36 health nurse jobs found in Madison, WI

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...

Become a part of our caring community and help us put health first Humana is seeking a Prior Authorization RN to join the Wisconsin Medicaid Market (iCare) team. This position reviews the clinical appropriateness of prior authorization (PA) requests and ensures that all benefits authorized meet medical necessity and other Medicare and/or Medicaid criteria if applicable, to promote cost-effective delivery of health care services. Share your talents and develop your skills all while doing your part to improve the lives of others. Essential Duties and Responsibilities: Review PA requests for home health services, durable medical equipment, outpatient therapies, skilled nursing facility therapies, and all outpatient procedures pursuant to applicable Medicare and Medicaid criteria, iCare guidelines, and PA Department policies and procedures. Review PA requests for inpatient medical stays, skilled nursing facility stays, long term acute hospital stays, inpatient...

Job Description As a Senior Clinical Consultant, you will collaborate with customer stakeholders and leaders to build relationships and positively impact clinical performance, satisfaction, and outcomes during projects involving the Oracle Health Workforce and Workload Solution Suite, formerly known as Clairvia, in Acute and Outpatient care. Drawing on your clinical expertise, you will guide customers and internal teams, help design effective clinical workflows, and analyze current and future states to identify gaps and recommend strategies for change adoption to achieve workforce and workload goals. You will own the customer's value measurement plan, support the engagement management team in meeting deliverables and timelines, lead customer meetings to align clinical goals with technology, and foster relationships to drive business outcomes. This role focuses on Oracle Health Workforce and Workload solutions like scheduling, caregiver assignments, acuity-based outcomes, and...

Become a part of our caring community and help us put health first The Care Manager, Telephonic Nurse utilizes clinical nursing skills to support the coordination, documentation, and communication of medical services and/or benefit administration. The work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Associate will be expected to participate in weekend rotation a minimum of one hour each on Saturday and Sunday once every 17 weeks. Work schedule can be between 8am-6:30pm EST. The Care Manager Telephonic Nurse uses clinical knowledge, communication skills, and independent critical thinking skills to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Understands department, segment, and organizational strategy and operating objectives, including their...

Become a part of our caring community and help us put health first Enjoy a rewarding career with a true work/life balance-no nights or weekends, giving you more time for what matters most. Humana is currently seeking RN Case Managers to join our teams in the La Crosse and Sparta offices, serving members in the Wisconsin Family Care (FC) program. In this vital role, you will collaborate with dedicated colleagues to ensure exceptional care coordination for our members, providing crucial support and education to help them thrive in their daily lives. Take the next step in your nursing career and make a meaningful difference with Humana. Key responsiblities: Partner with a Care Coach (also referred to as a Case Manager), taking the lead on health-related needs, to collaborate on an ongoing basis regarding the member and their care plan. Conduct regular health assessments for members and implement appropriate strategies and services to develop individualized care...

Become a part of our caring community and help us put health first Are you ready to make a difference in your career and your community? Humana is looking for a passionate Long Term Care Functional Screen Specialist to join the Inclusa team, supporting members in the Wisconsin Family Care Program. In this dynamic role, you’ll use the State Department of Health Services (DHS) screening tool to assess member needs and eligibility—directly impacting their quality of life and access to essential care. Jin us and help empower individuals to live their best lives! Key responsibilities: Schedule member appointments for annual or change-based functional eligibility re-determinations, optimizing time and travel resources. Use the DHS screening tool to assess members’ functional abilities, health, and required supports. Collaborate with staff to ensure assessment data aligns with internal records. Conduct in-home, face-to-face interviews and enter...

Summary This position serves as an Advanced Medical Support Assistant (MSA) in support of the Emergency Department at the William S. Middleton Memorial VA Hospital. This job is open to The public U.S. Citizens, Nationals or those who owe allegiance to the U.S. Clarification from the agency All U.S. Citizens NOTE: The 2-page Resume requirement does not apply to this position. For more information, refer to Required Documents below. Duties VA Careers - Medical Support Assistant: https://youtube.com/embed/EE9c4XkaELo Total Rewards of a Allied Health Professional The Advanced MSA is responsible for checking in/checking out patients through the Emergency Department. Duties include but are not limited to: Scheduling the patient into the ED using VISTA and updating EDIS board for immediate provider access Daily review and management of EDIS program Identifying at ED check Veterans in need of updating personal or financial...

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,...

About the Role Location: Remote -_ Wisconsin residents_ ~ Requires auto parts or relevant mechanical experience ~ (see Skills for Success below) Do you work with car, truck or SUV parts as a car enthusiast, or as an auto retail specialist at a parts store or dealership? This could be a great career move for you - especially if you're interested in working from home! This is more than just an auto parts job at Morley. It's an opportunity for you to make a difference in the automotive industry with a leading auto manufacturer. What You'll Do Answer calls from dealerships and auto manufacturer employees to assist with parts information Provide directions to part warehouse locations Locate parts in an online parts catalog Place part orders Identify corrections to auto parts catalogs Research and learn new auto parts so you are on the leading edge of new car parts knowledge Offer timely and accurate solutions...

Job Description The Nurse Informatics Executive supports VA's Federal EHR deployment and advances clinical informatics initiatives to enhance care delivery and patient outcomes. This role requires deep expertise in clinical care, health informatics, executive leadership, and change management to drive organizational transformation. Collaborating with stakeholders at all levels - including clinical end users and leadership at VAMC, VISN, and national levels - the Nurse Informatics Executive aligns organizational goals, fosters cross-functional collaboration, and ensures successful EHR implementation. Key responsibilities include driving end-user adoption, resolving implementation challenges, and optimizing workflows using data-driven solutions. The Nurse Informatics Executive leverages clinical data analytics to support evidence-based decision-making, regulatory adherence, and long-term strategic objectives. By evaluating and recommending informatics solutions, the...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: Job Description As a Clinical Reviewer, Nurse, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients'...

Job Description This position is working with our federal clients; US Citizenship is required Job Description We're on a journey to advance how health happens with technologies that empower patients, support clinicians, inspire innovation, and save lives. Our mission? To create a human-centric healthcare experience powered by unified global data. It's a big challenge, but big challenges are what we do best. We're already transforming some of the world's largest health systems-helping them turn data into lifesaving decisions and better patient care. We want people just as dedicated as we are to improving health equity and delivering quality care across the globe. If you're excited about making healthcare more human, you've come to the right place. As a Clinical Consultant, you are responsible for driving the customer through the design of clinical and business processes, solution and technology workflow, and successful adoption that will lead to achieved value....

Summary This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific eligibility requirements per VHA policy and submit your EDRP application within four months of appointment. Program Approval, award amount (up to $200,000) & eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. Responsibilities This Registered Nurse - Community Living Center (CLC) position is located at the William S. Middleton Memorial Veterans Hospital in Madison, WI. The CLC is a sub-acute, short stay, extended care environment with a 26-bed blended care environment consisting of Transitional, Hospice/Palliative, and Rehabilitation levels of care. The average length of stay (ALOS) is less than 30 days. The adult/geriatric Veteran population served includes individuals who may be...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: This job performs clinical review and data abstraction of patient records to support compliance with nationally recognized quality initiatives and the network's clinical process improvement and patient safety initiatives. The incumbent requires in-depth understanding of anatomy, physiology and clinical scenarios, critical thinking skills, attention to detail and the ability to meet set deadlines. The incumbent will be responsible for communicating with physicians and staff to seek clarification and provide education as needed. ESSENTIAL RESPONSIBILITIES Abstracts key clinical findings accurately and in a timely manner and performs direct data entry for inclusion into an aggregate database to meet the requirements of the state, internal use, third party payer requirements and external quality improvement participation based on guidelines. Identifies outliers, records them appropriately...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Special Investigations Unit (SIU) Investigator - Remote Job Description The Special Investigations Unit (SIU) Investigator is responsible for conducting standard investigations of potential pharmacy, member, and/or prescriber fraud, waste and abuse (FWA). This position conducts claims data mining, fraud analysis and auditing/monitoring activities and proactively identifies improvement opportunities in investigation procedures and FWA prevention efforts ensure proper identification of potential FWA. The SIU Investigator prepares investigative reports for leadership, remediation actions, recovery efforts, internal committees and/or referral to state and federal law enforcement agencies. Responsibilities Develop...

Summary This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific eligibility requirements per VHA policy and submit your EDRP application within four months of appointment. Program Approval, award amount (up to $200,000) & eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. Responsibilities The Registered Nurse - Float Pool is responsible and accountable for all elements of the nursing process when providing and/or supervising direct patient care. Assesses, plans, implements, and evaluates care based on age specific components. Assumes responsibility for the coordination of care focused on patient education, self-management, and customer satisfaction throughout the continuum of care. Administers medications and procedures per established policies...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Molina Healthcare. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. Job Description Job Summary The Clinical Appeals Nurse (RN) provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Assesses appropriateness of services, length of stay and level of care provided to members. Contributes to overarching strategy to provide quality and...

Current Employees: If you are currently employed at any of the Universities of Wisconsin, log in to Workday to apply through the internal application process. Job Category: Limited Employment Type: Regular Job Profile: Dean Job Summary: The University of Wisconsin-Madison, established in 1848 and considered one of the world's outstanding public research universities, invites applications and nominations for the position of Dean of the School of Nursing. UW-Madison, the flagship campus of the Universities of Wisconsin, is a major land-grant university committed to excellence in teaching, research and public service with revenues of $4.9 billion, a student body of nearly 50,000, faculty/staff of approximately 27,000, and a campus environment that facilitates cross disciplinary collaborative research. The University has a long-standing commitment to shared governance. The University of Wisconsin-Madison is ranked...

Job Title: Research Nurse (Weekend Night Shift)Job Description We are seeking a dedicated Research Nurse to join our clinical trials team. This position involves working on a straight weekend night shift from Friday to Sunday, 6pm to 6am CST. Schedules are typically set 2-3 weeks in advance. The Research Nurse will be responsible for overseeing study unit activities, focusing on the safety and welfare of study participants. Responsibilities Enroll patients into clinical trials, ensuring informed consent by educating and explaining study procedures to participants. Utilize nursing skills, knowledge, and clinical judgment to provide high-quality care for clinical trial participants. Conduct nursing assessments to observe participant well-being and potential adverse events. Document adverse events and take necessary actions. Perform study-related activities such as cannulation, telemetry, holters, vital signs, ECGs, and venipuncture. Collect...

Job Title: Research Nurse (Weekend Night Shift)Job Description We are seeking a dedicated Research Nurse to join our clinical trials team. This position involves working on a straight weekend night shift from Friday to Sunday, 6pm to 6am CST. Schedules are typically set 2-3 weeks in advance. The Research Nurse will be responsible for overseeing study unit activities, focusing on the safety and welfare of study participants. Responsibilities Enroll patients into clinical trials, ensuring informed consent by educating and explaining study procedures to participants. Utilize nursing skills, knowledge, and clinical judgment to provide high-quality care for clinical trial participants. Conduct nursing assessments to observe participant well-being and potential adverse events. Document adverse events and take necessary actions. Perform study-related activities such as cannulation, telemetry, holters, vital signs, ECGs, and venipuncture. Collect...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: Your Future Evolves Here Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe...

Job Title: Research Nurse (Weekend Night Shift)Job Description We are seeking a dedicated Research Nurse to join our clinical trials team. This position involves working on a straight weekend night shift from Friday to Sunday, 6pm to 6am CST. Schedules are typically set 2-3 weeks in advance. The Research Nurse will be responsible for overseeing study unit activities, focusing on the safety and welfare of study participants. Responsibilities Enroll patients into clinical trials, ensuring informed consent by educating and explaining study procedures to participants. Utilize nursing skills, knowledge, and clinical judgment to provide high-quality care for clinical trial participants. Conduct nursing assessments to observe participant well-being and potential adverse events. Document adverse events and take necessary actions. Perform study-related activities such as cannulation, telemetry, holters, vital signs, ECGs, and venipuncture. Collect...

Job Title: Research Nurse (Weekend Night Shift)Job Description We are seeking a dedicated Research Nurse to join our clinical trials team. This position involves working on a straight weekend night shift from Friday to Sunday, 6pm to 6am CST. Schedules are typically set 2-3 weeks in advance. The Research Nurse will be responsible for overseeing study unit activities, focusing on the safety and welfare of study participants. Responsibilities Enroll patients into clinical trials, ensuring informed consent by educating and explaining study procedures to participants. Utilize nursing skills, knowledge, and clinical judgment to provide high-quality care for clinical trial participants. Conduct nursing assessments to observe participant well-being and potential adverse events. Document adverse events and take necessary actions. Perform study-related activities such as cannulation, telemetry, holters, vital signs, ECGs, and venipuncture. Collect...

Summary This Registered Nurse - Community Living Center position is located at the William S. Middleton Memorial Veterans Hospital in Madison, WI. This is a temporary position not to exceed 1 year. Responsibilities The Registered Nurse - Community Living Center is responsible and accountable for all elements of the nursing process when providing and/or supervising direct patient care. Assesses, plans, implements, and evaluates care based on age specific components. Assumes responsibility for the coordination of care focused on patient education, self-management, and customer satisfaction throughout the continuum of care. Administers medications and procedures per established policies and guidelines. Influences care outcomes by collaborating with members of the interdisciplinary team. Executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex client care. The Registered Nurse - Community Living Center executes...