10 manager registered nurse jobs found in Madison, WI

Become a part of our caring community and help us put health first The Compact licensed telephonic Care Manager works from home in a call center environment. They assess and evaluate members' needs and requirements to achieve or maintain optimal wellness by providing care coordination and facilitating member or family interaction with resources appropriate for the care and wellbeing of the member. Job Description Humana Care Support is a division of Humana dedicated to helping adults remain independent in their homes. Our nurses are called Care Managers, because our case management services are centered on the person rather than the condition. The Care Manager uses a range of strategies and techniques to manage a member's physical, environmental, and psycho-social health issues. They identify and resolve barriers to effective care and continuously monitor progress through assessments and evaluations to ensure members achieve their desired health outcomes. Role...

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...

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. Position Title: Program Manager, Nursing & Health Professions Job Category: Academic Staff Employment Type: Regular Job Profile: Academic Program Manager Job Duties: The Universities of Wisconsin Office of Online & Professional Learning Resources (OPLR) seeks a Program Manager, Nursing to provide leadership and administrative coordination for the BSN@Home program—a collaborative, online baccalaureate completion program for registered nurses. BSN@Home is delivered jointly by multiple UW campuses, offering flexibility and academic excellence to practicing nurses across Wisconsin. This position plays a critical role in supporting program operations, facilitating cross-campus collaboration, maintaining core systems and communication structures, and contributing to the strategic...

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...

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...

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....

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...