Top 47 Utilization review Jobs in Bloomington, Mn

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
Diagnostic Radiology- Medical Record Reviewer
Dane Street, LLC —Minneapolis, MN
- Remote
- BC/BE
- Senior level
- Radiology
Quick Apply
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
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)
Senior Business Analyst - Utilization Management/Behavioral Health
Blue Cross and Blue Shield of Minnesota —Eagan, MN
- $90,800 - $149,800 a year
- Hybrid work
- Research
- Office
- Analysis skills
- Health insurance
- Dental insurance
5d
Utilization Management RN
North Memorial Healthcare —Robbinsdale, MN
- $39.83 - $59.74 an hour
- 8 hour shift
- Hybrid work
- Nursing
- RN License
- Mid-level
- Health insurance
- Tuition reimbursement
Supervisor, Utilization Management
Medica Services Company LLC —Minnetonka, MN
- $78,700 - $134,900 a year
- Microsoft Word
- Nursing
- Microsoft Excel
- Paid holidays
- Health insurance
7d
RN Case Manager
HealthPartners/GHI —Bloomington, MN
- $36.37 - $54.55 an hour
- Full-time
- Nursing
- RN License
- Computer literacy
- Health insurance
Care Coordinator, LSW (MSHO) – $2,500 Sign-On Bonus
Bluestone Physician Services —Maplewood, MN
- $65,000 - $75,000 a year
- Full-time
- Hybrid work
- RN License
- Experience working with individuals with disabilities
- English
- Mileage reimbursement
- Health savings account
Quick Apply
Clinical Risk Nurse
TPAC Underwriters —Blaine, MN
- $90,000 - $120,000 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- Microsoft Outlook
3d
RN Case Manager
North Memorial Healthcare —Robbinsdale, MN
- $37.49 - $56.23 an hour
- 8 hour shift
- Nursing
- RN License
- Mid-level
- Health insurance
- Tuition reimbursement
Medical Claims Review Medical Director - Surgeon - Remote
Optum —Eden Prairie, MN
- $248,500 - $373,000 a year
- Full-time
- Remote
- Medicine
- Microsoft Outlook
- Surgery
Quick Apply
10d
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, 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
12d
Manager, Clinical Pharmacy (Governance)
Medica Services Company LLC —Minnetonka, MN
- $113,400 - $194,400 a year
- Writing skills
- Office
- Bachelor's degree
- Paid holidays
- Health insurance
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
SSBV Medical Director - Remote
Optum —Plymouth, MN
- $248,500 - $373,000 a year
- Full-time
- Remote
- Medicine
- BC/BE
- Pass drug screening
National Medical Director Clinical Program Governance, Evaluation, and Innovation - Remote
UnitedHealthcare —Minnetonka, MN
- $386,500 - $579,500 a year
- Full-time
- Remote
- Medicine
- Microsoft Outlook
- BC/BE
3d
Director of Business Office
Capitol Park Mental Health Hospital —Saint Paul, MN
- Full-time
- Office
- 3 years
- High school diploma or GED
9d

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Case Manager ( RN / RT / SW / LPN )

Regency Hospital - Minneapolis -
Golden Valley, MN

Quick Apply

Job Details

Full-time

Benefits

Dental insurance
Paid time off
Employee assistance program
Vision insurance
401(k) matching
Paid sick time

Qualifications

Inpatient experience
Critical & intensive care
Acute care facility experience

Full Job Description

Overview:

Select Specialty Hospital

Critical Illness Recovery Hospital (LTACH)

Sign On Bonus: $7500

Case Manager

Full Time: Monday-Friday 8-5pm

Requires a current licensure in a clinical discipline either as a Nurse (RN/LPN/LVN) or a Respiratory Therapist (RT) OR Medical Social Work (license per state guidelines).

And

Previous discharge planning experience preferred.

Salary Range: 85-113,000 Dependent On Past Years Of Experience

Our hospital is a critical illness recovery hospital committed to providing world-class inpatient post-ICU services to chronic, critically ill patients who require extended healing and recovery. We help patients during some of the most vulnerable, painful moments of their lives – and our team plays a central role in providing compassionate, excellent care every step of the way.

Responsibilities:

We are looking for valued employees who will be Champions of the Select Medical Way, which includes putting the patient first, helping to improve quality of life for the community in which you live and work, continuing to develop and explore new ideas, providing high-quality care and doing well by doing what is right.

The Case Manager is responsible for utilization reviews and resource management, discharge planning, treatment plan management and financial management, while also completing medical record documentation. You will report directly to the Director of Case Management and provide social work services, as necessary, per state guidelines.

Develops and implements a patient specific, safe and timely discharge plan.
Performs verification of utilization criteria reviews.
Builds relationships and coordinate with payor sources to assure proper reimbursement for hospital provided services, promote costs attentive care via focus on resource management within the plan of care.
Demonstrates compliance with facility-wide Utilization Management policies and procedures.
Coordinates UR compliance with Quality Management to assure all licensure and accrediting requirements are fulfilled.
Maintains fiscal responsibilities. Assures the department is identifying and negotiating the fullest possible reimbursement to maximize insurance benefit coverage for the patient. Reviews insurance verification forms to minimize risk.
Facilitates multi-disciplinary team meetings including physicians, nurses, respiratory therapists and rehabilitation therapists.

Qualifications:

We are seeking results-driven team players. Qualified candidates must be passionate about providing superior quality in all that they do.

Minimum requirements:

Current licensure in a clinical discipline either as a Nurse or a Respiratory Therapist (RN preferred) OR current license / certified Social Work license per state guidelines
Previous RN/LPN/RT/SW/CM experience in an inpatient hospital setting dealing with critical care/acute care patients. (example: ICU, step-down, med surg, vents)

Preferred qualifications that will make you successful:

Specific experience in Care Management and Discharge Planning is preferred.
Working knowledge of the insurance industry and government reimbursement.

Additional Data:

General Benefits Full-time

Start Strong: Extensive and thorough orientation program to ensure a smooth transition into our setting
Recharge & Refresh: Generous PTO and Paid Sick Time for full-time team members to maintain a healthy work-life balance
Your Health Matters: Comprehensive medical/RX, health, vision, employee assistance program (EAP) and dental plan offerings for full-time team members
Invest in Your Future:Company-matching 401(k) retirement plan, as well as life and disability protection for full-time team members
Your Impact Matters:Join a team of over 44,000 committed to providing exceptional patient care

Equal opportunity employer, including disabled veterans

Quick Apply

Refine Your Search

utilization review jobs in bloomington, mn

Case Manager ( RN / RT / SW / LPN )

SSBV Clinical Claim Review RN

Diagnostic Radiology- Medical Record Reviewer

Director of Utilization Management

Clinical Solutions Specialist

Senior Business Analyst - Utilization Management/Behavioral Health

Utilization Management RN

Supervisor, Utilization Management

RN Case Manager

Care Coordinator, LSW (MSHO) – $2,500 Sign-On Bonus

Clinical Risk Nurse

RN Case Manager

Medical Claims Review Medical Director - Surgeon - Remote

Consultant, Clinical Pharmacy Program

Care Coordinator, LSW (MSHO)

Manager, Clinical Pharmacy (Governance)

Autism Care Manager, BCBA Pipeline

SSBV Medical Director - Remote

National Medical Director Clinical Program Governance, Evaluation, and Innovation - Remote

Director of Business Office

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