- Cognizant (Jefferson City, MO)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Humana (Jefferson City, MO)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in a compact state… more
- Fresenius Medical Center (Creve Coeur, MO)
- …requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory ... FMCNA Compliance Program, and FMS patient care and administrative policies as the clinical leader, has the authority to make daily decisions to ensure continuity of… more
- Fresenius Medical Center (Springfield, MO)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- CVS Health (MO)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
- AdventHealth (Kansas City, MO)
- …Platte, Clay, Cass Counties in Missouri **The role you'll contribute:** The Home Health Registered Nurse (RN) Care Manager is a professional nurse who ... requiring the use of advanced assessment, teaching and decision-making skills. The nurse is responsible for ensuring that appropriate referrals to other services are… more
- Humana (Jefferson City, MO)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN)** in the (appropriate state)… more
- Children's Mercy Kansas City (Kansas City, MO)
- …in Utilization Review + One of the following: Licensed RN - MO, Registered Nurse Multistate License Missouri required upon hire + One of the following: ... training oversight of programs and services. Responsible for effective utilization review and proper resource management of patients, including...Licensed RN - Kansas, Registered Nurse Multistate License Kansas required upon… more
- Saint Luke's (Kansas City, MO)
- …of care and billing. **Job Requirements** Applicable Experience: Less than 1 year Registered Nurse - Various Associate Degree **Job Details** PRN Day (United ... **Job Description** The Utilization Review RN is responsible for assuring the...appropriate level of service and length of stay, using clinical guidelines (InterQual). + Complies with CMS regulation regarding… more
- CenterWell (Jefferson City, MO)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... skills to make an impact** **Required Qualifications** + Licensed Registered Compact Nurse license (RN) with no...Lung or Critical Care Nursing experience required + Prior clinical experience preferably in an acute care, skilled or… more