- Cognizant (Jefferson City, MO)
- …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
- Truman Medical Centers (Kansas City, MO)
- …not possess a Baccalaureate in Nursing, then a graduate degree in Nursing is required + Registered Nurse licensed in state of Missouri, BSN preferred + 2 years ... **Please log into myWORKDAY (http://www.myworkday.com/trumed/d/home.htmld) to search for positions and apply.** Utilization Mgmt Nurse RN - Care Continuity - UH… more
- Humana (Jefferson City, MO)
- **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 ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN)** in the (appropriate state)… more
- Children's Mercy Kansas City (Kansas City, MO)
- …in Utilization Review + One of the following: Licensed RN - MO, Registered Nurse Multistate License Missouri required upon hire + One of the following: ... training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including...Licensed RN - Kansas, Registered Nurse Multistate License Kansas required upon… more
- HCA Healthcare (Kansas City, MO)
- …quality care in the most compassionate way. A Diagnostic Imaging Registered Nurse provides patient care through utilization of the nursing process. Unlock ... the opportunity to make a real impact. As a(an) Registered Nurse RN Interventional Radiology you can...your knowledge and expertise! **Job Summary and Qualifications** Our Registered Nurses raise the bar by providing clinical… more
- Veterans Affairs, Veterans Health Administration (MO)
- …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 ... the provision of competent, evidence-based care, the psychiatric MH nurse independently provides patient-centered and recovery-oriented care, milieu management, and… more
- CVS Health (Jefferson City, MO)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
- Evolent (Jefferson City, MO)
- …+ 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
- BJC HealthCare (St. Louis, MO)
- …Nurses Credentialing Center. To provide the hospital with an additional source of Registered Nurses for use by all patient care areas within Barnes-Jewish Hospital. ... other staffing options are not available. To assist in the cost effective utilization of nursing personnel to promote the delivery of quality patient care.… more
- Deloitte (Kansas City, MO)
- …certification a plus (CRC, CCA, CCS-P, CCS, CPC, CDIP, CCM) + Experience as clinical registered nurse , physician, physician assistant, case manager, ... or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical ...clinical documentation specialist, utilization review, informatics RN, Quality, DRG Validation and health… more
- Blue KC (MO)
- …**Employee discount program** **Job Description Summary:** This Registered Nurse presents data-driven insights and clinical health information to ... benefits) should be made. + Participate in existing client utilization and renewal meetings or tell our clinical... utilization and renewal meetings or tell our clinical value story as requested. + Track, monitor, and… more
- CVS Health (Jefferson City, MO)
- …in state of residence - 3+ years of acute experience as a Registered Nurse - 1+ years of Utilization Management experience - Must have experience using MS ... Works closely with functional area management to ensure consistency in clinical interventions supporting our members. Accountable for meeting the financial,… more
- BJC HealthCare (St. Louis, MO)
- …Outpatient Clinics, Registration sites, and Health Information Management. The Service employs registered nurses, social workers, a license practical nurse , a ... Care Services. The CM Service is comprised of three departments: Case Management, Utilization Management, and Social Work. Through the Triad Model of Care Delivery,… more
- SSM Health (St. Charles, MO)
- …Department of Financial and Professional Regulation (IDFPR) State of Work Location: Missouri + Registered Nurse (RN) Issued by Compact State + Or + Registered ... in standard work. + May also be responsible for: utilization management process, ED case management process, admission process,...of Professional Registration State of Work Location: Oklahoma + Registered Nurse (RN) Issued by Compact State… more
- SSM Health (Bridgeton, MO)
- …Support HealthCare Provider (BLS HCP) - American Heart Association (AHA) + And + Registered Nurse (RN) - Missouri Division of Professional Registration + Or + ... care and prevention program in order to achieve exceptional clinical outcomes. **Job Responsibilities and Requirements:** PRIMARY RESPONSIBILITIES +... Registered Nurse (RN) Issued by Compact State… more
- HCA Healthcare (Kansas City, MO)
- …quality care in the most compassionate way. A Diagnostic Imaging Registered Nurse provides patient care through utilization of the nursing process. Unlock ... and continue to learn! **Job Summary and Qualifications** Our Registered Nurses raise the bar by providing clinical...within 30 days of employment start date + (RN) Registered Nurse + Registered … more
- BJC HealthCare (St. Louis, MO)
- …Outpatient Clinics, Registration sites, and Health Information Management. The Service employs registered nurses, social workers, a license practical nurse , a ... Care Services. The CM Service is comprised of three departments: Case Management, Utilization Management, and Social Work. Through the Triad Model of Care Delivery,… more
- Highmark Health (Jefferson City, MO)
- …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
- Gentiva (St. Louis, MO)
- …Administrator to join our leadership team. This role is ideal for a licensed Registered Nurse (RN) with strong leadership experience in hospice care, home ... health, or clinical operations management. If you're a natural leader who...growth through census development, referral management, and efficient resource utilization + Maintain strong relationships with physicians, referral sources,… more
- HCA Healthcare (Kansas City, MO)
- …optimize outcomes and maximize available resources. **What qualifications you will need:** + (RN) Registered Nurse + Registered Nurse Diploma + Minimum ... you will do in this role:** + Responsible for utilization review, discharge planning and care coordination with the...of one year of acute clinical nursing experience preferred. + Two years Managed Care… more