- 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CenterWell (Pierre, SD)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Cognizant (Pierre, SD)
- …background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- CVS Health (Pierre, SD)
- …experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal ... clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult… more
- Avera (Sioux Falls, SD)
- …Provide all cares to include lab draws, nebulizer treatments, wound care, case management , discharge planning and as needed cares. Responsible for the care planning, ... utilization of services, coordination of care, and the education...and the education of the interdisciplinary teams in the management of patient care services. Develops all patient care… more
- Sanford Health (Sioux Falls, SD)
- …in the functions of the applicable technical software setting and process/ utilization improvement. Improves clinical patient care processes for quality patient ... and supports human resources administrative processing and procedures with staff management . May assist with providing feedback in the collection and preparation… more
- Highmark Health (Pierre, SD)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... within the first 6 months of employment. **Preferred** + Certification in utilization management or a related field + Certification in Case Management … more
- Avera (Scotland, SD)
- …offer quality care close to home. **Position Highlights** **Seeking a Registered Nurse (RN) to join our team at Landmann-Jungman Memorial Hospital.** **SUMMARY:** ... preferred. **CERTIFICATION, LICENSURE, and/or REGISTRATIONS:** + Current licensure as a Registered Nurse in the State of South Dakota and/or meeting the requirements… more
- Avera (Pierre, SD)
- …both clinically and administratively. As the off shift representative of management , supervises staff and makes administrative decisions, which may involve patients ... personnel/patient issues in the absence of clinical leaders. + Coordinates utilization of resources including staff, ancillary staff, equipment and facilitates… more