• Utilization Management Administration…

    Humana (St. Paul, MN)
    …a part of our caring community and help us put health first** The UM Administration Coordinator contributes to administration of utilization management. The ... UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations.… more
    Humana (10/10/25)
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  • Clinical Nurse, Case and Disease Management

    Blue KC (Workman, MN)
    …standards. Documents transplant authorization, issues authorization letters, and follows in FACETS UM system in accord with UM concurrent review guidelines. ... customers regarding transplant benefits. Directly educates the transplant financial coordinator of the transplant center, member and/or family members, brokers,… more
    Blue KC (09/30/25)
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  • Care Management Support Assistant

    Humana (St. Paul, MN)
    …Assistant 2- supports the Autism Care Demonstration (ACD). ACD Referral Coordinator (RC)-will process referrals from Military Treatment Facilities (MTFs) and ... ET to help handle internal phone queue + Medical terminology experience and/or UM /Coding Experience + 3 years experience in customer service or referral management… more
    Humana (10/18/25)
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  • Medical Management Auditor - RN

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …This position will work with the Health Plan Clinical Quality Coordinator to ensure compliant, effective and efficient investigations of quality issues ... as a subject matter expert to identify opportunities and/or risks associated with UM and CM process changes. ⦁ Maintains a high degree of professionalism and… more
    Blue Cross and Blue Shield of Minnesota (10/17/25)
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