- Humana (Columbus, OH)
- …and help us put health first** Humana Healthy Horizons in Ohio is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Dublin, OH)
- …caring community and help us put health first** Humana Healthy Horizons is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Columbus, OH)
- …to make health care more personal, convenient and affordable. Position Summary This Utilization Management (UM) Nurse Consultant role is fully remote ... /benefit management function.Required Qualifications* 3+ years of experience as a Registered Nurse * Must hold active and unrestricted RN licensure in state… more
- CVS Health (Columbus, OH)
- …and deliver solutions to make health care more personal, convenient and affordable. This Utilization Management (UM) Nurse Consultant role is fully remote ... external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications + 3+...Required Qualifications + 3+ years of experience as a Registered Nurse + Must hold active and… more
- CVS Health (Columbus, OH)
- …skills, both verbal and written Required Qualifications - 3+ years of experience as a Registered Nurse - Must possess 1+ years of clinical experience in acute or ... and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with… more
- Humana (Columbus, OH)
- …put health first** Humana Healthy Horizons in Virginia is seeking a Manager, Utilization Management (Behavioral Health) who will utilize their clinical skills to ... behavioral health services and/or benefit administration determinations. The Manager, Utilization Management (Behavioral Health) applies a Person-Centered… more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Compliance Utilization Management Nurse 2 reviews utilization management ... rotating schedule. (about 2 holidays per year) The Compliance Utilization Management Nurse 2 ensures...make an impact** **Required Qualifications** + Active unrestricted Licensed Registered Nurse , (RN), in your state of… 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Columbus, OH)
- … function. Required Qualifications + 1 year of varied UM ( utilization management ) experience within an inpatient/outpatient setting, concurrent review ... demonstrated ability to make thorough, independent decisions using clinical judgement. + A Registered Nurse that must hold an unrestricted license in their state… more
- Humana (Columbus, OH)
- …projects. **Use your skills to make an impact** **Required Qualifications** + Licensed as a Registered Nurse in the State of Wisconsin or have a compact license. ... inpatient and subacute activity daily for outcomes related to readmission, utilization , quality of care and provider performance in compliance with Humana/iCare… more
- Marriott (Columbus, OH)
- …Information** Nurse CARE Manager (CARE - Coordinated Action and Response) Registered Nurse license required **Job Number** 24069165 **Job Category** Finance ... Claims Services + Collaborate with Claims department regarding case management . + Collaborate with UNM on utilization ...informed **Education or Certification** + Must be a licensed registered nurse + Certification as an occupational… more
- Trinity Health (Columbus, 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 ... or discharge. This is done with the intentions of cost effective utilization of hospital resources, minimizing out of pocket expenses for patients, providing… more
- Trinity Health (Columbus, 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 ... or discharge. This is done with the intentions of cost effective utilization of hospital resources, minimizing out of pocket expenses for patients, providing… more
- BrightSpring Health Services (Columbus, OH)
- …Degree from an accredited school of nursing. * Certificates, Licenses: License as a Registered Nurse (RN), current and in good standing. Valid driver's license ... Works with nursing personnel on survey preparation/ chart reviews/staffing concerns/ED utilization and hospital admission reduction.* Provides survey management … more
- Trinity Health (Columbus, OH)
- …Requirement - Current license to practice nursing in the State of Ohio as a Registered Nurse ; BLS healthcare provider training required. + Minimum of five years' ... Responsible for quality and standards of patient care, performance improvement, program management , business operations, budget and resource utilization , and … more
- CVS Health (Columbus, OH)
- …industry-leading solutions for our customers and members. This role partners with a registered nurse case manager to utilize a collaborative process of ... - Advanced care planning experience - Hospice/palliative care experience - Case management and discharge planning experience - Managed care/ utilization review… more