- Cognizant (Pierre, SD)
- …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
- Sanford Health (Rapid City, SD)
- …preferred. Experience in medical necessity review preferred. Currently holds an unencumbered registered nurse (RN) license with the State Board of Nursing ... time **Weekly Hours:** 40.00 **Department Details** Join our team as a Utilization Review and Case Management Manager and lead a high-impact, data-driven program… more
- CVS Health (Pierre, SD)
- …+ 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
- Avera (Sioux Falls, SD)
- …**May Be eligible for a $10,000 Sign on Bonus** **Student Loan Repayment:** This Registered Nurse (RN) position may be eligible for Avera's Student Loan ... hardship to the employer. **Required Education, License/Certification, or Work Experience:** + Registered Nurse (RN) - Board of Nursing Upon Hire **Preferred… more
- Sanford Health (Sioux Falls, SD)
- …business need, prior to new Sanford education requirements. Three years' experience as a registered nurse (RN) in a clinical role preferred. Thorough ... skilled in the functions of the applicable technical software setting and process/ utilization improvement. Improves clinical patient care processes for quality… more
- Humana (Pierre, SD)
- **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
- Avera (Sioux Falls, SD)
- …undue hardship to the employer. **Required Education, License/Certification, or Work Experience:** + Registered Nurse (RN) - Board of Nursing An active license ... the face of Avera@Home. + Establishes operational systems to insure maximum resource utilization and financial performance of the clinical continuum of care. +… more
- Sanford Health (Sioux Falls, SD)
- …**Job Summary** Responsible for analyzing and synthesizing of data to maximize utilization of data in clinical decision-making, business and strategic ... Coordinates educational activities associated with orientation and ongoing training. The Clinical Program Specialist for the Cancer Center is a program-wide resource… more
- Evolent (Pierre, SD)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals.… more
- STG International (Pierre, SD)
- …the management/coordination of the clinic's day-to-day activity, in conjunction with the Registered Nurse (RN)/CBOC Manager and VA Program's philosophy. *Comply ... into the VA health care system. *Participate in the orientation of clinical staff physicians, physician assistants and nurse practitioners. *Provide leadership… more