- Fairview Health Services (St. Paul, MN)
- …role (grandfather status) + Current RN licensure in MN + 3-5 years utilization review or case management experience in hospital, clinic, insurance ... M Health Fairview has an immediate opening for a Utilization Management Specialist RN . This...care hospital nursing experience. + Excellent computer and database management skills. + Prior Utilization Review… 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
- Highmark Health (St. Paul, MN)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements the effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES:** + Implement care management review processes that are consistent with established… more
- Humana (St. Paul, MN)
- …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
- Mille Lacs Health System (Onamia, MN)
- …+ Graduate from an accredited school of nursing with current licensure as a Registered Nurse in the state of Minnesota + Knowledge of nursing principles, ... of the Mille Lacs Health System clinics SummaryThe Clinic RN works in collaboration and continuous partnership with clinic...at the end of the bullet point. + Perform Nurse visits* + Facilitate process and work flows to… more
- St Croix Hospice (Oakdale, MN)
- …job-related tasks other than those stated in this description. Qualifications + Registered nurse with current licensure to practice professional nursing in ... Quality Assurance Nurse ( RN ) Job Details Level Experienced...preferred). + Experience with performance improvement, quality assessment, and utilization management . + Is self-directed and able… more
- Elevance Health (Gilbert, MN)
- …**How you will make an impact:** + Develops, maintains and enhances the claims review process. + Assists management with developing unit goals, policies and ... **Anticipated End Date:** 2024-09-16 **Position Title:** RN Hospital Bill Audit/Appeal Lead **Job Description:** **...Management Exempt **Workshift:** **Job Family:** MED > Licensed Nurse Please be advised that Elevance Health only accepts… more
- Sanford Health (Bemidji, MN)
- …Summary** Responsible for analyzing and synthesizing of data to maximize utilization of data in clinical decision-making, business and strategic initiative. ... in a changing environment. Possesses strong public relations skills, time management skills, and positive personal relations. Communicates effectively across all… more
- Fairview Health Services (St. Paul, MN)
- …Information Technician (RHIT), Registered Health Information Administrator (RHIA), Registered Nurse ( RN ), Certified Documentation Integrity Specialist ... Health Information Administrator (RHIA). AND + One of the following: Registered Nurse ( RN ), Certified Documentation Integrity Specialist (CCDS),… 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 ... will provide coaching and guidance to claims regarding medical management **What you'll be doing** * Evaluate medical information...looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license… more
- Mille Lacs Health System (Onamia, MN)
- …job functions include but are not limited to: collection of quality data; utilization review ; monitoring variances from expected outcomes and analysis of data. ... electronic medical records and report trends and outcomes.* + Review utilization and report.* + Monitor variances...MLHS award and accolades. Required Education and Experience + Registered Nurse Degree with Minnesota Licensure +… more
- Sanford Health (MN)
- …specialty, quality, process improvement, or data analytics or equivalent required. If a licensed registered nurse ( RN ), currently hold an unencumbered RN ... Maintain knowledge on trends and changes in healthcare quality measurement. Review primary sources of information for regulatory changes and proactively prepare… 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 ... Three years in mental health or related setting License/Certification/Registration Current Registered Nurse license in Minnesota Basic Life Support Certification… more
- Elevance Health (Gilbert, 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
- Sharecare, Inc. (St. Paul, MN)
- …of the care enhancement program by providing telephonic care and resource utilization for members in an appropriate, efficient, and cost-effective manner while ... members of the health care team to support appropriate total healthcare management . RD colleague is supervised by an Operations Manager. All Sharecare clinicians… more
- Fresenius Medical Center (Cloquet, MN)
- …dialysis clinic. You will collaborate with the Medical Director and the Charge Nurse regarding the provision of quality patient care in the dialysis clinic. ... data collections and auditing activities. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review… more