- 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
- 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
- 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
- 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
- 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
- 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
- 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
- Prime Therapeutics (St. Paul, MN)
- …clinical experience. + Experience in managed care, specialty drugs, care management and utilization review . + Meets Credentialing criteria. + At minimum must ... every decision we make. **Job Posting Title** Infusion Referral Nurse - REMOTE **Job Description** Under supervision, is responsible for...both the member and the ordering physician (or office staff ) and to agree to find a lower cost… more
- 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
- Fresenius Medical Center (Shakopee, MN)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more