- Evolent (Cheyenne, WY)
- …the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as...I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools… more
- Veterans Affairs, Veterans Health Administration (Sheridan, WY)
- …a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program. ... and Responsibilities include but ARE NOT limited to: The Nurse Inpatient Staff Registered Nurse (RN) is...of the rationale for care processes and decisions Questions clinical practices for the purpose of providing evidence-based care… more
- CenterWell (Cheyenne, WY)
- …with the ability to obtain Compact Nursing License + A minimum of three years clinical RN experience; + Prior clinical experience, managed care experience, ... actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that… more
- Veterans Affairs, Veterans Health Administration (Sheridan, WY)
- … nurse practitioners, physician assistants, psychologists, psychiatrists, social workers, clinical pharmacists, and nursing staff) to accomplish team goal setting ... an individual patient cannot be scheduled within mandated clinic timeframes. Daily review of active/pending consults, Electronic Wait List, Recall list and Audiocare… more
- CenterWell (Cheyenne, WY)
- …in care, ensuring timeless access to important medications and solving urgent clinical needs. This Virtual Physician Collaborator shares in our vision to innovate ... in care, ensuring timeless access to important medications and solving urgent clinical needs. This Virtual Physician Collaborator shares in our vision to innovate… more
- CVS Health (Cheyenne, WY)
- …referrals. + Handles incoming requests for appeals and pre-authorizations not handled by Clinical Claim Management. Performs review of member claim history to ... with contract. + Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target… more