- 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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) with compact license with… 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)
- …attend the first 3 weeks training required 100% participation during 8:30am-5pm Monday-Friday.A Registered Nurse that must hold an unrestricted license in their ... 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)
- …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)
- …of our caring community and help us put health first** The Manager, Utilization Management Nursing uses clinical knowledge, communication skills, and independent ... management and operations of the department. Oversees utilization management functions which include timely authorizations...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the states of… more
- Trinity Health (Grove City, OH)
- …degree strongly desired. + Licensure / Certification: Current license to practice as a Registered Nurse in State of Ohio. + Experience: Minimum of four to ... five years recent clinical experience in hospital setting with Care Manager/Charge Nurse or other relevant hospital management experience required. + Effective… more
- Intermountain Health (Columbus, OH)
- …cost-effective outcomes. Provides focused support to various areas such as utilization management , emergency department, acute, ambulatory and specialty care. ... Registered /Professional Nursing program. + Required Licensure/Certification: State licensure as a Registered Nurse (RN) in Colorado or Compact + Basic Life… more
- Lincoln Financial Group (Columbus, OH)
- …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... will provide coaching and guidance to claims regarding medical management **What you'll be doing** * Evaluate medical information...looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license… 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
- Ciena Healthcare (Columbus, OH)
- …American Association of Nursing Assessment Coordinators (AANAC) requirements. **Qualifications** + Registered Nurse (RN) licensure or Licensed Practical Nurse ... 24 hours per week.** Are you an experienced MDS nurse interested in the next step? The MDS Coordinator...PPS board for monitoring of Medicare days and RUGs utilization in the absence of the Care Management… 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