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Humana
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Saint Paul, Minnesota
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communication of medical services and/or benefit administration determinations. The Manager, Utilization ... approach, resources, schedules and goals.
The Manager, Utilization Management Nursing is responsible for
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UnitedHealth Group
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Eden Prairie, Minnesota
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comprehensive care management or utilization review services in various locations.
*This is a 100 ... collaboration
Utilization Review Nurse
Provides utilization management services, in coordination with
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Mayo Clinic
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Rochester, Minnesota
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by ensuring appropriate utilization management, care coordination, resource utilization, and clinical ... Case Manager provides leadership through education on case management/utilization management concepts
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Coloplast Corp.
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Minneapolis, Minnesota
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labor, material and equipment utilization while meeting regulatory requirements. Major Areas of ... activities via utilization of engineering and technical knowledge / skill set. Document new and existing
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Humana
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Saint Paul, Minnesota
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, utilization management, case management, discharge planning and/or home health or post acute services such as ... interpretation and determinations whether services provided by other healthcare professionals are in agreement
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Humana
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Saint Paul, Minnesota
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insurance, other healthcare providers, clinical group practice management.
Utilization management ... interpretation and determinations whether services provided by other healthcare professionals are in agreement
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University of Minnesota - 15th Ave
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Minneapolis, Minnesota
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utilization, planning, and management. This position serves as a key resource to support decision-making at ... space planning and utilization at the University c. Keep abreast of space planning and management trends
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Humana
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Saint Paul, Minnesota
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medical interpretation and determinations whether services provided by other healthcare professionals are ... in teams focusing on quality management, utilization management, case management, discharge planning
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Humana
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Saint Paul, Minnesota
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determinations whether services provided by other healthcare professionals are concordant with national ... , with prior experience participating in teams focusing on quality management, utilization management
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McKinsey & Company Inc
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Minneapolis, Minnesota
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Performance Improvement, a group within our Healthcare Systems & Services practice. Provider Performance ... weigh in knowledgably with clients on issues of clinical equivalency, utilization management and
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Elevance Health
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Mendota Heights, Minnesota
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Elevance PulsePoints.
The Nurse Medical Management II is responsible to collaborate with healthcare ... or case management, utilization management or managed care experience; or any combination of
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CVS Health
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Saint Paul, Minnesota
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utilization management, quality management, network management and clinical coverage and policies ... .
Coordinates with the MCOs' care management staff and providers on medical services not included in the aligned
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Elevance Health
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Gilbert, Minnesota
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management, utilization management or managed care experience; or any combination of education and experience ... Management II
Job Description:
Location : This position can be located
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Humana
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Saint Paul, Minnesota
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and determinations whether services provided by other healthcare professionals are in agreement with ... in teams focusing on quality management, utilization management, case management, discharge planning
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LTCG
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REMOTE, Minnesota
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healthcare educational programs to promote healthy lifestyles and changes in healthcare utilization and ... The nation's leading administrator of insurance services is looking for YOU. This is your
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University of Minnesota - 15th Ave
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Minneapolis, Minnesota
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About the Job Job Summary CUHCC provides targeted case management services (TCM) to adults with serious ... - Friday. Key Responsibilities Provide adult or child case management services: 85% Assessment and Planning
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Humana
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Saint Paul, Minnesota
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medical interpretation and determinations whether services provided by other healthcare professionals are ... participating in teams focusing on quality management, utilization management, case management, discharge
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Solventum
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Maplewood, Minnesota
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our goals. On April 1, 2024, 3M Healthcare underwent a corporate spin-off leading to the creation of a ... now SolventumAt Solventum, we enable better, smarter, safer healthcare to improve lives. As a new
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Mayo Clinic
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Rochester, Minnesota
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tasks, allowing healthcare staff to refocus resources on other critical work functions. Our aim is to enhance patient convenience and satisfaction, ultimately contributing to better overall healthcare
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Intermountain Health
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Saint Paul, Minnesota
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, utilization management strategies and supply management strategies.
Serves as primary executive point of ... Intermountain Healthcare by coordinating complex and critical decision-making processes, implementation, and
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Prime Therapeutics
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Saint Paul, Minnesota
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management, reporting & analytics, benefits consulting, healthcare, financial services or related field ... for Centers for Medicaid/Medicare Services reporting and analysis, including the management of
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The Cigna Group
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Bloomington, Minnesota
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JOB SUMMARY:
Provides counsel and advice to top management on significant Program Management matters, often requiring coordination between organizations. Supports the delivery of a strategic
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UnitedHealth Group
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Eden Prairie, Minnesota
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. The Manager (Strategy & Growth) Advisory Services will need substantial industry knowledge and will ... , improve financial and market performance, rationalize services, and meet the many challenges that health
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Humana
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Saint Paul, Minnesota
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interpretation skills, with prior experience participating in teams focusing on quality management, utilization ... , hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers
Utilization
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HealthEdge Software Inc
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Saint Paul, Minnesota
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for Quality Assurance), CMS (Centers for Medicare & Medicaid Services), URAC (Utilization Review ... Overview
Position Overview:
Looking for a subject matter expert in the healthcare
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Humana
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Saint Paul, Minnesota
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insurance, other healthcare providers, clinical group practice management
Utilization management ... focusing on quality management, utilization management, case management, discharge planning and/or home
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Veterans Affairs, Veterans Health Administration
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Saint Cloud, Minnesota
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Veterans Affairs (VA), Veterans Health Administration (VHA), Veterans Integrated Services Network 23 (VISN ... and management of all Health Administration Service (HAS) functions and responsibilities. Serves as
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Highmark Health
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Saint Paul, Minnesota
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then creates the case (data entry) in Highmark's utilization management system for clinical review ... utilization management system.
Use knowledge of process and judgement to evaluate identified cases that
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Humana
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Saint Paul, Minnesota
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**
Registered Nurse
Experience in Medicare Utilization Management
Project Management Professional (PMP ... company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for
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Essentia Health
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Duluth, Minnesota
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assure appropriate resource utilization, consistent operations and scope of services provided. Monitors ... services (utilization, procurement, contracting, pathways, etc.) is involved.•Recruits, develops, and
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