Top 67 Utilization review Jobs in Minnesota

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
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
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
MDS Coordinator
Aftenro Society Home for the Aged —Duluth, MN
- $35 - $45 an hour
- Part-time
- Nursing
- Skilled nursing facility
- RN License
- Health insurance
- Dental insurance
Quick Apply
7d
Manager (RN) - Utilization Review
Hennepin Healthcare —Minneapolis, MN
- $63.83 - $95.74 an hour
- Full-time
- Hybrid work
- Nursing
- Psychiatry
- RN License
- Disability insurance
- Health insurance
Clinical Risk Nurse
TPAC Underwriters —Blaine, MN
- $90,000 - $120,000 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- Microsoft Outlook
Workers' Compensation MediatorArbitrator/Dispute Prevention Resolution Specialist
State of Minnesota - Labor & Industry Dept —Saint Paul, MN
- $37.91 - $56.39 an hour
- Online Application
- Hybrid work
- Background check
- Mid-level
- Office
- Paid parental leave
- Paid holidays
14d
Clinical Appeals Specialist II-Hybrid
Mayo Clinic —Rochester, MN
- $88,358 - $123,780 a year
- Full-time
- Hybrid work
- Nursing
- RN License
- Mid-level
- Health savings account
- 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
RN Case Manager
HealthPartners/GHI —Bloomington, MN
- $36.37 - $54.55 an hour
- Full-time
- Nursing
- RN License
- Computer literacy
- Health insurance
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
Regional Director Admissions, Access and Assessment
PrairieCare —Brooklyn Park, MN
- Full-time
- LMFT
- Nursing
- Psychiatry
7d
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
340B Program Director
Visante Consulting LLC —Saint Paul, MN
- Full-time
- Remote
- Microsoft Excel
- 5 years
- Writing skills
Quick Apply
13d
Consultant, Clinical Pharmacy Program
HealthPartners/GHI —Bloomington, MN
- $61.91 - $92.87 an hour
- Full-time
- Research
- Mid-level
- Analysis skills
- Health insurance
Regional Director Admissions, Access and Assessment
Newport Healthcare —Brooklyn Park, MN
- $130,000 - $160,000 a year
- LMFT
- Psychiatry
- Inpatient
Quick Apply
8d
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
Record Analyst/HIM Spec/Transcriptionist
LifeCare Medical Center —Roseau, MN
- $20.69 - $28.96 an hour
- Weekends as needed
- Anatomy knowledge
- Hospital
- Computer literacy
- Disability insurance
- Health insurance
Quick Apply
6d
Clinical Pharmacy Manager, Formulary Strategy
Medica Services Company LLC —Minnetonka, MN
- $113,400 - $194,400 a year
- Writing skills
- Office
- Bachelor's degree
- Paid holidays
- Health insurance

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SSBV Clinical Claim Review RN

Optum -
Plymouth, MN

Apply Now

Job Details

Full-time
$28.94 - $51.83 an hour

Benefits

AD&D insurance
Employee stock purchase plan
Paid holidays
Disability insurance
Health insurance
Dental insurance
401(k)
Tuition reimbursement
Paid time off
Employee assistance program
Vision insurance
Employee discount
Referral program
Pet insurance

Qualifications

Inpatient experience
RN License
Spreadsheets
Care documentation
Clinical documentation
Acute care experience
Productivity software
Associate's degree

Full Job Description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Let's face it, no industry is moving faster than health care. And no organization is better positioned to lead health care forward than UnitedHealthcare, part of the UnitedHealth Group family of businesses. As a SSBV Clinical Claims Review RN, you can put your skills and talents to work. This is a multifaceted role that is highly rewarding.

It feels great to have autonomy, though there's also a lot of responsibility that comes with it. In this role, you'll be accountable for making decisions that directly impact on our members. And at the same time, you'll be challenged by a demanding case load in a rapidly changing, production-driven environment.

You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

Perform administrative reviews of short stay inpatient hospital claims in accordance with Federal, State and client specific requirements
Responsible for documentation of all determinations
Maintain accurate use of screening criteria

What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
Medical Plan options along with participation in a Health Spending Account or a Health Saving account
Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
401(k) Savings Plan, Employee Stock Purchase Plan
Education Reimbursement
Employee Discounts
Employee Assistance Program
Employee Referral Bonus Program
Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

Associate's degree
Current and unrestricted RN license in the state of residency
5+ years of clinical documentation experience
3+ years of experience as an RN, including inpatient/acute setting
Intermediate level of proficiency in Microsoft Office (to include Microsoft Excel and One Note)
Intermediate level of proficiency in writing
Designated home office workspace with access to install secure high-speed internet via cable/DSL

Preferred Qualifications:

Undergraduate or higher degree
A background in utilization review for an insurance company or experience in case management
Familiarity with InterQual and/or MCG Care Guidelines
Critical thinking skills
All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.94 to $51.83 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

#RPO #GREEN

Apply Now

Refine Your Search

utilization review jobs in minnesota

SSBV Clinical Claim Review RN

Diagnostic Radiology- Medical Record Reviewer

Senior Business Analyst - Utilization Management/Behavioral Health

Director of Utilization Management

MDS Coordinator

Manager (RN) - Utilization Review

Clinical Risk Nurse

Workers' Compensation MediatorArbitrator/Dispute Prevention Resolution Specialist

Clinical Appeals Specialist II-Hybrid

Autism Care Manager, BCBA Pipeline

RN Case Manager

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

Regional Director Admissions, Access and Assessment

Supervisor, Behavioral Health Case Management (BCBA)

340B Program Director

Consultant, Clinical Pharmacy Program

Regional Director Admissions, Access and Assessment

Medical Claims Review Medical Director - Surgeon - Remote

Record Analyst/HIM Spec/Transcriptionist

Clinical Pharmacy Manager, Formulary Strategy

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