• Staff Nurse - Utilization

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …Some positions may require specialized certifications(s). **Title:** * Staff Nurse - Utilization Review (Float)* **Location:** *MN-Minneapolis-Downtown ... *_SUMMARY:_* We are currently seeking a* Staff Nurse *to join our Utilization...may require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse more
    Minnesota Visiting Nurse Agency (10/02/25)
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  • Nurse ( Utilization Review

    Justice, Bureau of Prisons/Federal Prison System (Rochester, MN)
    …Department of a Bureau of Prisons, Medical Referral Center (MRC). Serves as the Utilization Review Nurse and assists in quality improvement activities ... to the appropriateness of medical care and communicates findings to the Utilization Review Committee. Applies predetermined evidence-based criteria sets and… more
    Justice, Bureau of Prisons/Federal Prison System (10/03/25)
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  • Utilization Review Manager

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    review functions. Oversees daily operations, which include supervising staff performing utilization management activities. The goal is to achieve ... *_SUMMARY:_* We are currently seeking a* Utilization Review Manager* to join ourTransitional...utilization and denial management. Liaises with provider office staff and facilitates meetings with payers, as appropriate *… more
    Minnesota Visiting Nurse Agency (09/30/25)
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  • RN, Manager, Utilization Management Nursing

    Humana (St. Paul, MN)
    Nurse (RN) license in the state of Michigan. + Previous experience in utilization management and/or utilization review . + Minimum of two (2) years ... for providing leadership and oversight of the physical health utilization management (UM) staff in daily operations....of the physical health utilization management (UM) staff in daily operations. + Uses clinical knowledge, communication… more
    Humana (09/28/25)
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  • Associate Manager, Clinical Health Services…

    CVS Health (Workman, MN)
    …members. **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff . This position is responsible for the ... other key business areas. + May develop/assist in development and/ review new training content. + May collaborate/deliver inter and...+ 5+ years of acute experience as a Registered Nurse + 3+ years of Utilization Management… more
    CVS Health (10/08/25)
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  • Utilization Management Analyst, Denials…

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …or related field * Minimum 3 years of experience in clinical care, utilization review , case management, or clinical denials/appeals -OR- * An approved ... *_SUMMARY:_* We are currently seeking a Utilization Management Analyst to join our Denials Analysis....supporting a denials prevention program * Collaborate with UM staff to review for medical necessity and… more
    Minnesota Visiting Nurse Agency (08/28/25)
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  • Registered Nurse - Primary and Specialty…

    Veterans Affairs, Veterans Health Administration (St. Cloud, MN)
    …from the community. He/she possesses the knowledge related to VHA guidelines, utilization review criteria, current evidence-based standards of care, compliance ... series. For more information, refer to Required Documents below. The Registered Nurse - Quality Coordinator functions directly to support the activities of the St.… more
    Veterans Affairs, Veterans Health Administration (10/08/25)
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  • Acute Inpatient Charge Registered Nurse

    Fresenius Medical Center (Coon Rapids, MN)
    …Dialysis treatments in contracted hospitals/facilities and ensure efficient patient scheduling and staff utilization in accordance with the TAP scheduling tool. ... day (Excel skills needed). **PURPOSE AND SCOPE:** The Inpatient Services Charge Nurse is an additional "responsibility" assigned to the Inpatient Services RN, for… more
    Fresenius Medical Center (09/18/25)
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  • Nurse Practitioner - SOC Triage Hospitalist…

    Fairview Health Services (St. Paul, MN)
    …to Fairview Hospitalist APPs **Fairview** is seeking an experienced **Hospitalist** ** Nurse Practitioner** to perform triage work in the System Operations Center ... tertiary hospitals, and community hospitals. This role ensures optimal utilization of system resources by coordinating with patient placement...Daytime (8 AM-6 PM) as we expand and fully staff the service + Serve as the clinical coordinator… more
    Fairview Health Services (08/26/25)
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  • Registered Nurse - Case Manager…

    Mayo Clinic (Rochester, MN)
    …and multi-disciplinary teams. Major Functions of the RN Case Manager include: Utilization Review , including concurrent admission status and continued stay ... to work well within a creative and challenging work environment. Experience in utilization review , ability to navigate medical records, value based purchasing… more
    Mayo Clinic (10/02/25)
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