Top 1292 Nursing Jobs in Omaha, Ne

Utilization Management Nurse
Detego Health —Omaha, NE
- $75,000 - $85,000 a year
- Full-time
- RN License
- Mid-level
- Office
Quick Apply
22h
Dispensing Nurse - LPN
BAART Programs —Omaha, NE
- Part-time
- CPR Certification
- Nursing
- Computer literacy
Nurse Disability Consultant
Lincoln Financial —Omaha, NE
- $72,900 - $131,600 a year
- Online Application
- Remote
- Nursing
- RN License
- Mid-level
- Disability insurance
- Tuition reimbursement
Clinical Specialist II - Omaha, NE
Boston Scientific —Omaha, NE
- $75,000 - $95,000 a year
- Full-time
- Nursing
- Surgery
- Physical & Rehabilitation Medicine
Shared Living Provider
360 Community Services —Omaha, NE
- $42,000 - $153,000 a year
- Contract
- Background check
- Spanish
- Cooking
- Flexible schedule
Quick Apply
Triage Nurse (RN)
Nebraska Cancer Specialists —Omaha, NE
- No weekends
- Nursing
- RN License
- Entry level
- Continuing education credits
- Health savings account
Nursing Assistant
Douglas County, NE —Omaha, NE
- $22.56 an hour
- Overtime
- Skilled nursing facility
- Vital signs
- Pass drug screening
- Health savings account
- Dental insurance
4d
Clinical Coordinator
Live On Nebraska —Omaha, NE
- Call employer
- RN License
- PALS Certification
- Hospital
10d
Clinical Study Nurse Coordinator
University of Nebraska Medical Center —Omaha, NE
- $73,400 - $110,100 a year
- Full-time
- Nursing
- Microsoft Access
- Microsoft Outlook
Staff RN - Experienced Bedside CC - Cardiac Care Unit - Full time/Nights
Children's Nebraska —Omaha, NE
- Weekends as needed
- Nursing
- RN License
- PALS Certification
Supervisor Clinical Nursing / Inpatient Nursing Float Pool Full time/Nights
Children's Nebraska —Omaha, NE
- Weekends as needed
- Nursing
- Float pool
- RN License
Licensed Practical Nurse (LPN) – Pulmonary Unit
Ambassador Health of Omaha —Omaha, NE
- Weekends only
- CPR Certification
- Hospital
- BLS Certification
- Paid training
- Paid holidays
Quick Apply
Director of Acute Behavioral Health (RN)
Children's Nebraska —Omaha, NE
- Full-time
- Acute care
- Nursing
- 7 years
Registered Nurses (RN) Full-time Days
Allergy Asthma & Immunology Associates —Omaha, NE
- Full-time
- Private practice
- CPR Certification
- Nursing
- Travel reimbursement
- Mileage reimbursement
Quick Apply
Staff RN - Experienced Bedside Behavioral Health / Emergency - Full time/Nights
Children's Nebraska —Omaha, NE
- Weekends as needed
- Nursing
- Medication administration
- RN License
Registered Nurse (RN) – Pediatric Specialty Care
Ambassador Health of Omaha —Omaha, NE
- Weekends only
- Acute care
- CPR Certification
- Nursing
- Paid training
- Paid holidays
Quick Apply
Registered Nurse Case Manager
Monarch Hospice of Nebraska —Omaha, NE
- $75,000 - $85,000 a year
- Full-time
- Nursing
- Vital signs
- RN License
- Mileage reimbursement
- Health insurance
Quick Apply
RN - Weekend Warrior
Immanuel —Omaha, NE
- Up to $47.28 an hour
- 8 hour shift
- Background check
- Skilled nursing facility
- RN License
- Wellness program
- Health savings account
Director of Clinical Informatics - Registered Nurse and Masters Required
Midwest Gastrointestinal Associates —Omaha, NE
- $95,000 - $120,000 a year
- Full-time
- Nursing
- Microsoft Excel
- Computer Science
- Health savings account
- Disability insurance
Quick Apply
Registered Nurse / RN, $15,000 Bonus Package, Home Health
AccentCare, Inc. —Omaha, NE
- $79,000 - $87,000 a year
- Full-time
- CPR Certification
- Nursing
- Management
- Health savings account
- Paid holidays
Quick Apply

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nursing jobs near omaha, ne

Utilization Management Nurse

Detego Health -
Omaha, NE

Quick Apply

Job Details

Full-time
$75,000 - $85,000 a year
22 hours ago

Qualifications

Teamwork
RN License
Patient assessment
Health insurance policy knowledge
Regulatory compliance
Utilization management
Attention to detail
Resource utilization in healthcare

Full Job Description

Position Summary

As a Utilization Management Nurse you will work with members to ensure they obtain the proper healthcare in the most cost-effective manner. The Utilization Management Nurse will also review planned, in-process, or completed health care services to ensure medical necessity and effectiveness according to evidence-based criteria.

Key Responsibilities (included but not limited to): · Conduct thorough reviews of medical records, treatment plans, and other relevant documentation to determine the medical necessity and appropriateness of healthcare services.· Communicate with healthcare providers, insurance companies, and other stakeholders to gather necessary information and discuss patient care plans.· Maintain detailed records of utilization management activities, including findings, decisions, and communications with stakeholders.· Ensure that all utilization management activities adhere to regulatory requirements, accreditation standards, and organizational policies and procedures.· Identify opportunities to optimize healthcare resources, such as by recommending alternative treatments or care settings that may be more cost-effective or clinically appropriate.· Advocate for patients' rights and ensure that they receive timely and appropriate healthcare services based on their individual needs.· Participate in quality improvement initiatives aimed at enhancing the efficiency, effectiveness, and safety of healthcare delivery.· Coordinate peer-to-peer reviews between providers and medical directors in determining coverage of requested services.· Refer members with costly medications or non-covered medications to ScriptAide for assistance via the Patient Assistance Program or the Prescription Importation Program.· Collaborate with the Medical Director on review of procedures/medications that do not meet medical necessity review per clinical guidelines. · Provide procedure and/or medication cost to the member’s plan.

Career experience required:

· Active RN license preferred; or, LPN license

· Health plan utilization management experience

· Strong clinical assessment skills

· Excellent communication and interpersonal skills

· Ability to work independently and collaboratively in a fast-paced environment

· Knowledge of healthcare regulations and reimbursement policies

· Experience with a TPA or in the health insurance industry preferred

Behavioral competencies desired:

· Critical Thinking – Use of exceptional critical thinking skills and attention to detail

· Analytical Skills – Analyze information and exercise sound judgement when making decisions

· Innovation – Take a multi-faceted approach to problem-solving and creation of novel solutions to problems. Champion organization-wide learning and sharing of information. Take a viewpoint that is broader than one’s immediate group or department and encompasses external factors.

· Collaboration – Understand the importance of relationships to enable effective teamwork. Modify personal style, focus on the needs of others, and listen effectively to ensure effective outcomes for group endeavors.

· Business Acumen – Knowledge of general business practices in the TPA world as well as knowledge of the organization’s functioning. An understanding of organizational culture and the ability to function effectively within its social structure.

Pay: $75,000.00 - $85,000.00 per year

Work Location: In person

Quick Apply

Refine Your Search

nursing jobs in omaha, ne

Utilization Management Nurse

Dispensing Nurse - LPN

Nurse Disability Consultant

Clinical Specialist II - Omaha, NE

Shared Living Provider

Triage Nurse (RN)

Nursing Assistant

Clinical Coordinator

Clinical Study Nurse Coordinator

Staff RN - Experienced Bedside CC - Cardiac Care Unit - Full time/Nights

Supervisor Clinical Nursing / Inpatient Nursing Float Pool Full time/Nights

Licensed Practical Nurse (LPN) – Pulmonary Unit

Director of Acute Behavioral Health (RN)

Registered Nurses (RN) Full-time Days

Staff RN - Experienced Bedside Behavioral Health / Emergency - Full time/Nights

Registered Nurse (RN) – Pediatric Specialty Care

Registered Nurse Case Manager

RN - Weekend Warrior

Director of Clinical Informatics - Registered Nurse and Masters Required

Registered Nurse / RN, $15,000 Bonus Package, Home Health

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