- Children's Mercy Kansas City (Kansas City, MO)
- …+ Experience in Utilization Review + One of the following: Licensed RN - MO, Registered Nurse Multistate License Missouri required upon hire + ... training oversight of programs and services. Responsible for effective utilization review and proper resource management of...One of the following: Licensed RN - Kansas, Registered Nurse … more
- Saint Luke's (Kansas City, MO)
- **Job Description** The Utilization Review RN is responsible for assuring the receipt of high quality, cost efficient medical outcomes through ... utilization review and management. This position includes...billing. **Job Requirements** Applicable Experience: Less than 1 year Registered Nurse - Various Associate Degree **Job… more
- Humana (Jefferson City, MO)
- …an impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...in an acute care setting + Previous experience in utilization management/ utilization review for a… more
- CVS Health (Jefferson City, MO)
- … with behavioral health background. **Preferred Qualifications** + 3 years Managed care/ utilization review experience preferred. + Crisis intervention skills and ... Service/Health Services (as applicable to hiring program) or Associates degree with a Registered Nurse with Behavioral Health experience/ background with 3 years… more
- CVS Health (Jefferson City, MO)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse 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
- Banner Health (MO)
- …Requires a level of education as normally demonstrated by a Bachelor's degree. Requires Registered Nurse ( RN ) licensure in the state of practice. Requires ... work and receive care. As an Associate Manager of RN Denials Management, you will be an integral part...in payer clinical denials. Collaborates with Care Coordination, physician, Utilization Review , and other internal/external departments to… more
- Fresenius Medical Center (St. Louis, MO)
- …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
- Fresenius Medical Center (Creve Coeur, MO)
- …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
- Truman Medical Centers (Kansas City, MO)
- …and Excel + Proficiency in English, both spoken and written **Preferred Qualifications:** + RN experience in hospital utilization review , utilization ... for positions and apply.** Case Manager Care Continuity Services RN - Care Continuity - UH Truman Medical Centers...are seeking a dedicated and detail-oriented Case Manager (CM)-a registered nurse committed to optimizing both patient… more
- BJC HealthCare (St. Louis, MO)
- …to Millennium Park. Care Coordination consist of Case Management, Social Services and Utilization Review . The personnel in this office are responsible for ... Coeur, MO 63141 + At least 2 years of RN experience + BSN + At least 1 year...identify and resolve issues. Performs and provides consultation regarding Utilization Management and Performance Improvement programs in order to… more