6 licensed practical nurse jobs found

Why Wellmark : We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors–our members. If you’re passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today! Learn more about our unique benefit offerings here. Want to know more? You can learn about life at Wellmark here. Job Description Use Your Strengths at Wellmark as a Utilization Management Nurse! About the role: As a Utilization Management (UM) Nurse, you will provide UM services, transition of care and support to members and health care providers. You will utilize clinical knowledge and expertise to interpret and appropriately apply medical policy, medical necessity criteria...

Company Description Why Wellmark : We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors–our members. If you’re passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today! Learn more about our unique benefit offerings here. Want to know more? You can learn about life at Wellmark here. Job Description Use Your Strengths at Wellmark as a Utilization Management Nurse! About the role: As a Utilization Management (UM) Nurse, you will provide UM services, transition of care and support to members and health care providers. You will utilize clinical knowledge and expertise to interpret and appropriately apply medical policy,...

The University of Iowa Health Care Department of Radiology is seeking a full time (100%) assistant nurse manager for nursing services within Radiology. The assistant nurse manager will provide managerial and clinical leadership to assure all staff provide safe clinical care and have the education, methods and resources to accomplish their performance objectives. The assistant nurse manager will participate in direct patient care and focus on planning, organizing, directing, evaluating, and improving nursing operations in Radiology. Duties Include Human Resources Management Hire, develop and manage the performance of staff in a nursing unit. Responsible for talent management of staff and identify succession plan strategies. Knowledgeable of and implement human resources policies/procedures and provisions in the collective bargaining agreements. Financial Management Prepare budget or assist in development; provide projections and recommendations. Monitor and...

Company : Highmark Inc. Job Description : JOB SUMMARY This job has primary ownership and oversight over a specified panel of members that range in health status/severity and clinical needs. The incumbent assesses health management needs of the assigned member panel and utilizing data/analytics in conjunction with professional clinical judgement to identify the right clinical intervention for each member. The incumbent will be supported by a multi-disciplinary team and will use clinical judgment to refer members to appropriate multi-disciplinary resources. In addition to identifying the appropriate clinical interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are enrolled in case management. The incumbent conducts outreach to members enrolled in case management including but is not limited to: developing a care plan, encouraging behavior changes, identifying and addressing barriers, helping members to coordinate...

Company : Highmark Inc. Job Description : JOB SUMMARY This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource utilization, identification of opportunities for referral to a Health Coach/case management, and identification and resolution of quality issues. Monitors and analyzes the delivery of health care services; educates providers and members on a proactive basis; and analyzes qualitative and quantitative data in developing strategies to improve provider performance/satisfaction and member satisfaction. Responds to customer inquiries and offers interventions and/or alternatives. ESSENTIAL RESPONSIBILITIES Implement care management review processes that are consistent with established industry and corporate standards and are within the care manager's professional discipline. Function in accordance with applicable state,...

Medical Policy Program Manager Print (https://www.governmentjobs.com/careers/iowa/jobs/newprint/5158079) Apply ? Medical Policy Program Manager Salary $62,337.60 - $96,699.20 Annually Location Des Moines - 50316 - Polk County, IA Job Type Full-time Job Number 26-01447 Agency 400 Health & Human Services - Medicaid Opening Date 12/02/2025 Closing Date 12/14/2025 11:59 PM Central LinkedIn Tag #LI-POST Point of Contact Jenny Erdman - jenny.erdman@hhs.iowa.gov Description Benefits Questions Job Description Only applicants who meet the Minimum Qualification Requirements and meet all selective requirements (listed below) will be placed on the eligible list. The Iowa Department of Health and Human Services (HHS), Division of Medicaid, Bureau of Quality Innovation and Medical Policy is seeking aMedicaid Pediatric and Early Prevention, Screening, Diagnosis and Treatment Policy Specialist (EPSDT)to join our team! Job...