- St. Peters Health (Helena, MT)
- The Utilization Management RN reports directly to Utilization Review RN Coordinator. The UR RN supports the UR RN Coordinator and other UR ... denials as assigned, and participation in the organizations Utilization Review Committee. In collaboration with the patient /family, physicians, and the… more
- Cognizant (Helena, MT)
- …to be considered** + Educational background - Registered Nurse ( RN ) + 2-3 years combined clinical and/or utilization management experience with managed ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...as well as timely filing deadlines and processes. + Review clinical denials including but not limited to referral,… more
- Humana (Helena, MT)
- …an impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... 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
- Logan Health (Kalispell, MT)
- …manner + Partnering with the Chief Medical Officer on utilization review initiatives, length of stay management, and patient throughput + Ensuring ... as our Manager of Clinical Documentation Integrity (CDI) & Utilization Review ! This role is ideal for...Review ! This role is ideal for a collaborative RN leader who understands the acute care clinical environment,… more
- Intermountain Health (Miles City, MT)
- **Job Description:** The Registered Nurse ( RN ) is a professional caregiver who assumes responsibility and accountability for assessing, planning, ... Minimum of three (3) years of experience as a Registered Nurse in an acute care setting...of nursing experience- Prior knowledge of managed care / utilization review **Physical Requirements:** Ongoing need for… more
- Billings Clinic (Columbus, MT)
- …within 9 months of employment at hire * Current Montana state license as a registered nurse required at hire Billings Clinic is Montana's largest health system ... principles, state survey/accreditation readiness activities, quality audits, quality improvement and patient safety teams, peer review processes, etc. * Develops… more
- Intermountain Health (Billings, MT)
- …Education + Communication + Prioritization **Physical Requirements:** **Minimum Qualifications** + Current Registered Nurse ( RN ) license in state of ... **Job Description:** The RN Hospital Care Manager I delivers comprehensive care...Case Management Certification + Demonstrated experience in case management, utilization review , value-based care, and/or discharge planning.… more
- Logan Health (Kalispell, MT)
- …ensuring seamless coordination of services for optimal patient outcomes. Inpatient Utilization Management + Manage and review inpatient services to ensure ... Logan Health Medical Center is looking for a PRN RN to join our Case Management Team! Located in...Health, State, and Federal requirements as they relate to Utilization Review , Discharge Planning, and Care Coordination… more
- Veterans Affairs, Veterans Health Administration (Billings, MT)
- …and record relevant patient information. Completed work should need only a general review by a registered nurse or physician for appropriateness and ... MD/DO. Knowledge and ability to recognize urgent and emergent patient care situation, seek assistance of the RN...Significant amounts of time standing assisting assigned patients - Utilization of safe patient handling and mobility… more
- Health Care Service Corporation (Helena, MT)
- …to acute in- patient to out- patient office visits. **JOB REQUIREMENTS:** * Registered Nurse ( RN ) or Masters-level Behavioral Health Professional (LPC, ... skills. *PC and database experience. **PREFERRED JOB REQUIREMENTS:** * Utilization review experience. *MUST be licensed to...of years) at the independent practice level *If a Registered Nurse ( RN ): must have… more
- Billings Clinic (Roundup, MT)
- …the needs of the department/organization. Maintains clinical expertise to work as a registered nurse providing direct patient care. MINIMUM QUALIFICATIONS * ... Responsibilities also include other services as assigned (eg, Pharmacy), utilization review /case management, discharge planning, orientation and training… more
- Bozeman Health (Bozeman, MT)
- …in Nursing; equivalent combination of education and experience considered + Current Montana Registered Nurse ( RN ) licensure + American Heart Association ... and transfer of patients, appropriately guiding physician understanding of admission Utilization Review InterQual criteria + Facilitate and communicate the… more
- Cabinet Peaks Medical Center (Libby, MT)
- …Services, Laboratory Services, Nutrition and Diabetes Education, Quality Risk Management, Utilization Review and Risk Management, Employee Health Education, ... the overall day-to-day operations of the clinical departments and patient care outcomes. The RN House Manager...concert with hospital leadership to reach departmental goals. The Nurse House Manager will work with other patient… more
- Evolent (Helena, MT)
- …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
- Bozeman Health (Bozeman, MT)
- …executive team. Provides oversight of case management, discharge planning and utilization review . Provides leadership, direction, supervision, oversight and ... Bachelor of Science in Nursing + Current Montana Licensure ( Registered Nurse ) + Three (3) years of...work may be required to respond promptly to organizational, patient , or employee needs. Physical Requirements Lifting (Rarely -… more