- Elevance Health (Louisville, KY)
- ** Medical Management Nurse ** **Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training ... members in different states; therefore, Multi-State Licensure will be required.** The ** Medical Management Nurse ** is responsible for review of the most… more
- Elevance Health (Louisville, KY)
- ** Medical Management Nurse ** **Hours: 8am-6pm flexible start time** **Location** : This role enables associates to work virtually full-time, with the ... for employment, unless an accommodation is granted as required by law. The ** Medical Management Nurse ** is responsible for review of the most complex or… more
- Molina Healthcare (Louisville, KY)
- …set schedule) Looking for a RN with experience with appeals, claims review, and medical coding. **Job Summary** Provides support for medical claim and internal ... quality and cost-effective member care. **ESSENTIAL JOB DUTIES:** + Facilitates clinical/ medical reviews of retrospective medical claim reviews, medical… more
- ChenMed (Louisville, KY)
- … management programs, clinical meetings and other meetings. The Nurse Practitioner will adhere to strict departmental goals/objectives, standards of performance, ... management programs, clinical meetings and other meetings. The Nurse Practitioner will adhere to strict departmental goals/objectives, standards of performance,… more
- Fresenius Medical Center (Louisville, KY)
- …care to dialysis patients, in either a chronic or acute setting. + Medical /surgical nursing preferred. + Supervisory or management experience preferred. + ... compliance, and regulatory requirements and programs. As the Charge Nurse , manages the daily decisions to ensure continuity of...direct patient care staff + Promote efficient use of medical supplies. + Attend and participate in monthly Quality… more
- Veterans Affairs, Veterans Health Administration (Louisville, KY)
- …VA Healthcare System, Louisville, Kentucky is currently recruiting for a Chief Nurse -Surgical Services Louisville, Kentucky 603. Responsibilities The Chief Nurse ... who possesses a wide range of experience and leadership ability. The Chief Nurse of Surgical Services provides senior leadership and oversight for daily clinical and… more
- Veterans Affairs, Veterans Health Administration (Louisville, KY)
- …System, Louisville, Kentucky is currently recruiting for a Registered Nurse -Referral Coordination Team Louisville, Kentucky 603. Responsibilities The Referral ... Coordination Team (RCT) Registered Nurse (RN) is responsible for executing a streamlined approach to receiving, triaging, and directing timely, coordinated care. The… more
- ChenMed (Louisville, KY)
- … management programs, clinical meetings and other meetings. The Nurse Practitioner will adhere to strict departmental goals/objectives, standards of performance, ... we need great people to join our team. The Nurse Practitioner - Cardiology (NP) acts as part of...is responsible for providing direct patient care in ChenMed/Jencare medical centers, nursing homes, skilled nursing facilities (SNF) and… more
- Molina Healthcare (Louisville, KY)
- JOB DESCRIPTION Job Summary Provides screening, preventive primary care and medical care services to members - primarily in non-clinical settings where members feel ... quality and cost-effective member care. Essential Job Duties * Provides general medical care and care coordination to various and/or specific patient member… more
- BrightSpring Health Services (Louisville, KY)
- …of HIPAA and OSHA regulations + Demonstrated proficiency in computer-based data management programs, electronic medical record (EMR) systems, and Microsoft ... Company Abode Care Partners Overview Are you a licensed nurse practitioner (NP) looking for a new opportunity? We...structure, you will have the opportunity to grow your medical skills while providing personalized care to seniors and… more
- Fresenius Medical Center (Louisville, KY)
- …communicated to and implemented by the facility staff. + Maintains integrity of medical records and other FMS administrative and operational records. + Complies with ... the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member...**STAFF:** + Responsible for implementation of FMS staffing, and medical supply models, to provide quality patient care, and… more
- BrightSpring Health Services (Louisville, KY)
- Our Company Abode Care Partners Overview The Nurse Care Manger is an LPN who plays a crucial role in delivering patient-centered care by focusing on clinical ... care planning, and patient education. Working closely with field-based providers, the Nurse Care Manager assesses patient needs, coordinates care, and ensures that… more
- Molina Healthcare (Louisville, KY)
- …may be required. * Serves as a clinical resource for utilization management , chief medical officer, physicians, and member/provider inquiries/appeals. * Provides ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support for internal appeals clinical...Central time Remote position **Essential Job Duties** * Performs clinical/ medical reviews of previously denied cases in which a… more
- CenterWell (Bardstown, KY)
- …Health Registered Nurse ** , you will: + Provide admission, case management , and follow-up skilled nursing visits for home health patients. + Administer on-going ... meaningful impact every day as a CenterWell Home Health nurse . You'll provide personalized, one-on-one care that helps patients...care and case management for each patient, provide necessary follow-up as directed… more
- Molina Healthcare (Louisville, KY)
- **JOB DESCRIPTION** **Job Summary** The Delegation Oversight Nurse provides support for delegation oversight quality improvement activities. Responsible for ... proficient, self-directed, autonomous and experience working from home. Care Management & Waiver Service Auditing experience is highly preferred. Work… more
- Elevance Health (Louisville, KY)
- ** Nurse Case Manager II** **Work Schedule** **: M-F... Case Manager I** I is responsible for care management within the scope of licensure for members with ... assessments to identify individual needs and a specific care management plan to address objectives and goals as identified... plan and modifies as necessary. + Interfaces with Medical Directors and Physician Advisors on the development of… more
- Elevance Health (Louisville, KY)
- **Telephonic Nurse Case Manager II** **Sign On Bonus: $3000** **Location** : This role enables associates to work virtually full-time, with the exception of required ... in different states; therefore Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for performing care management … more
- YesCare Corp (Louisville, KY)
- …**Key Responsibilities** + Provide timely and effective responses to medical emergencies, including performing CPR until relieved. + Administer medications ... security and safety protocols. + Complete additional duties as assigned by management . **Key Qualifications** + Graduate of an accredited School of Nursing. +… more
- Molina Healthcare (Louisville, KY)
- JOB DESCRIPTION Job Summary Provides support for health management activities within the care management /care coordination functions. Collaborates with ... health care concerns, uses clinical judgment to provide care management or refer members to a higher level of...goals, and educates members on best practices to manage medical needs. * Provides condition-specific education designed to assist… more
- Molina Healthcare (Louisville, KY)
- JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness and medical necessity of services provided to members, targeting ... and cost-effective member care. Essential Job Duties * Determines appropriateness and medical necessity of health care services provided to plan members. * Supports… more