Top 47 Utilization review Jobs in Saint Paul Mn

RN - Admissions Acute
Capitol Park Mental Health Hospital —Saint Paul, MN
- $42.00 - $48.80 an hour
- Full-time
- Acute care
- CPR Certification
- Nursing
- Free parking
- Health insurance
Case Manager ( RN / RT / SW / LPN )
Regency Hospital - Minneapolis —Golden Valley, MN
- Full-time
- RN License
- Inpatient
- Mid-level
- Dental insurance
- Paid time off
Quick Apply
SSBV Clinical Claim Review RN
Optum —Plymouth, MN
- $28.94 - $51.83 an hour
- Full-time
- Remote
- Nursing
- RN License
- Pass drug screening
- AD&D insurance
- Employee stock purchase plan
Clinical Documentation Integrity (CDI) Specialist
Optum —Eden Prairie, MN
- $72,800 - $130,000 a year
- Full-time
- Hybrid work
- Microsoft Excel
- Hospital
- 5 years
Diagnostic Radiology- Medical Record Reviewer
Dane Street, LLC —Minneapolis, MN
- Remote
- BC/BE
- Senior level
- Radiology
Quick Apply
Case Manager, Behavioral Health
HealthPartners/GHI —Bloomington, MN
- $34.28 - $51.42 an hour
- Full-time
- LMFT
- RN License
- Mid-level
- Health insurance
Education Development Specialist, Comprehensive Care Advocacy
HealthPartners/GHI —Bloomington, MN
- $39.73 - $59.59 an hour
- Full-time
- Nursing
- Microsoft Excel
- Microsoft Outlook
22h
Director of Utilization Management
Blue Cross and Blue Shield of Minnesota —Eagan, MN
- $135,500 - $230,300 a year
- Hybrid work
- Office
- 3 years
- High school diploma or GED
- Health insurance
- Dental insurance
Supervisor, Utilization Management
Medica Services Company LLC —Minnetonka, MN
- $78,700 - $134,900 a year
- Microsoft Word
- Nursing
- Microsoft Excel
- Paid holidays
- Health insurance
1d
Clinical Solutions Specialist
Medline Industries —Minneapolis, MN
- $79,000 - $119,000 a year
- Full-time
- Nursing
- Microsoft Excel
- Bachelor of Science
- Health insurance
- 401(k)
RN Case Manager
HealthPartners/GHI —Bloomington, MN
- $36.37 - $54.55 an hour
- Full-time
- Nursing
- RN License
- Computer literacy
- Health insurance
Director of Business Office
Capitol Park Mental Health Hospital —Saint Paul, MN
- Full-time
- Office
- 3 years
- High school diploma or GED
3d
Autism Care Manager, BCBA Pipeline
HealthPartners/GHI —Bloomington, MN
- $34.28 - $51.42 an hour
- Full-time
- RN License
- Mid-level
- 3 years
- Health insurance
Care Coordinator, LSW (MSHO)
Bluestone Physician Services —Mendota Heights, MN
- $65,000 - $75,000 a year
- Full-time
- Hybrid work
- Nursing
- RN License
- Experience working with individuals with disabilities
- Mileage reimbursement
- Health savings account
Quick Apply
6d
Supervisor, Behavioral Health Case Management (BCBA)
HealthPartners/GHI —Bloomington, MN
- $38.19 - $59.19 an hour
- Full-time
- RN License
- Mid-level
- Master's degree
- Health insurance
Surgery Center RN Manager
Southdale Specialty Surgery Center —Minneapolis, MN
- $110,000 - $133,000 a year
- Full-time
- Nursing
- RN License
- 5 years
- Health insurance
- Dental insurance
Quick Apply
Registered Nurse
Amivie CustomCare —West Saint Paul, MN
- $48 - $55 an hour
- On call
- Nursing
- Current TB test
- RN License
- Paid holidays
- Health insurance
Consultant, Clinical Pharmacy Program
HealthPartners/GHI —Bloomington, MN
- $61.91 - $92.87 an hour
- Full-time
- Research
- Mid-level
- Analysis skills
- Health insurance
Care Coordinator, RN (MSHO)
Bluestone Physician Services —Mendota Heights, MN
- $65,000 - $75,000 a year
- Full-time
- Hybrid work
- Nursing
- RN License
- Experience working with individuals with disabilities
- Mileage reimbursement
- Health savings account
Quick Apply
6d
SSBV Medical Director - Remote
Optum —Plymouth, MN
- $248,500 - $373,000 a year
- Full-time
- Remote
- Medicine
- BC/BE
- Pass drug screening

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RN - Admissions Acute

Capitol Park Mental Health Hospital -
Saint Paul, MN

Apply Now

Job Details

Full-time
$42.00 - $48.80 an hour

Benefits

Free parking
Health insurance
Dental insurance
401(k)
Vision insurance

Qualifications

CPR Certification
RN License
BLS Certification
Associate's degree
Associate Degree in Nursing

Full Job Description

Overview:

Pay Range: $42/hr - $48.80/hr

Available Shifts:

Evenings: 3:00pm to 11:00pm

Nights: 7:00pm to 7:00am

Rotating weekends

BENEFITS:

Free Parking Onsite
$4 Lunches for employees
Competitive hourly rate with shift differentials available
Strong benefit plan including medical, dental, and vision insurance
Acadia Healthcare 401(k) plan
Work in a brand new, state of the art facility outfitted with cutting edge technology and safety features
Professional growth opportunity that is second to none in the industry.

PURPOSE STATEMENT:

Clinical professional is responsible for facilitating admissions, clinical intake assessments, and utilization review processes to assure continuity for the most appropriate level of care for patients and their benefit/resource utilization.

Responsibilities:

Review medical documentation for all admissions, complete medication reconciliation, and obtain admission orders from physicians.
Facilitate emergency transfers for patients presenting with emergency medical conditions outside of the facility’s capabilities.
Review referrals from hospitals, facilities, and other community agencies for medical and behavioral acuity and respond within facility policy timeframes.
Respond to inquiries about the facility and provide appropriate recommendations.
Conduct assessments to determine the appropriate level of care within the facility.
Collaborate with other facility medical and psychiatric personnel to ensure appropriate recommendations and admissions.
Facilitate admissions process for incoming patients including assessment, consent, and inventory of patient belongings.
Perform insurance benefit verifications and secure initial pre-authorization for treatment and admission.
Monitor patient status throughout the admissions process in accordance with facility policy and/or physician orders.
Utilize multiple web-based programs to track and review referrals.
Communicate projected admissions to designated internal representatives promptly.
Ensure all clinical information from referral sources or patients (including medical comorbidity information) is received, when possible, prior to patient admission.
Schedule (when applicable) and complete pre-admission assessments, consult with the admitting physician and communicate disposition recommendations to the patient or their family.
Possess skill in preparing and maintaining appropriate medical record documentation that will result in authorization at the level of care being requested of the payor.
Complete initial pre-authorization for treatment and admission prior to admission, when possible, and within payor timeframe guidelines.
Admit the patient to the registration and accounting system. Complete all admission and consent forms with the patient.
Demonstrate a positive, empathetic, and professional attitude toward customers always. When patient needs are not met, acknowledge and work to resolve complaints. Recognize that patient safety is a top priority.
When a patient’s needs are not met, acknowledge and work to resolve complaints. Recognize that patient safety is a top priority.
Coordinate care for patients who are not being admitted and ensure that they receive appropriate follow-up care and referrals.
Demonstrate a sense of urgency related to the importance of patient safety and provide excellent customer service.
Responsible for conducting safety checks and ensuring that supervision is conducted at 15-minute intervals, as noted in special precautions, or in accordance with individualized supervision guidelines as needed.

OTHER FUNCTIONS:

Perform other functions and tasks as assigned.

Qualifications:

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:

Minimum of Associate’s degree in Nursing.
Minimum one year of experience working with individuals in a clinical or observational capacity, preferably within the area of specialty for the hiring facility.

LICENSES/DESIGNATIONS/CERTIFICATIONS:

Clear and active nursing license in the state.
CPR and de-escalation/restraint certification required (training available upon hire and offered by facility).
First aid may be required based on state or facility

We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual’s characteristics protected by applicable state, federal and local laws.

AHRN

#LI-JM1

#LI-CPMHH

Apply Now

Refine Your Search

utilization review jobs in saint paul mn

RN - Admissions Acute

Case Manager ( RN / RT / SW / LPN )

SSBV Clinical Claim Review RN

Clinical Documentation Integrity (CDI) Specialist

Diagnostic Radiology- Medical Record Reviewer

Case Manager, Behavioral Health

Education Development Specialist, Comprehensive Care Advocacy

Director of Utilization Management

Supervisor, Utilization Management

Clinical Solutions Specialist

RN Case Manager

Director of Business Office

Autism Care Manager, BCBA Pipeline

Care Coordinator, LSW (MSHO)

Supervisor, Behavioral Health Case Management (BCBA)

Surgery Center RN Manager

Registered Nurse

Consultant, Clinical Pharmacy Program

Care Coordinator, RN (MSHO)

SSBV Medical Director - Remote

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