- Avera (Sioux Falls, SD)
- …cause undue hardship to the employer. **Required Education, License/Certification, or Work Experience:** + Registered Nurse ( RN ) - Board of Nursing An active ... the Clinical Appeals Specialist to ensure tracking and trending of all Utilization Review related denials/appeals are appropriately documented. + Assists with the… more
- Avera (Scotland, SD)
- …join our team! We offer quality care close to home. **Position Highlights** **Seeking a Registered Nurse ( RN ) to join our team at Landmann-Jungman Memorial ... professional level of behavior in her/his role as an RN . The American Nurses Associations (ANA) scope and standards...**CERTIFICATION, LICENSURE, and/or REGISTRATIONS:** + Current licensure as a Registered Nurse in the State of South… more
- Avera (Sioux Falls, SD)
- …schedule **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 ... cause undue hardship to the employer. **Required Education, License/Certification, or Work Experience:** + Registered Nurse ( RN ) - Board of Nursing Upon Hire… more
- Avera (Pierre, SD)
- …cause undue hardship to the employer. **Required Education, License/Certification, or Work Experience:** + Registered Nurse ( RN ) - Board of Nursing An active ... personnel/patient issues in the absence of clinical leaders. + Coordinates utilization of resources including staff, ancillary staff, equipment and facilitates… more
- Avera (Sioux Falls, SD)
- …cause undue hardship to the employer. **Required Education, License/Certification, or Work Experience:** + Registered Nurse ( RN ) - Board of Nursing An active ... to the patient including expected outcomes, including efficient and effective utilization of resources to achieve positive outcomes. + Manages the plan… 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 ... in the functions of the applicable technical software setting and process/ utilization improvement. Improves clinical patient care processes for quality patient… more
- Humana (Pierre, SD)
- …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...Greater than one year of clinical experience in a RN role in acute care setting with preference for… more
- CVS Health (Pierre, SD)
- …+ Active and good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult inpatient behavioral… more
- Sanford Health (Sioux Falls, SD)
- …for Nursing Commission for Nursing Education Accreditation (NLN CNEA). Currently holds an unencumbered registered nurse ( RN ) license with the State Board of ... level of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to assure… more