- Humana (Pierre, SD)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Highmark Health (Pierre, SD)
- …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
- Highmark Health (Pierre, SD)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES:** + Implement care management review processes that are consistent with established… more
- Sanford Health (Sioux Falls, SD)
- …management techniques. Minimum of three years' experience in population health, case management , utilization review , health plan, ambulatory care, or ... * Make rounds at hospital on new referrals to review service and begin assessment if patient accepts *...quality management required. Currently holds an unencumbered RN license with the State Board of Nursing where… more
- Sanford Health (Sioux Falls, SD)
- …experience. Minimum of three years nursing experience is required. Currently holds an unencumbered registered nurse ( RN ) license with the State Board of ... utilization and potentially, prior authorization. Assists the department in monitoring the utilization of resources, risk management and quality of care for… more
- Guardian Life (Pierre, SD)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… more
- Sanford Health (Sioux Falls, SD)
- …with significant background in case management , transplant services and/or other utilization review experience. Minimum of three years nursing experience is ... Full time **Weekly Hours:** 40.00 **Salary Range:** $29.00 - $46.50 **Department Details** Registered Nurse Case Manager position on the Care Transitions team.… more
- Sanford Health (Sioux Falls, SD)
- …Summary** Responsible for analyzing and synthesizing of data to maximize utilization of data in clinical decision-making, business and strategic initiative. ... in a changing environment. Possesses strong public relations skills, time management skills, and positive personal relations. Communicates effectively across all… more