- Molina Healthcare (Columbus, OH)
- … 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 (Columbus, OH)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. ... a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in...+ Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. +… more
- Veterans Affairs, Veterans Health Administration (Columbus, OH)
- …for Community Care. Duty location is in Columbus, OH. The Referral Coordination Team - Registered Nurse ( RN ) ) is responsible and accountable for all ... of the Veteran throughout the consult 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
- Cognizant (Columbus, OH)
- …expectations. **What you need to have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...the medical necessity determinations to the Health Plan/ Medical Director based on the review of… more
- Surgery Care Affiliates (Dublin, OH)
- …change. If you join our team, they will. Responsibilities We are actively hiring for an Registered Nurse ( RN ) PreOp PACU. + Promote the mission, vision, and ... your health, well-being, and financial future. Our offerings include medical , dental, and vision coverage, 401k plan with company...to care. + Delegate tasks according to the state Nurse Practice Act (if applicable), state board of nursing… more
- Molina Healthcare (Columbus, OH)
- …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 (Columbus, OH)
- 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 (Columbus, OH)
- 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 (Columbus, OH)
- …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 (Columbus, OH)
- …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 (Columbus, OH)
- …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 (Columbus, OH)
- …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
- Trinity Health (Columbus, OH)
- …in Nursing preferred. + **License / Certification** : Current license to practice as Registered Nurse in the State of Ohio. + **Experience:** Minimum of five ... policies. + Attends Joint Commission or other regulatory meetings related to medical staff review of OPPE. + Maintains confidentiality of all peer review … more
- Molina Healthcare (Columbus, OH)
- …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
- Humana (Columbus, OH)
- …Typical work hours are Monday-Friday, 8 hours/day, 5 days/week. **Required Qualifications** + Registered Nurse ( RN ), holding an active and unrestricted ... resources, schedules and goals. The Manager, Fraud and Waste Investigator: Nurse Audit/ Review validates and interprets medical documentation to ensure… more
- Humana (Columbus, OH)
- …an impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and… more
- OhioHealth (Columbus, OH)
- …to ensure holistic patient needs are met. **Minimum Qualifications:** Bachelor's Degree: Nursing (Required) RN - Registered Nurse - Ohio Board of Nursing ... to prepare patients and families for transplantation; gather and review medical and social history. Coordinate pre-transplant...**SPECIALIZED KNOWLEDGE** Minimum 2 years of experience as a nurse in transplant or at least 5 years of… more
- BrightSpring Health Services (Columbus, OH)
- Our Company ResCare Community Living Overview Works under the supervision of a Registered Nurse . Duties include providing routine care, general observation of ... .* Ensures incidents are recorded, the individual is safe, receives required medical care, communicates to RN , operations leadership timely* Transcribes… more
- Fresenius Medical Center (Columbus, OH)
- …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
- Humana (Columbus, OH)
- …timeframe **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) Compact license, with no disciplinary action ... determination of the appropriate courses of action. The Utilization Management Behavioral Health Nurse 2 completes medical record reviews from medical … more