- CVS Health (Columbus, OH)
- …Must have active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in EST zones.… more
- CVS Health (Columbus, OH)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Utilizes clinical experience and skills in a… more
- CVS Health (Columbus, OH)
- …day. **Position Summary** This Clinical Consultant position is with Aetna's Utilization Management (UM) team and is a field-based/Remote position out of ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable… more
- CVS Health (Columbus, OH)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is ... external constituents in the coordination and administration of the utilization /benefit management function **Required Qualifications** + Licensed independent… more
- Bon Secours Mercy Health (Lorain, OH)
- …smooth transition to acute rehab unit. Maintains expertise in clinical field, utilization review and case management ; communicates to insurance companies/third ... excellence. **Primary Function/General Purpose of Position** The Admissions Coordinator Registered Nurse (RN) is responsible for the coordination of all Acute… more
- Bon Secours Mercy Health (Toledo, OH)
- …area. **KNOWLEDGE, SKILLS AND ABILITIES:** + Must possess current license as a registered nurse in the state where practice setting is located. + BSN from an ... prevent disease and seek early treatment. + Provides nursing case management for assigned patients. Follows guidelines for care according to diagnosis/procedure.… more
- ProMedica Health System (Toledo, OH)
- …Specialist focuses on the lifelong learning needs of the professional nurse including orientation, continuing education, and ongoing competency development. The ... department, division, hospital or system level. He/she serves as a consultant , researcher, evidence-based practice mentor, performance improvement leader and project… more
- Cleveland Clinic (Warrensville Heights, OH)
- …compliance with all standards and favorable performance on safety, quality, utilization and experience metrics. + Participate in engraining the safety, quality ... data and participate in improvement strategy development. + Act as a consultant in educating and evaluating clinical and support department caregivers regarding… more
- Cleveland Clinic (Mayfield Heights, OH)
- …compliance with all standards and favorable performance on safety, quality, utilization , and experience metrics. + Participate in engraining the safety, quality, ... when a deviation in standard practice has occurred. + Act as a consultant in educating and evaluating clinical and support department staff regarding quality … more