- UnitedHealth Group (Minneapolis, MN)
- …concurrent and/or retrospective overpayment identification audits Experience working with Utilization Management Experience with readmission reviews of claims ... base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our… more
- Adecco US, Inc. (Minneapolis, MN)
- …**Pay** : $40.00 - $43.25 per hour based on experience **Responsibilities of the Utilization Management Nurse ** : . Responsible for reviewing proposed ... Nurses** ! This role is work from home and remote but we are requiring Nurses to live in...Generally work is self-directed and not prescribed. . The Utilization Management Nurse works under… more
- CVS Health (St. Paul, MN)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and knowledge in ... and every day. **Position Summary** This is a fully remote role open to candidates with an active RN...to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking… more
- Baylor Scott & White Health (St. Paul, MN)
- …to fit their needs. + Proficiency in discharge planning, setting case management referral standards, reviewing utilization , and categorizing levels of care. ... on position type and/or level **Job Summary** As the Utilization Review RN you will review patient cases for...issues or trends impacting specific entities to the appropriate management is expected. + Part of your work will… more
- Sharecare (St. Paul, MN)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- Sanford Health (Bemidji, MN)
- …minimum of five years of clinical practice. Knowledge and experience in case management , utilization management and/or Coding highly preferred. Currently ... Full time **Weekly Hours:** 40.00 **Salary Range:** $31 - $49.50 **Department Details** Remote Work Flexibility: Enjoy the option to work remotely, offering a better… more
- CVS Health (St. Paul, MN)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... each and every day. **Position Summary** **This is a remote work from home role anywhere in the US...or Specialty Pharmacy.** **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
- Sharecare (St. Paul, MN)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... the Family Health Advocate is an exciting and innovative remote role newly created to provide meaningful support to...+ Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex… more
- Humana (St. Paul, MN)
- …**Key Functions:** **Strategic Planning and Implementation:** + Develop and implement utilization management strategies that align with organizational goals. + ... care. **Cost Containment:** + Identify opportunities for cost savings through effective utilization management practices. + Monitor and analyze utilization … more
- Humana (St. Paul, MN)
- …will be a key enterprise leader, with responsibility for evolving Humana's Utilization Management of medical review by physician or nurse , with a focus on ... members. The Director, Physician leadership will lead Medical Directors performing utilization management for Medicare inpatient and behavioral medicine case… more
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