- Humana (Louisville, KY)
- **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 ... benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the state of… more
- Signature Healthcare (Louisville, KY)
- …communication with leadership, patients, families, internal care givers, and external Utilization Management Nurses. + Coordinate internal and external health ... billing. What you Need to make a Difference + Registered Nurse (RN) in good standing with...Previous experience with MDS and assessment preferred Hospital Case Management /Hospital Utilization Management . Obtaining… more
- Veterans Affairs, Veterans Health Administration (Louisville, KY)
- …Louisville KY is current recruiting for a Specialty Care Outpatient Staff Registered Nurse - Nuclear Cardiology. Responsibilities Specialty Care Outpatient Staff ... Registered Nurse (RN) is responsible for providing...and coaching on wellness, disease prevention, and chronic care management . The nurse will assist in directing… more
- Humana (Frankfort, KY)
- …a part of our caring community and help us put health first** The Utilization Management (UM) Director, Clinical Strategy and Practice for Medicaid builds ... of how organization capabilities interrelate across the function or segment. The Utilization Management (UM) Director, Clinical Strategy and Practice for… more
- Veterans Affairs, Veterans Health Administration (Lexington, KY)
- Summary The Registered Nurse Transfer coordinator is directly responsible for the facilitation and monitoring of the community hospital referrals to the VA ... for collaborating with other staff for appropriate oversight and management of emergency care received through community hospitals. Responsibilities...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- CVS Health (Frankfort, KY)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse (RN) with at least 1...Specialty Pharmacy** **.** **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
- CVS Health (Frankfort, KY)
- …SEE REQUIRED QUALIFICATIONS FOR LICENSING DETAILS_** This is a fulltime remote Utilization Management Clinical Consultant opportunity with Aetna Better Health of ... to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking...LMFT, LPAT_** **_) - OR - Active unrestricted Compact Registered Nurse (RN) license with psychiatric specialty… more
- Sharecare (Frankfort, KY)
- …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting...disease management program intervention guidelines. A Clinical Registered Nurse is supervised by an Operations… more
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- …Registered Nurses Must be licensed by the state of Kentucky as a Registered Nurse , as well as NRP/BLS/ACLS certified. Required Experience Minimum Work ... signs, starting IV and drawing blood, vaginal exams, pain management and obtaining pertinent information and able to document...of care set by state board of nursing, state nurse practice act, and other governing agency regulations. Resolving… more
- ChenMed (Louisville, KY)
- …We're rapidly expanding and we need great people to join our team. The Registered Nurse , Care Line, is responsible for providing telephonic triage directional ... Triage assessments within license and as possible given technology and medium. The registered nurse collaborates with primary caregivers and others on the… more
- AdventHealth (Manchester, KY)
- …Jackson or Clay County depending on RN. **The role you'll contribute:** The Home Health Registered Nurse (RN) Care Manager is a professional nurse who ... on individual patient needs. The RN Care Manager is responsible for independent management of the Home Health patient population requiring the use of advanced… more
- Bon Secours Mercy Health (Paducah, KY)
- …partnership * Interprofessional collaboration and leadership * Understanding and utilization of office and clinical technologies * Compassionate, relationship-based ... for professional actions * Effective stewardship of available resources * Conflict management and resilience * Authority for delegating activities to others, while… more
- Fresenius Medical Center (Mount Sterling, KY)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... + Preferred but not required: + 3+ years supervisory or project/program management experience. + Med/surg or ICU/CCU experience. **PHYSICAL DEMANDS AND WORKING… more
- HCA Healthcare (Frankfort, KY)
- …Nursing required; Master's Degree in healthcare-related field preferred. + Current licensure as a Registered Nurse (RN) in the state of Kentucky or compact state ... effective labor management , including position control, scheduling excellence, productivity management , and premium pay utilization to maintain staffing to… more
- HCA Healthcare (Bowling Green, KY)
- …of an accredited school of Professional Nursing required. + Current licensure as a Registered Nurse (RN) in the state of Kentucky or compact state required. ... effective labor management , including position control, scheduling excellence, productivity management , and premium pay utilization to maintain staffing to… more
- Molina Healthcare (KY)
- … Nurse in good standing. **Preferred Education** Completion of an accredited Registered Nurse (RN) Program or a bachelor's degree in Nursing. **Preferred ... contained in the delegation agreement. **KNOWLEDGE/SKILLS/ABILITIES** The Delegation Oversight Nurse is responsible for ensuring that Molina Healthcare's UM… more
- Molina Healthcare (KY)
- …Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + ... as may be required. + Serves as a clinical resource for Utilization Management , Chief Medical Officer, Physicians, and Member/Provider Inquiries/Appeals. +… more
- Lincoln Financial (Frankfort, KY)
- …as indicated **What we're looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where the ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...Care, , Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's… more
- United Therapeutics (Frankfort, KY)
- …years of PAH nursing experience, including ICU and critical care of PAH patients + Registered Nurse (RN) - State Licensure and/or Compact State Licensure RN - ... make a difference. The Regional Field Director, RNS Program Management serves as a director of all clinical field...Registered Nurse - State Licensure and/or Compact… more
- HCA Healthcare (Bowling Green, KY)
- …actively engaging interdisciplinary teams and external stakeholders. The Director is a registered nurse with responsibility for all operational aspects of the ... degree in Nursing, Health Administration, or Business Administration, preferred + Either Registered Nurse (RN) licensure , Licensed Clinical Social Worker (LCSW)… more