- St. Peters Health (Helena, MT)
- The Utilization Management RN reports directly to Utilization Review RN Coordinator. The UR RN supports the UR RN Coordinator and other UR ... denials as assigned, and participation in the organizations Utilization Review Committee. In collaboration with the patient /family, physicians, and the… more
- Fresenius Medical Center (Butte, MT)
- …a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. As the facility leader, ... auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic… more
- Humana (Helena, MT)
- …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
- CenterWell (Helena, MT)
- …community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that focuses on excellent… more
- Intermountain Health (Miles City, MT)
- **Job Description:** The Registered Nurse ( RN ) is a professional caregiver who assumes responsibility and accountability for assessing, planning, ... Minimum of three (3) years of experience as a Registered Nurse in an acute care setting...of nursing experience- Prior knowledge of managed care / utilization review **Physical Requirements:** Ongoing need for… more
- Intermountain Health (Butte, MT)
- …+ Patient Education + Communication + Prioritization **Minimum Qualifications** + Current Registered Nurse ( RN ) license in state of practice. + Bachelor ... of word processing and Excel software. **Physical Requirements:** **Minimum Qualifications** + Current Registered Nurse ( RN ) license in state of practice. +… more
- Veterans Affairs, Veterans Health Administration (Billings, MT)
- …and record relevant patient information. Completed work should need only a general review by a registered nurse or physician for appropriateness and ... MD/DO. Knowledge and ability to recognize urgent and emergent patient care situation, seek assistance of the RN...Significant amounts of time standing assisting assigned patients - Utilization of safe patient handling and mobility… more
- Bozeman Health (Bozeman, MT)
- …in Nursing; equivalent combination of education and experience considered + Current Montana Registered Nurse ( RN ) licensure + American Heart Association ... and transfer of patients, appropriately guiding physician understanding of admission Utilization Review InterQual criteria + Facilitate and communicate the… more
- Datavant (Helena, MT)
- …with clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
- Evolent (Helena, MT)
- …the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care… more