- CVS Health (Columbus, OH)
- …(Teams, Outlook, Word, Excel, etc.) Preferred Qualifications -1+ years' experience Utilization Review experience -1+ years' experience Managed Care - ... work the following schedule: Monday-Friday 8:00am-4:30pm EST. Position Summary As a Utilization Management Nurse Consultant, you will utilize clinical skills to… more
- CVS Health (Columbus, OH)
- …unrestricted RN licensure in state of residence - Must have previous inpatient utilization review experience - Must be able to work Monday through Friday ... in multiple IT platforms/systemPreferred Qualifications - Knowledge of Medicare/Medicaid - Utilization Review experience preferred - Managed care experience -… more
- Fresenius Medical Center (Washington Court House, OH)
- …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
- Lincoln Financial Group (Columbus, OH)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred ... looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license...in a career at Lincoln, we encourage you to review our current openings and apply on our website.… more
- Trinity Health (Grove City, OH)
- …! About the job: The Case Management Coordinatorwould work under the direction of the RN Care Managers, Utilization Review Care Manager and the Social ... experience required. Licensure / Certification: Medical assistant or Licensed Practical Nurse (LPN) highly preferred. Experience: Prior experience in a medical… more
- CVS Health (Columbus, OH)
- …in New Albany OH, Chandler AZ or High Point NC. Precertification Nurse Case Manager is responsible for telephonically assessing, planning, implementing and ... health care innovators.Fundamentals:Through the use of clinical tools and information/data review , conducts an evaluation of member's needs and benefit plan… more
- Ciena Healthcare (Columbus, OH)
- …the American Association of Nursing Assessment Coordinators (AANAC) requirements. **Qualifications:** + Registered Nurse or Licensed Practical Nurse . + AANC ... Are you an experienced nurse who wants to remain clinically involved in...+ Assesses resident through physical assessment, interview and chart review . + Discusses resident care needs with care givers,… more
- Sharecare, Inc. (Columbus, OH)
- …support appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... during the week_** **_Every 3rd Sat. 8:00am-4:30pm CT._** The RN has the responsibility for supporting the goals and...orientation and to take the pre and posttests to review competency during orientation. Yearly competency test is required… more
- CVS Health (Columbus, OH)
- …visit, inpatient, skilled nursing, or rehabilitative stay. Under the direction of a Registered /Licensed RN , the TOC Coach ensures the member experiences a ... or changes in condition to be transitioned back to RN . + Complete post discharge call and required assessments...who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current… more
- Elevance Health (Columbus, OH)
- …clinical operations department. Manages the delivery of quality care management, clinical utilization , and referral services. **How you will make an impact:** + ... practice that is relevant to the clinical areas under review . + Identifies areas for quality improvement and implements...unrestricted license in a mental health field as an RN , PhD, LCSW (as applicable by state law and… more
- CVS Health (Columbus, OH)
- …Schedule is Monday - Friday 8:00am - 5:00pm. Will have to maintain clinical review skills through he annual use of IRR. Will work with leadership for continual ... process improvement within Duals UM Program. Required Qualifications + RN with current unrestricted "multi-state privilege" compact license. + 3+ years of clinical… more