- Molina Healthcare (Louisville, KY)
- … and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Provides support for … 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 ... as pertinent. **STAFF:** + Responsible for implementation of FMS staffing, and medical supply models, to provide quality patient care, and makes recommendations. +… more
- Veterans Affairs, Veterans Health Administration (Louisville, KY)
- …Coordination Team Louisville, Kentucky 603. Responsibilities The Referral Coordination Team (RCT) Registered Nurse ( RN ) is responsible for executing a ... of the Veteran throughout the consultation process. The RCT RN supports the medical center's mission to...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Elevance Health (Louisville, KY)
- **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 ... opportunities for fraud and abuse prevention and control. + Review and conducts analysis of claims and medical...Skills, Qualifications, and Experiences:** + Fraud and Abuse experienced Nurse with a CPC are highly desired. For candidates… more
- Elevance Health (Louisville, KY)
- …states; therefore, Multi-State Licensure will be required.** The ** Medical Management Nurse ** is responsible for review of the most complex or challenging ... ** Medical Management Nurse ** **Location: Virtual: This...Skills and Experiences:** + ACMP experience is preferred. + Medical Management experience is preferred, + Utilization Review… more
- Elevance Health (Louisville, KY)
- …unless an accommodation is granted as required by law. The ** Medical Management Nurse ** is responsible for review of the most complex or challenging cases ... ** Medical Management Nurse ** **Hours: 8am-6pm flexible...and requires a minimum of 2 years clinical, utilization review , or case management experience; or any combination of… more
- Molina Healthcare (Louisville, KY)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...specific programs supported by the plan such as utilization review , medical claims review , long-term… more
- Molina Healthcare (Louisville, KY)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Louisville, KY)
- For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This role will be doing Utilization review for ... authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted… more
- Molina Healthcare (Louisville, KY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support...care unit, or in a telemetry type setting. UM medical review experience highly preferred. Work Hours:… more
- Molina Healthcare (Louisville, KY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The Care Review Clinician ( RN ) provides support for...requests within required timelines. * Refers appropriate cases to medical directors (MDs) and presents them in a consistent… more
- Molina Healthcare (Louisville, KY)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
- Molina Healthcare (Louisville, KY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Molina Healthcare (Louisville, KY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- ChenMed (Louisville, KY)
- …to join our team. The Community Care team is a multidisciplinary service including Registered Nurse ( RN ) Community Care nurses, Licensed Practical Nurse ... patients and their primary care physicians to meet their medical and social needs with the aims of fully...has completed their episode of care management the register nurse ( RN ) will review patient… more
- Elevance Health (Louisville, KY)
- …and efficiency recommendations. **Minimum Requirements:** + Requires current, active, unrestricted Registered Nurse license in applicable state(s). + Requires a ... **Diagnosis Related Group Clinical Validation Auditor- RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This role enables associates to work virtually full-time,… more
- Signature Healthcare (Louisville, KY)
- …with all changes and as appropriate. What you Need to make a Difference + Registered Nurse with required current state licensure. + Minimum three (3) years of ... assessment and meeting with families. Knowledgeable of nursing and medical practices and procedures, as well as laws, regulations,...end meetings to assure federal billing requirements are met. Review Plan of Care at least quarterly and with… more
- Fresenius Medical Center (Louisville, KY)
- …effective dialysis therapy for assigned patients under the direct supervision of a registered nurse . Participates in the implementation and evaluation of patient ... as your own._ **Connect with your goals and change lives** **with Fresenius Medical Care North America.** Here, we make connections that empower patients, their… 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 ... different states; therefore Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for performing care management within… more
- Fresenius Medical Center (Louisville, KY)
- …Report any significant information and/or change in patient condition directly to the registered nurse or supervisor. + Observe patient and conduct machine ... policy. Report any change or unusual findings to the registered nurse or supervisor. + Perform and...+ Monitors patients performing self-care under the supervision of RN . **Staff Related** + Assists in training of applicable… more