- BJC HealthCare (St. Louis, MO)
- …of RN experience performing care for hospitalized patients + 2 years of Utilization Review (UR) experience reviewing hospital admissions for medical necessity + ... quality of medical services provided by the medical team. Ensure appropriate utilization , which includes the evaluation of potential under and over- utilization … more
- Cognizant (Jefferson City, MO)
- …Monday to Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced level work ... to have to be considered** + Educational background - Registered Nurse (RN) + 2-3 years combined...Nurse (RN) + 2-3 years combined clinical and/or utilization management experience with managed health care plan +… more
- Children's Mercy Kansas City (Kansas City, MO)
- …of, and training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including patient ... quality, and Lean process improvements, and facilitating the quarterly Utilization Review Committee meetings. Provides evidence based...+ One of the following: Licensed RN - MO, Registered Nurse Multistate License Missouri required upon… more
- Humana (Jefferson City, MO)
- …impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN)** in the (appropriate state) with no disciplinary ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...in an acute care setting + Previous experience in utilization management/ utilization review for a… 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 ... determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.… more
- Evolent (Jefferson City, MO)
- …the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care… more
- HCA Healthcare (Kansas City, MO)
- …satisfaction and personal growth, we encourage you to apply for our Operating Room Nurse PRN opening. We review all applications. Qualified candidates will be ... have the PRN career opportunities as an Operating Room Nurse PRN you want with your current employer? We...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… 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 ... within 30 days of employment start date + (RN) Registered Nurse + Registered ...our RN Interventional Radiology opening. Our team will promptly review your application. Highly qualified candidates will be contacted… 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** ... and the proper action to complete the retrospective claim review with the goal of proper and timely payment...data to assure appropriate level of payment and resource utilization . It is also used to identify issues which… more
- HCA Healthcare (Kansas City, MO)
- …patient needs. **What you will do in this role:** + Responsible for utilization review , discharge planning and care coordination with the patient, patient's ... available resources. **What qualifications you will need:** + (RN) Registered Nurse + Registered ...our RN Case Manager opening. Our team will promptly review your application. Highly qualified candidates will be contacted… more
- Truman Medical Centers (Kansas City, MO)
- …Overview:** We are seeking a dedicated and detail-oriented Case Manager (CM)-a registered nurse committed to optimizing both patient outcomes and healthcare ... both spoken and written **Preferred Qualifications:** + RN experience in hospital utilization review , utilization management, or case management **Why… more
- Deloitte (Kansas City, MO)
- …degree in nursing, medical degree, or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical Documentation Specialist ... (CRC, CCA, CCS-P, CCS, CPC, CDIP, CCM) + Experience as clinical registered nurse , physician, physician assistant, case manager, clinical documentation… more
- HCA Healthcare (Kansas City, MO)
- …patient needs. What you will do in this role: + Responsible for utilization review , discharge planning and care coordination with the patient, patient's ... and maximize available resources. **What qualifications you will need:** + (RN) Registered Nurse + Registered Nurse Diploma Research Medical Center… more
- HCA Healthcare (Kansas City, MO)
- …physician to adhere to the self-denial process. **What qualifications you will need:** + (RN) Registered Nurse + Registered Nurse Diploma, or Associate ... supporting a balance of optimal care and appropriate resource utilization . + Responsible for ensuring other RN CM in...RN Case Manager Lead opening. Our team will promptly review your application. Highly qualified candidates will be contacted… more
- HCA Healthcare (Kansas City, MO)
- …patient needs. What you will do in this role: + Responsible for utilization review , discharge planning and care coordination with the patient, patient's ... and maximize available resources. **What qualifications you will need:** + (RN) Registered Nurse + Registered Nurse Diploma Research Medical Center… more
- Blue KC (MO)
- …financial assistance** **Employee discount program** **Job Description Summary:** This Registered Nurse presents data-driven insights and clinical health ... and regularly attends client meetings (with benefits managers and executives) to review health outcomes and cost information. + Actively monitors care management… more