentia Health (Duluth, MN)
- …timely and accurate information to payers. The role integrates and coordinates utilization management , care facilitation and discharge planning functions. This ... meet patient needs, manage length of stay, and promote efficient utilization of resources for a designated caseload. **Education Qualifications:** Educational… more
- Huron Consulting Group (St. Paul, MN)
- …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. (St. Paul, MN)
- …/ 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 (Mendota Heights, MN)
- …responsible for identifying, monitoring, and analyzing aberrant patterns of utilization and/or fraudulent activities by health care providers through prepayment ... + Develops, maintains and enhances the claims review process. + Assists management with developing unit goals, policies and procedures. + Investigates potential… more
- All Homecaring - Minnesota (Columbia Heights, MN)
- …and plan of care under the direction and supervision of the Director of Nursing . Essential Job Functions + Assists the physician or intermediate care provider in ... care planning. + Performs the duties of agency case manager when client is not concurrently open to skilled... when client is not concurrently open to skilled nursing , including performing start of cares, ongoing recertifications, transfers,… more