- Insight Global (Minnetonka, MN)
- …Description The Registered Nurse will report into the Director of Clinical Programs. The Registered Nurse will perform telephonic, patient-centered ... scheduling. The RN will be required to meet or exceed established productivity and quality metrics and work to support the hours of operation of the business. We… more
- Sharecare (St. Paul, MN)
- …support in an appropriate, efficient and cost-effective manner while ensuring high quality care. The Disease Management Nurse works with participating members ... through the lens of their personal health and making high- quality care more accessible and affordable for everyone. To...drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is… more
- CVS Health (St. Paul, MN)
- …do it all with heart, each and every day. **Position Summary** **This is a remote work from home role anywhere in the US with virtual** **training.** American Health ... Management. AHH delivers flexible medical management services that support cost-effective quality care for members. **Key Responsibilities** + This position consists… more
- Insight Global (Minnetonka, MN)
- …York, Oregon 1 or more years of experience in HEDIS/Star programs, preferably in a clinical quality consultant role 2 or more years of Call Center or Telephonic ... Job Description The Clinical Performance Quality (CPQ) Clinical...Registered Nurses, Pharmacy Technicians, and Care Coordinators. The Registered Nurse will report into the Director of Clinical… more
- Sharecare (St. Paul, MN)
- …supporting each individual through the lens of their personal health and making high- quality care more accessible and affordable for everyone. To learn more, visit ... program in an appropriate and efficient manner by providing high- quality telephonic Case or Care Management with CareFirst members....+ Actively participate in team huddles and contribute to clinical learning. + Remain current on clinical … more
- Highmark Health (St. Paul, MN)
- …over a specified panel of members that range in health status/severity and clinical needs; and assesses health management needs of the assigned member panel and ... utilizing data/analytics in conjunction with professional clinical judgement to identify the right clinical ...personal health goals. Will work with providers to insure quality and appropriate care is being delivered in a… more
- Veterans Affairs, Veterans Health Administration (Minneapolis, MN)
- Summary VISN 23 CLINICAL CONTACT CENTER is recruiting for an Advanced Practice Nurse (APN) Nurse Practitioner assigned to the virtual clinic care provider ... team to provide virtual clinical care to Veterans. This position is on-site in...Minneapolis, MN. This position is currently not eligible for remote work. Relocation expenses are not authorized. VISN 23… more
- Adecco US, Inc. (Minneapolis, MN)
- …HEDIS and HEDIS-like measures. + Conduct data entry and data mining of market-specific clinical quality data. + Request and track medical records from provider ... Navigate multiple EHRs/documentation systems to obtain required information. + Respond to clinical quality inquiries (phone, fax, email, etc.). + Attend required… more
- CVS Health (St. Paul, MN)
- … healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. **Key Responsibilities** + Apply ... experience in a managed care organization (MCO). + Experience in a high-volume clinical call center or prior remote work environment. **Education** + Associate's… more
- Humana (St. Paul, MN)
- **Become a part of our caring community and help us put health first** The Appeals Nurse 2 resolves clinical complaints and appeals. The Appeals Nurse 2 work ... and independent determination of the appropriate courses of action. The Appeals Nurse 2 reviews documentation and interprets data obtained from clinical … more