- Trinity Health (Columbus, OH)
- …to call your own in Columbus. Learn more at www.experiencecolumbus.com ! The Peer Review Specialist provides leadership and coordination for the provider ... peer review processes across the facilities and...**License / Certification** : Current license to practice as Registered Nurse in the State of Ohio.… more
- Fresenius Medical Center (Columbus, OH)
- …As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. As the facility ... come together for professional and personal development, discussion, activities, and peer support. Our diverse workforce and culture encourage opportunity, equity,… more
- Humana (Columbus, OH)
- …corrective actions as assigned. Coordinates case presentations and presents to Patient Safety Peer Review Committee. Audits quality cases for compliance and ... Participates in case presentation and discussion at Patient Safety Peer Review Committee (PSPRC) meetings + ... RN experience + 2 years of Utilization Review , Case Management, or Quality Management experience… more
- Humana (Columbus, OH)
- …timeframe **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) Compact license, with no disciplinary action ... us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the...and extract information from claims + Complete documentation for Quality Reviews for Peer Reviews + Discuss… more
- Highmark Health (Columbus, OH)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... coding criteria, as well as other approved guidelines, payment and medical policies.Promote quality and efficiency in the delivery of review services. + Respect… more
- Cardinal Health (Columbus, OH)
- …be needed to perform your duties up to 25%. **_Qualifications_** + Current, unrestricted Registered Nurse license, required. + BA, BS or equivalent experience in ... and satisfactory experience for all customers. The Supervisor, Clinical Operations monitors nurse to patient contact quality and provides coaching as needed… more
- OhioHealth (Columbus, OH)
- …Service Line, CGC, Physicians and Front Line Staff. 6. Mentors system accreditation peer member's and quality teams on performance improvement tools and ... supports, monitors and directs multidisciplinary projects across OhioHealth to drive Quality and Safety improvement projects. Works to support and direct OhioHealth… more
- Highmark Health (Columbus, OH)
- …in achieving their personal health goals. Will work with providers to insure quality and appropriate care is being delivered in a timely manner. **ESSENTIAL ... to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, corporate, state, and… more