- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
- CVS Health (Columbus, OH)
- … solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. ... a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM...are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence… more
- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The RN , Utilization Management (UM) Nurse 2 utilizes clinical nursing skills to support the ... in Ohio, Illinois or Indiana.** + An Active, unrestricted Registered Nurse ( RN ) license in...Michigan. + One (1) year of previous experience in utilization management /LTSS service authorization. + Two (2)… more
- CVS Health (Columbus, OH)
- …/benefit management function. **Required Qualifications** 3+ years of experience as an Registered Nurse Active and unrestricted RN licensure in state of ... it all with heart, each and every day. _Utilization Management is a 24/7 operation and work schedule may...to promote quality effectiveness of Healthcare Services and benefit utilization Consults and lends expertise to other internal and… more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Fresenius Medical Center (Columbus, OH)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... of education and experience. + Graduate of an accredited School of Nursing ( RN ). + Current appropriate state licensure. **EXPERIENCE AND SKILLS:** + Required: + 6+… more
- Molina Healthcare (Columbus, OH)
- …and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** Looking for a RN that has a current active unrestricted license...appropriate reimbursement to providers. + Resolves escalated complaints regarding utilization management and long-term services and supports… more
- CVS Health (Columbus, OH)
- …health. + Active and good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC ... clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- CVS Health (Columbus, OH)
- …Service/Health Services (as applicable to hiring program) or Associates degree with a Registered Nurse with Behavioral Health experience/ background with 3 years ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable… more
- OhioHealth (Columbus, OH)
- …State of Ohio Board of Nursing, BLS - Basic Life Support - American Heart Association, RN - Registered Nurse - Ohio Board of Nursing **Additional Job ... continuum to promote patients' optimal health through disease prevention and management strategies. Evidence-based interventions are applied to populations for cost… more
- Molina Healthcare (Columbus, OH)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Sharecare (Columbus, OH)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the… more
- Trinity Health (Columbus, OH)
- …degree in nursing preferred . Licensure / Certification: Current license to practice as registered nurse in the State of Ohio . Experience: Minimum of 3-5 ... **Employment Type:** Full time **Shift:** **Description:** ** RN Case Manager, ED** The RN ...difficult situations. . Knowledge of the functional operations of utilization management , discharge planning, care coordination and… more
- Gentiva (Circleville, OH)
- …Executive Director to join our leadership team. This role is ideal for a licensed Registered Nurse ( RN ) with strong leadership experience in hospice care, ... budgeting while driving branch revenue growth through census development, referral management , and efficient resource utilization + Maintain strong relationships… more
- Trinity Health (Westerville, OH)
- …Associates degree from an accredited RN program + Current license to practice as registered nurse in the State of Ohio + Minimum of 3-5 years recent clinical ... **Employment Type:** Full time **Shift:** Day Shift **Description:** ** RN Case Manager, St. Ann's Campus** **Position Purpose:** Our RN Case Manager in… more
- Gentiva (Columbus, OH)
- …Hospice Administrator to join our leadership team. This role is ideal for a licensed Registered Nurse ( RN ) with strong leadership experience in hospice care, ... budgeting while driving branch revenue growth through census development, referral management , and efficient resource utilization + Maintain strong relationships… more
- Molina Healthcare (Columbus, OH)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At least 2… more
- Molina Healthcare (Columbus, OH)
- …medical claims review, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary The RN Lead, DRG Coding/Validation provides lead level support...* Performs clinical reviews of medical records and other utilization management documentation to evaluate issues of… more
- Molina Healthcare (Columbus, OH)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
- Molina Healthcare (Columbus, OH)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary The Care Review Clinician RN provides support for clinical member services review...to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required… more