- Humana (Helena, MT)
- **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
- Fresenius Medical Center (Butte, MT)
- **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 (Helena, MT)
- …+ 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
- St. Peters Health (Helena, MT)
- …school of nursing required. LICENSE/CERTIFICATION/REGISTRY: Current Montana License as a Registered Nurse required. Current and valid American Heart Association ... principles of case management to ensure effective coordination of care and utilization of community resources. Works collaboratively with other members of the… more
- Evolent (Helena, MT)
- …+ 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
- Intermountain Health (Butte, MT)
- …Service + Patient Education + Communication + Prioritization **Minimum Qualifications** + Current Registered Nurse (RN) license in state of practice. + Bachelor ... Intermediate knowledge of word processing and Excel software. **Minimum Qualifications** + Current Registered Nurse (RN) license in state of practice. + Bachelor… more
- Health Care Service Corporation (Helena, MT)
- …visits to acute in-patient to out-patient office visits. **JOB REQUIREMENTS:** * Registered Nurse (RN) or Masters-level Behavioral Health Professional (LPC, ... This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity...of years) at the independent practice level *If a Registered Nurse (RN): must have at least… more
- Highmark Health (Helena, MT)
- …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