- Humana (Madison, WI)
- …professional onsite, field, or remote based opportunities. The Prior Authorization, Registered Nurse , RN, Intern will utilize Humana's Medicaid training and ... the goal to put health first? The Prior Authorization, Registered Nurse , RN, Intern will review prior...to complete medical necessity reviews for requested services using clinical judgment and refers to internal stakeholders for review… more
- Intermountain Health (Madison, WI)
- …of hire unless you possess a minimum of fifteen (15) years of proven continuous Registered Nurse experience in an acute care setting, required + Current Colorado ... for the management of the patient population + Performs clinical triage, including a comprehensive assessment, disposition and education...Eligible: Yes + Shift Details: This position is a remote position + Location: This position is a virtual… more
- Lincoln Financial Group (Madison, WI)
- …as indicated **What we're looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where the ... Carolina); Omaha, NE (Nebraska); Work from Home **Work Arrangement:** Remote : Work at home employee residing outside of...We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization.… more
- Molina Healthcare (Madison, WI)
- …Excel (edit/save spreadsheets, sort/filter) **Required License, Certification, Association** Licensed registered nurse (RN), Licensed practical nurse ... benefits, and medical records to document relevant findings of a post pay clinical review. This position manages documents and prioritizes case load to ensure timely… more
- Sharecare (Madison, WI)
- …within a matrix organizational design. **Qualifications:** + Current multi-state compact Registered Nurse licensure in state of residence is required, ... + Actively participate in team huddles and contribute to clinical learning. + Remain current on clinical ...to clinical learning. + Remain current on clinical knowledge via self-directed learning. **Specific Skills/ Attributes:** +… more
- Intermountain Health (Madison, WI)
- …REGISTRATION, LICENSE (*indicates primary source verification requirement) Required: + Active Registered Nurse License Preferred: + Certified Healthcare Access ... the quality and cost effectiveness of patient care using clinical acumen in preparation of documentation, audits of patient...Associate (CHAA) EXPERIENCE Required: + Licensed Registered Nurse + Minimum of 2 years'… more
- SSM Health (Madison, WI)
- …degree in Nursing if Master's is not in Nursing EXPERIENCE * Three years' registered nurse experience, with one year in leadership REQUIRED PROFESSIONAL LICENSE ... St. Mary's Hospital in Madison, WI and is not remote work eligible. **_Named 150 Top Places to Work...(BLS HCP) - American Heart Association (AHA) And * Registered Nurse (RN) Issued by Compact State… more
- Highmark Health (Madison, WI)
- …+ Bachelor's degree in Nursing **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Case Manager (CCM) **Language ... Group **Job Description :** **JOB SUMMARY** This job is responsible for analyzing clinical data to assess potential stop loss and managed care claim liability,… more
- WelbeHealth (Madison, WI)
- …compliance with regulatory standards **Job Requirements:** + Bachelor's degree required + Registered Nurse (RN), master's degree, or other relevant advanced ... 100% REMOTE OPPORTUNITY At WelbeHealth, each participant of our...is guided by our interdisciplinary team (IDT), composed of clinical and non- clinical members who work cohesively… more
- Molina Healthcare (Madison, WI)
- **JOB DESCRIPTION** **_For this position we are seeking a (RN) Registered Nurse with previous experience in Hospital Acute Care, Concurrent Review/ Utilization ... flexible and willing to work holidays. This is a remote position, and you may work from home._** **_Further...all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence… more
- Molina Healthcare (Madison, WI)
- **JOB DESCRIPTION** _For this position we are seeking a (RN) Registered Nurse who must have a current active unrestricted RN license in the state of OH (Compact ... Licensure)_ _Case Manager RN will work in remote setting supporting our Medicare/Medicaid population who have recently been admitted into Hospital. The Case Manager… more