- Actalent (Des Moines, IA)
- Job Title: Post Review Nurse - Utilization Management Job Description We are seeking a dedicated and skilled Post Review Nurse to join our Utilization ... Management team. In this role, you will perform timely utilization management reviews and claims assessments, ensuring adherence to medical policy and… more
- Actalent (Des Moines, IA)
- Job Title: Post Review Nurse - Utilization Management Job Description We are seeking a diligent and detail-oriented Post Review Nurse to perform timely ... efficiency and quality of our healthcare services. Responsibilities + Conduct utilization management reviews and claims assessments using InterQual criteria… more
- George C. Grape Community Hospital (Hamburg, IA)
- Utilization Review & Chronic Care Management (CCM) Nurse George C. Grape Community Hospital & Clinics is seeking a full-time Utilization Review & Chronic ... Care Management (CCM) Nurse . This unique role bridges hospital inpatient care and...this position, you'll split your time between: * Hospital Utilization Review - Conduct daily face-to-face rounds with providers… more
- Humana (Des Moines, IA)
- …documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are ... a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the… more
- Humana (Des Moines, IA)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
- Actalent (Des Moines, IA)
- Job Title: Post Review Nurse - Utilization Management Job Description We are seeking a dedicated Post Review Nurse to join our Utilization ... Management team. In this role, you will perform timely utilization management reviews and claims assessments using InterQual criteria and medical policy. You… more
- Sharecare (Des Moines, IA)
- …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
- CVS Health (Des Moines, IA)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... or Maternity/ Obstetrics experience . **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Molina Healthcare (Sioux City, IA)
- …Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + ... as may be required. + Serves as a clinical resource for Utilization Management , Chief Medical Officer, Physicians, and Member/Provider Inquiries/Appeals. +… more
- Trinity Health (Davenport, IA)
- **Employment Type:** Full time **Shift:** Evening Shift **Description:** Evening charge nurse 0.9 FTE - begin shift in staffing, transition to charge role at 1500 or ... Click here: MercyOne Genesis | Stronger. Together. As One! As a Charge Nurse at MercyOne, you will provide shift-to-shift leadership for the practice and delivery… more