• Clinical UM Nurse

    CenterWell (St. Paul, MN)
    …our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical ... **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no disciplinary action and ability...Lung or Critical Care Nursing experience required + Prior clinical experience preferably in an acute care, skilled or… more
    CenterWell (01/14/26)
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  • Clinical Nurse Case Disease…

    Blue KC (Workman, MN)
    …case management and clinical transplant experience + Valid and active Registered nurse (RN) licensure in all 50 states and the District of Columbia initiated ... Uses standardized tools to complete assessments in the areas of clinical , functional, financial, support system, psychosocial and cognitive and environmental realms.… more
    Blue KC (12/13/25)
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  • Clinical Reviewer, Nurse (Medical…

    Evolent (St. Paul, MN)
    …for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member...medical management activities in a managed care environment + UM /UR experience + Clinical experience in Oncology,… more
    Evolent (12/10/25)
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  • Staff Nurse - Utilization Review (ED)

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …improvement initiatives *Education*: * Attains and maintains current knowledge in UR/ UM practices, payer requirements, clinical guidelines, and regulations ... **12/2/2025 - REVISED FTE *_SUMMARY:_* We are currently seeking a*Staff Nurse *to join our Utilization Management department for the/Emergency Department / This… more
    Minnesota Visiting Nurse Agency (12/03/25)
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  • Transplant Care Nurse (Remote)

    Highmark Health (St. Paul, MN)
    …experience, or provider operations and/or health insurance experience + 1 year in a clinical setting **Preferred** + 5 years in UM /CM/QA/Managed Care + 1 year ... panel of members that range in health status/severity and clinical needs; and assesses health management needs of the...RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) or WV or DE or… more
    Highmark Health (01/10/26)
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