- Centene Corporation (Columbus, OH)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... a fresh perspective on workplace flexibility. **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service and… more
- Evolent (Columbus, OH)
- …Will work with the Director of UM to ensure client satisfaction. Perform all peer clinical review activities while located in a state or territory of the United ... mission. Stay for the culture. **What You'll Be Doing:** The Nurse Practitioner/Physician Assistant (ARNP/NP/PA) Cardiology is responsible for support and assistance… more
- Veterans Affairs, Veterans Health Administration (Columbus, OH)
- …to the educational mission as a mentor or preceptor providing didactic and clinical instruction in anesthesia to student nurse anesthetists, medical and dental ... determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.… more
- Sharecare (Columbus, OH)
- … helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and...and to take the pre and post tests to review competency during orientation. Yearly competency tests are required… more
- Elevance Health (Columbus, OH)
- **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
- CenterWell (Columbus, OH)
- …with the ability to obtain Compact Nursing License + A minimum of three years clinical RN experience; + Prior clinical experience, managed care experience, ... actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that… more
- Molina Healthcare (Columbus, OH)
- …review , and medical coding. JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying ... For this position we are seeking a (RN) Registered Nurse who must hold a compact license. This is...years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent… more
- Molina Healthcare (Columbus, OH)
- JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... least 2 years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of relevant… more
- Molina Healthcare (Columbus, OH)
- JOB DESCRIPTION **Job Summary** The Care Review Clinician (RN) provides support for clinical member services review assessment processes. Responsible for ... least 2 years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of relevant… more
- Molina Healthcare (Columbus, OH)
- JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for ... least 2 years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of relevant… more
- Molina Healthcare (Columbus, OH)
- JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... least 2 years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of relevant… more
- Molina Healthcare (Columbus, OH)
- …**Preferred Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of ... compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical… more
- Fresenius Medical Center (Columbus, OH)
- …+ Monitor patients' response to dialysis therapy and report any unusual findings to nurse supervisor. + Obtain vital signs prior to reinfusion; perform all ... dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with FMCNA policies, procedures, and training and in compliance… more
- Fresenius Medical Center (Columbus, 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
- ChenMed (Columbus, OH)
- … nurse practitioner role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization, provide family education and identify ... Fellow will be part of an accelerated development for new clinical leaders within the organization dedicated to patient-centered, value-based healthcare, supporting… more
- OhioHealth (Columbus, OH)
- …individual patients while performing daily tasks. The incumbent serves as a clinical resource for other team members, patients, and caregivers, referring providers, ... patients to ensure a successful continuum of care. Must be able to prioritize clinical issues and case manage patients in various stages of the transplant process… more
- Trinity Health (Grove City, OH)
- …**Position Purpose:** + Oncology Care specialists coordinate with clinic staff, nurse navigators, physicians and other health care professionals to provide critical ... provide non- licensed support to clinic staff and oncology Nurse Navigators and act as a team to triage...services. Coordinates care and ensures the chart is complete prior to upcoming visits. Serves as lead to triage… more
- Battelle Memorial Institute (Columbus, OH)
- …Health Technician will require performing a variety of administrative and clinical tasks, including data collection, report preparation, and coordination of ... + Under the supervision of a licensed psychiatrist, social worker, psychiatric nurse or psychologist, responsible for providing a wide range of behavioral health… more
- CVS Health (New Albany, OH)
- …network management and clinical coverage policies. + Through the use of clinical tools and information/data review , conducts an evaluation of member's needs ... (1-2 times per quarter).** Typical training hours are Monday-Friday 8-4:30 EST. Nurse Care Manager is responsible for telephonically and/or face to face assessing,… more