Top 30 Utilization management Jobs in Wausau, Wi

Registered Nurse - General Surgery
Surgical Associates, SC —Wausau, WI
- Full-time
- Nursing
- Vital signs
- Surgery
- Health savings account
- Health insurance
Quick Apply
FRAUD WASTE ABUSE ANALYST - ASPIRUS HEALTH PLAN
ASPIRUS HEALTH —Wausau, WI
- Full-time
- RN License
- Mid-level
- Analysis skills
- Wellness program
- Retirement plan
Full Time Health Information Management Specialist
Behavioral Health Clinic —Wausau, WI
- $24 - $30 an hour
- Full-time
- Mid-level
- Associate's degree
- Paid holidays
- Disability insurance
Quick Apply
8d
PATIENT PLACEMENT SPECIALIST - ADMISSION AND TRANSFER
ASPIRUS HEALTH —Wausau, WI
- Full-time
- Hospital
- Mid-level
- 3 years
- Wellness program
- Retirement plan
SUPERVISOR - WESTON CLINIC
ASPIRUS HEALTH —Weston, WI
- Full-time
- Background check
- Mid-level
- Clinic
- Wellness program
- Paid time off
Quick Apply
Social Services Coordinator - Part-Time 1st Shift
Wausau Manor Health Services —Wausau, WI
- Part-time
- Nursing home
- Computer literacy
- English
- Paid holidays
- Disability insurance
Quick Apply
DIRECTOR - MEDICAL DIRECTOR - ASPIRUS HEALTH PLAN
ASPIRUS HEALTH —Wausau, WI
- Full-time
- Medicine
- 5 years
- BC/BE
- Wellness program
- Paid time off
Registered Nurse – Pre/Post Op- ECLSI
Eye Clinic of Wisconsin —Wausau, WI
- CPR Certification
- Nursing
- Surgery
Quick Apply
Registered Nurse (RN) - Pain
Bone and Joint Center, S.C. —Wausau, WI
- $30.70 - $44.82 an hour
- Online Application
- Vital signs
- RN License
- High school diploma or GED
Quick Apply
Rehab Therapy Market Director
Powerback Rehabilitation —Wausau, WI
- $76,000 - $110,000 a year
- Full-time
- Bachelor's degree
- Recruiting
- 1 year
- Relocation assistance
- Health insurance
9d
Hospital - Clinical Pharmacist Specialist (Bone Marrow Transplant)
UT Health Science Center at San Antonio —United States
- Hospital
- Outpatient experience
- 3 years
Quick Apply
Complex Care Manager RN-Western MA (Hybrid)
WellSense Health Plan —United States
- $74,000 - $107,000 a year
- Full-time
- Hybrid work
- Background check
- School experience
- Nursing
- Health insurance
- Dental insurance
Family Medicine Medical Director Utilization Management
Amerihealth Caritas —United States
- Weekends as needed
- Hybrid work
- Medicine
- Physical & Rehabilitation Medicine
- 3 years
- Paid holidays
- Health insurance
Inpatient Medical Coding Quality Auditor
Pena4 Inc. —United States
- $80,000 - $90,000 a year
- 8 hour shift
- Remote
- 5 years
- US work authorization
- Senior level
- Health insurance
- Dental insurance
Quick Apply
12d

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Quality Inspector/CWI - 2nd Shift
Veritas Steel LLC —Wausau, WI
Monitor and record welding parameters to insure compliance to approved WPS. Work with outside inspectors to resolve quality issues on the floor.
$26 - $40 an hour
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Quality Technician I
Piper Products —Wausau, WI
Coordinates incoming documentation for returned goods due to customer complaints as required. Documents and communicates with supply chain, production, and…
$20 an hour
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Utilization Management Specialist
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Utilization Review Specialist - Autism
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Bachelor’s Degree in Social Work, Psychology, or related field, required. Conducts utilization reviews of behavioral health cases to determine medical necessity…
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utilization management jobs near wausau, wi

Registered Nurse - General Surgery

Surgical Associates, SC
Wausau, WI

Quick Apply

Job Details

Full-time

Benefits

Health savings account
Health insurance
Dental insurance
Paid time off
Employee assistance program
Vision insurance
Life insurance
Retirement plan

Qualifications

Vital signs
RN License
BLS Certification
Epic
Associate's degree
Associate Degree in Nursing

Full Job Description

GENERAL SURGERY: RN - Clinic Support & Triage

Monday - Friday, 1st shift

NO Nights/Call/Weekends/Holidays

Full-time, 1.0 FTE

SUMMARY

Responsible for providing clinical support, patient triage, care coordination, and nursing services for patients within a surgical specialty clinic.

ESSENTIAL JOB FUNCTIONS

1. Provides clinical nursing support, patient assessments, treatment guidance, and follow-up instructions for patients within the surgical specialty clinic.

2. Performs patient triage through telephone and electronic communication by assessing symptoms, determining urgency of care needs, and directing patients appropriately to emergency services, urgent care, physician appointments, or home care guidance.

3. Conducts brief patient assessments, including gathering chief complaint information, vital signs, mental status observations, and relevant patient history when appropriate.

4. Collaborates with physicians and other care team members to create, implement, monitor, and coordinate patient care plans.

5. Obtains provider input and direction as needed to determine appropriate clinical course of action and patient disposition.

6. Refers patients with high-risk symptoms or conditions for emergency evaluation and provides appropriate guidance to patients not requiring emergent care.

7. Coordinates patient scheduling needs, including arranging appointments directly or collaborating with scheduling staff.

8. Provides routine nursing guidance, patient education, pre-operative and post-operative support, and care coordination within scope of practice.

9. Manages prescription refill requests in accordance with provider direction and organizational protocols.

10. Manages patient calls, electronic communications, referrals, and electronic in-basket workflows in a timely and professional manner.

11. Accurately documents patient symptoms, concerns, nursing assessments, clinical advice provided, and patient responses within the electronic medical record (Epic).

12. Performs clinical support duties including wound care, VAC dressing changes, IV insertion, lab draws, assisting with minor procedures, and utilization of sterile technique as appropriate.

13. Assists with clinic operations including chart preparation, exam room turnover, clinic preparation activities, and maintaining medical supply and medication inventory as needed.

14. Supports clinic floor operations, including local and outreach clinic coverage, as needed.

15. Precepts and assists with onboarding or training of new team members as assigned.

16. Collaborates effectively with providers, nursing staff, leadership, and interdisciplinary teams to support efficient clinic operations and quality patient care.

17. Maintains professional communication, confidentiality, and compliance with organizational standards, policies, HIPAA requirements, and scope of practice expectations.

18. Performs other duties, projects, and responsibilities as assigned.

19. Supports Clinic floor, procedure or triage (local or outreach) as needed.

20. Perform other projects/tasks as requested.

This list is not inclusive of all duties and responsibilities that may be assigned. They are only listed as typical. Any other duties and responsibilities assigned will be of a similar nature requiring the same relative skill and capabilities.

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION and/or EXPERIENCE

· Bachelor’s degree in Nursing is preferred.

· Minimum of an Associate’s degree in Nursing is required.

· Current RN state license is required.

· 3+ years of experience as RN is required.

· BLS certification is required.

· Previous triage experience is preferred. Previous wound care management is preferred.

· Experience working with Epic software is preferred.

KNOWLEDGE, SKILLS & ABILITIES – COMPETENCIES

· Possesses skills with technology.

· Possesses knowledge of basic nursing performance standards as outlined in the Wisconsin Nurse Practice Act and functions within the scope of the legal guidelines.

· Demonstrates compassion and focuses on quality patient care.

· Possesses knowledge of patient care charts and history (preferably charting in Epic).

· Possesses strong organizational, communication, and problem-solving skills.

· Models a professional disposition and communication style.

· Must possess initiative and ability to work independently.

· Adherence to strict confidentiality standards and compliance as to scope of role, record keeping, PHI and HIPPA.

· Demonstrates the ability to make triage decisions based on brief patient assessment.

· Possesses the ability to react calmly and effectively in emergency situations.

· Demonstrates the ability to work under pressure and with constant interruptions.

· Specific safety certification/recertification may be required per the organization.

PHYSICAL/MENTAL DEMANDS and WORK ENVIRONMENT

Telephones system at medical practice or contractor office. Computer hardware/software for access to patient history and medical information databases. Office setting, well lighted, good air quality. Rare direct contact with patients. Mostly sedentary position. Hand/arm injury possible from repetitive movements. Stress generated if high volume of calls and emergencies.

This job description is not a guarantee of employment. It is understood that employment is “at will,” and the employer or the employee may terminate employment at any time.

To perform this position successfully, an individual must be able to perform the essential job duties satisfactorily (with or without accommodation). Reasonable accommodations may be made to enable individuals with disabilities to perform the primary job functions.

Job Type: Full-time

Benefits:

Dental insurance
Employee assistance program
Health insurance
Health savings account
Life insurance
Paid time off
Retirement plan
Vision insurance

Application Question(s):

How did you hear about this opportunity?

Experience:

Epic: 2 years (Preferred)

Ability to Commute:

Wausau, WI 54401 (Required)

Ability to Relocate:

Wausau, WI 54401: Relocate before starting work (Required)

Work Location: In person

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Refine Your Search

utilization management jobs in wausau, wi

Registered Nurse - General Surgery

FRAUD WASTE ABUSE ANALYST - ASPIRUS HEALTH PLAN

Full Time Health Information Management Specialist

PATIENT PLACEMENT SPECIALIST - ADMISSION AND TRANSFER

SUPERVISOR - WESTON CLINIC

Social Services Coordinator - Part-Time 1st Shift

DIRECTOR - MEDICAL DIRECTOR - ASPIRUS HEALTH PLAN

Registered Nurse – Pre/Post Op- ECLSI

Registered Nurse (RN) - Pain

Rehab Therapy Market Director

Hospital - Clinical Pharmacist Specialist (Bone Marrow Transplant)

Complex Care Manager RN-Western MA (Hybrid)

Family Medicine Medical Director Utilization Management

Inpatient Medical Coding Quality Auditor

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