- 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
- CVS Health (Pierre, SD)
- …shift times are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence required. + Minimum ... solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team.… more
- CVS Health (Pierre, SD)
- …good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… 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
- 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
- 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
- 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
- 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 Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are… more
- Sharecare (Pierre, SD)
- …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… 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