- Cognizant (St. Paul, MN)
- …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
- Fresenius Medical Center (Hastings, MN)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- CVS Health (St. Paul, MN)
- …conditions. + **Diabetes education experience** is required. + Current, unrestricted ** Registered Nurse (RN) license** ; multi-state licensure preferred. + ... health outcomes by engaging telephonically with individuals living with diabetes. This nurse will guide members through actionable steps to close gaps in care,… more
- Evolent (St. Paul, MN)
- …+ 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
- Fairview Health Services (Maplewood, MN)
- …Three years in mental health or related setting **License/Certification/Registration** + Current Registered Nurse license in Minnesota + Basic Life Support ... Certification **Preferred** **Experience** + Outpatient experience **License/Certification/Registration** + Certified Registered Nurse **Additional Requirements (must be obtained… more
- CVS Health (St. Paul, MN)
- …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
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …improve provider performance and member satisfaction. Required Skills and Experience * Registered nurse or licensed behavioral health clinician (ie LICSW, LPCC, ... join us. The Impact You Will Have This job implements effective utilization management strategies including: review of appropriateness of pre and post service… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …to ensure optimal and cost-effective health outcomes. Required Skills and Experience * Registered nurse with current MN license and with no restrictions * ... effective plan of care that leads to optimal, cost-effective outcomes. Leveraging clinical expertise, strong critical thinking skills and a keen business sense, the… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …needs across the continuum of care by leveraging member partnership, pre-service clinical utilization review, case and disease management processes, skill sets ... care coordination, and transition of care between settings. Required Skills and Experience * Registered nurse with current MN license and with no restrictions. *… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …* Attend community events to engage with members. Required Skills and Experience * Registered nurse with current MN license and with no restrictions or ... the BCBSMN Care Management team. Behavioral Health Care Advisors will provide clinical approaches that will serve and support members from communities. The… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …coordination, and transition of care between settings. Required Skills and Experience * Registered Nurse licensure in the state of Minnesota with no ... * Receives referral and/or reaches-out to member and leverages clinical knowledge, motivational interviewing and behavioral modification techniques. * Conducts… more
- Highmark Health (St. Paul, MN)
- …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
- Bluestone Physician Services (Eagan, MN)
- …to identify high risk patients Qualifications: Education/Certification/Experience + Social Worker, Registered Nurse , or LPN with 4-year degree or commensurate ... Home communities throughout Minnesota, Wisconsin and Florida and are supported by clinical operations and administrative colleagues who work remotely or at our… more