20 Best Registered Nurse jobs in Minnetonka, MN (Hiring Now!)

RN Nurse Reviewer - Remote
UnitedHealth Group —Eden Prairie, MN
Identify any cases that are at high-risk for complex discharge planning or case/risk management intervention and make appropriate referrals.
$58,300 - $114,300 a year
1d
Registered Nurse (RN)- Group Home- NEW GRADS WELCOME!
Plateau Healthcare LLC —Brooklyn Center, MN
Medical, Dental and Vision insurance offered (Employer Pays up to 50% of employee cost). Administer medications, provide wound care, and care for other…
$33.50 - $38.00 an hour
Quick Apply
6d
Triage RN - Remote
Great Lakes Mgmt Co —Plymouth, MN
Maintains a current state license as a Registered Nurse per state regulations. Take triage calls from the various AL and MC sites during nonbusiness hours and…
$36 - $40 an hour
Quick Apply
11d
RN- Registered Nurse
Estates at Bloomington —Bloomington, MN
Through the collection and analysis of data, the RN is accountable for performing a comprehensive assessment to establish the baseline health status of tenants…
$37.00 - $39.50 an hour
Quick Apply
13d
ADON/MDS Dual Role Nurse
Confidential —Brooklyn Center, MN
Active Registered Nurse (RN) license in the state of [Specify State]. Collaborate with interdisciplinary teams to develop resident care plans based on MDS…
From $120,000 a year
Quick Apply
4d
Certified Registered Nurse Anesthetist - University of Minnesota Medical Center - East Bank (Signing Bonus Available)
Fairview Health Services —Minneapolis, MN
Have a current Minnesota APRN license and be board certified or eligible from the National Board on Certification and Recertification of Nurse Anesthetists …
Estimated: $245K - $310K a year
RN and LPN PRN Flu Vaccination Positions
Ramp Health —Brooklyn Park, MN
Current and valid Registered Nurse (RN) or Licensed Practical Nurse (LPN) license in your state. Perform COVID-19 vaccinations utilizing vaccines from multiple…
$36 - $44 an hour
Quick Apply
10d
Registered Nurse (RN)
Highland Chateau Health + Rehabilitation Center —Saint Paul, MN
Current license by the Minnesota Board of Nursing to practice as a Registered Nurse. Providing direct patient care in accordance with state, federal, and…
$32.59 - $38.38 an hour
Quick Apply
EXPERIENCED Hospice RN Visit Nurse - $8,000 Sign On Bonus!
Superior Hospice —Minnetonka, MN
*RN Licensure:* Active registered nurse license, demonstrating proficiency and adherence to nursing standards. Hospice Nursing: 1 year (Preferred).
$90,000 - $130,000 a year
Quick Apply
4d
Registered Nurse - RN Case Manager - $2500 Sign On Bonus
Lifespark Group LLC —Bloomington, MN
Experience in customer service/direct member contact field preferred. Graduate of an accredited school of nursing. Paid Time Off – Vacation Time.
From $88,000 a year
Quick Apply
4d
Registered Nurse (IV Drip)
Restore Hyper Wellness L5 Be Well —Maple Grove, MN
Must possess a valid unencumbered Registered Nurse license in the state you are applying. Uses proactive communication to understand client needs to develop the…
Estimated: $76.8K - $97.2K a year
Quick Apply
19h
AM Registered Nurse
Presbyterian Homes & Services —Spring Park, MN
Registered Nurse with current licensure with the State Board of Nursing in state(s) in which he/she practices. Full-time AM (6:30AM - 3PM) in Long Term Care.
$37.00 - $39.08 an hour
Registered Nurse MDS Coordinator
Southview Acres Healthcare Center —West Saint Paul, MN
MDS nurses are vital to the operations and patient care practices of long-term care facilities, particularly those that receive federal funding or reimbursement…
$85,000 - $92,000 a year
Quick Apply
Registered Nurse (RN)
Premier Care Home Services —Lakeville, MN
Must have a current and clean nursing license, registered with the Minnesota Board of Nursing. Perform independent treatments including wound care, G Tube, J…
$50 - $60 an hour
Quick Apply
Experienced Hospice Nurses Needed! $8,000 Sign-On Bonus
Superior Hospice —Golden Valley, MN
*RN Licensure:* Active registered nurse license in the Minnesota, demonstrating competency and compliance with nursing standards.
$90,000 - $130,000 a year
Quick Apply
4d
Clinical Director, RN- Providence Place Senior Living
Senior Care Providence LLC —Minneapolis, MN
Graduate of an accredited school of nursing and a valid state licensure as a Registered Nurse. In this position you will be responsible for the overall…
$40 - $45 an hour
Quick Apply
5d
School Nurse (multiple FTE available)
Eastern Carver County Schools —Chaska, MN
School Nurse license will need to be applied for by the start of your employment with Eastern Carver County Schools. Non Public School/s District Wide.
Estimated: $58.1K - $73.6K a year
Registered Nurse - Float
DAVITA —Saint Louis Park, MN
Comprehensive benefits: Medical, dental, vision, 401(k) match, paid time off, PTO cash out. Associates Degree in Nursing (A.D.N) from accredited school of…
$37 - $45 an hour
12d
RN- Registered Nurse
Estates at Chateau —Minneapolis, MN
Through the collection and analysis of data, the RN is accountable for performing a comprehensive assessment to establish the baseline health status of tenants…
$37.00 - $39.50 an hour
Quick Apply
12d
Home Care Nurse - Part Time
Home Instead Minneapolis —Maple Grove, MN
Conduct in-home Client Assessments and develop individualized Care Plans. This position is a supervisory position assisting in oversight and delivery of non…
From $40 an hour
Quick Apply

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RN Nurse Reviewer - Remote

UnitedHealth Group - Eden Prairie, MN

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Job Details

Full-time $58,300 - $114,300 a year 1 day ago

Benefits

401(k) matching

Qualifications

NICU experience
RN License
Surgery
Case management
Utilization management
Bachelor of Science in Nursing
Discharge planning
Organizational skills
Certified Case Manager
2 years
Communication skills
Compact State Nurse License

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 diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

Position in this function provides efficient, effective risk management according to each specific benefit plan for PreferredOne products, using utilization review.

You will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

Utilize the Preferred One medical criteria and those of other regulatory bodies, (i.e. NCQA, DOH), the exempt and focused review programs, and the patient’s benefit plan summary to perform medical necessity, level of service and appropriateness review
Perform inpatient and outpatient pre-admission, concurrent review and decision support based on medical necessity, appropriateness of treatment setting and length of stay utilizing Preferred One criteria and/or community standards and professional judgments
Document timely and concise information which clearly outlines the utilization review strategy online
Accurately apply benefit language to each review situation
Identify any cases that are at high-risk for complex discharge planning or case/risk management intervention and make appropriate referrals
Perform utilization reviews for complex medical conditions such as Transplants and NICU inpatient to meet the needs of internal and external customers
Perform utilization reviews and assist with Transition of Care and Extended Hour Nursing to meet the needs of internal and external customers
Perform Pre-Service and Post-Service Appeal reviews
Refer cases that do not meet medical necessity criteria to a medical reviewer for medical necessity determination. Coordinate peer review, medical determination and appeal
Identify before or at the time of admission, any cases which have high case management potential due to large dollar amounts, utilization of out of network provider, multiple providers requiring care integration, or complex discharge planning needs
Identify and appropriately transfer cases for Chronic Illness Management or Complex Case Management/Behavioral Health Case Management as appropriate
Work collegially with PreferredOne providers, requesting, providing, and collaborating in obtaining information as needed
In a timely fashion, contact Manager, Director and Account Manager to make recommendations for flexing or extending benefits to prevent the possibility of using more costly services with equivalent outcomes
Assist with the development of policies, procedures, criteria, exempt and focused review programs etc., as required, refine and revise the risk management process to better meet its dual goals of cost efficiency and quality care delivery
Through collaboration and sharing of information, work with other Preferred One staff to assist in identifying and solving problematic issues through provider education, contracting issues, focused review programs, etc.
Review claims, data from pharmacy benefit administrators and other information available to assess patients who have high case management potential or who would benefit from further integration of medical services
Monitor case information for quality and patient safety issues and refer as needed per company guidelines for further review
Ad hoc activities as designated by management, i.e. training and orienting other staff, arranging in-services, researching clinical information on the internet

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:

Compact State Nursing License
5+ years of clinical experience
2+ years of Utilization Management experience in a managed health care setting
Proven excellent communication skills with the ability to interact and collaborate effectively with all levels of the organization and outside clients
Proven good interpersonal skills and ability to work effectively in an environment characterized by high levels of activities
Proven ability to multi-task and prioritize in a fast-paced environment

Preferred Qualifications:

BSN or higher degree
Certified Case Manager
Experience in Case Management
Medical experience in NICU, Transplants, Rehabilitation, Surgical, Home Healthcare and Appeals
Knowledge of insurance industry including benefit plans, reinsurance and State and National mandates (requirements)

Special Requirements:

Compliance with regulatory and accrediting organizations (e.g., MDH, NCQA) and applicable laws and regulations (e.g., HIPAA, Affordable Care Act)
Adherence to internal quality control guidelines and processes (e.g., SOC1)

All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington or Washington, D.C. Residents Only: The salary range for this role is $58,300 to $114,300 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

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.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

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

Apply Now

Registered Nurse jobs in Minnetonka, MN

RN Nurse Reviewer - Remote

Registered Nurse (RN)- Group Home- NEW GRADS WELCOME!

Triage RN - Remote

RN- Registered Nurse

ADON/MDS Dual Role Nurse

Certified Registered Nurse Anesthetist - University of Minnesota Medical Center - East Bank (Signing Bonus Available)

RN and LPN PRN Flu Vaccination Positions

Registered Nurse (RN)

EXPERIENCED Hospice RN Visit Nurse - $8,000 Sign On Bonus!

Registered Nurse - RN Case Manager - $2500 Sign On Bonus

Registered Nurse (IV Drip)

AM Registered Nurse

Registered Nurse MDS Coordinator

Registered Nurse (RN)

Experienced Hospice Nurses Needed! $8,000 Sign-On Bonus

Clinical Director, RN- Providence Place Senior Living

School Nurse (multiple FTE available)

Registered Nurse - Float

RN- Registered Nurse

Home Care Nurse - Part Time

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