- Baylor Scott & White Health (St. Paul, MN)
- …priority. Note: Benefits may vary based on position type and/or level **Job Summary** As the Utilization Review RN you will review patient cases for ... provider's care coordination departments. Your expertise is needed to review medical necessity. Working with the team, you'll verify...experience is required. + You must hold a valid Registered Nurse License ( RN ). As… more
- CVS Health (St. Paul, MN)
- …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... in a hospital setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- Adecco US, Inc. (Minneapolis, MN)
- …the direct supervision of an RN or MD. . Performs utilization review activities, including pre-certification, concurrent, and retrospective reviews according ... turn around times. . Reviews, documents, and communicates all utilization review activities and outcomes including, but...** : . Knowledge of Home Health processes. . Registered Nurse with a current license to… more
- CVS Health (St. Paul, MN)
- …care **Preferred Qualifications** + NICU experience highly preferred + Managed care/ utilization review experience + Ability to multitask, prioritize and ... remote role open to candidates with an active RN licensure in the state in which they reside....to promote quality effectiveness of healthcare services and benefit utilization . **Required Qualifications** + Active and unrestricted RN… more
- Highmark Health (St. Paul, MN)
- …Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management,… more
- Sharecare (St. Paul, MN)
- …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification… more