- Actalent (Columbus, OH)
- …standards. Essential Skills + Utilization management + Prior authorization + Utilization review + Clinical review + Patient care + Licensed registered ... Job Description The Authorization Specialist will perform medical necessity and clinical reviews of authorization requests in accordance with regulatory guidelines… more
- Fresenius Medical Center (Dublin, OH)
- …regulations at: https://content.intranet.fmcna.com/regulatory-affairs/wp-content/uploads/sites/46/2019/05/Pre-Licensed- Nurse -50-State- Review ... of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a...for other staff members. + Routinely meets with the Clinical Manager to discuss personnel and patient care status,… more
- Molina Healthcare (Columbus, OH)
- …compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical ... and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina Healthcare… more
- Fresenius Medical Center (Westerville, OH)
- …dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance ... + Monitor patients' response to dialysis therapy. + Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of… more
- Public Consulting Group (Columbus, OH)
- …learn more, visit www.publicconsultinggroup.com . PCG is currently seeking a qualified Registered Nurse to perform as a Case Manager. The Case Manager will be ... providing case management services, assisting families and program recipients through prior approval of certain healthcare services, and collaborating with the… more
- Sedgwick (Columbus, OH)
- …Workplaces in Financial Services & Insurance RN Consultant Sr - Professional Liability ** Prior Legal Nurse Consulting expereince highly preferred in order to be ... Consultant) Certification or training preferred. **Experience** Five (5) years related clinical nursing experience and two (2) years nurse consultant experience… more