• Utilization Management Nurse

    CVS Health (St. Paul, MN)
    …for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. **Key Responsibilities** + Apply critical ... a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM...some weekends and holidays, per URAC and client requirements. ** Remote Work Expectations** + This is a 100% … more
    CVS Health (08/31/25)
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  • Disease Management Nurse

    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
    Sharecare (08/13/25)
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  • Infusion Referral Nurse - REMOTE

    Prime Therapeutics (St. Paul, MN)
    …and drives every decision we make. **Job Posting Title** Infusion Referral Nurse - REMOTE **Job Description** Under supervision, is responsible for performing ... Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - Care Mgmt...experience. + Experience in managed care, specialty drugs, care management and utilization review. + Meets Credentialing… more
    Prime Therapeutics (07/24/25)
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  • Clinical Reviewer, Nurse

    Evolent (St. Paul, MN)
    …Doing:** As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... Clinical Reviewers are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts and analyzes clinical… more
    Evolent (08/19/25)
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  • Dementia Care Navigator, LPN or Certified…

    Bluestone Physician Services (Plymouth, MN)
    …with primary care teams to ensure high quality team-based care + Use utilization management tools to facilitate appropriate transitional care management ... their unique needs. Using an evidence-based approach focused on quality care management and data-driven medical decisions, Bluestone care teams collaborate to manage… more
    Bluestone Physician Services (08/08/25)
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  • Key Account Manager - Cardiovascular…

    Amgen (Minneapolis, MN)
    …formulary adoption in targeted / assigned hospital accounts to help drive appropriate utilization of approved CV products; works with other sales colleagues to lead ... Representatives, District Sales Managers, Regional Sales Directors, Reimbursement/Access Specialists, Nurse Educators, Regional Marketing Managers, and the Value Based… more
    Amgen (08/20/25)
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  • Care Coordinator, LSW

    Bluestone Physician Services (Edina, MN)
    …medical care teams to ensure health care quality measures are met and use utilization management tools to meet value-based goals + Supporting members during ... Location: ~70% travel throughout Edina, Minneapolis, MN areas, ~30% remote work from home. Salary Range: $65,000 - $75,000...grads encouraged to apply) + OR current Minnesota Registered Nurse license + One or more years of experience… more
    Bluestone Physician Services (08/11/25)
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