- PharmaCord (Louisville, KY)
- … Utilization Management, Call Center Case Management, a plus. Case management or Clinical Trial Nurse experience, a plus. Bachelor's degree preferred. We are ... independently while collaborating to share ideas, support, and resources. As a Nurse Advocate you are responsible for contact with program patients and assessing… more
- Cognizant (Frankfort, KY)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Humana (Frankfort, KY)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in a compact state… more
- CVS Health (KY)
- …health clinician with Kentucky state licensure (LCSW, LPCC, LMFT, LPAT) or a Registered Nurse (RN) with active current and unrestricted Kentucky state license ... every day. **Position Summary** This is a fully **remote** Utilization Review Clinical Consultant. **Must reside in...of an Associate's in Nursing or Diploma RN for Registered Nurses **Anticipated Weekly Hours** 40 **Time Type** Full… more
- Signature Healthcare (Louisville, KY)
- …documentation to facility accurate billing. What you Need to make a Difference + Registered Nurse (RN) in good standing with required current state license. + ... communication with leadership, patients, families, internal care givers, and external Utilization Management Nurses. + Coordinate internal and external health care… more
- Fresenius Medical Center (Georgetown, KY)
- …requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory ... FMCNA Compliance Program, and FMS patient care and administrative policies as the clinical leader, has the authority to make daily decisions to ensure continuity of… more
- Fresenius Medical Center (Madisonville, KY)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- Veterans Affairs, Veterans Health Administration (Louisville, KY)
- …Rex VA Healthcare System, Louisville, Kentucky is currently recruiting for a Registered Nurse -Mental Health Substance Treatment Program Louisville, Kentucky 603. ... Responsibilities The Mental Health (MH) Substance Treatment Program (STP) Registered Nurse (RN) executes position responsibilities to improve patient and… more
- CVS Health (KY)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
- Humana (Frankfort, KY)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN)** in the (appropriate state)… more
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- …by the state of Kentucky or hold license in a compact state as a Registered Nurse . ACLS preferred. Required Certifications: Basic Life Support (BLS) must be ... Registered Nurses are accountable for providing safe and...of care set by state board of nursing, state nurse practice act, and other governing agency regulations. Resolving… more
- CVS Health (KY)
- …Services (as applicable to hiring program) or Associates degree with a Registered Nurse with Behavioral Health experience/background with 3 years experience. ... we do it all with heart, each and every day. **Position Summary** Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization… more
- Centene Corporation (Frankfort, KY)
- …required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required Pay Range: ... 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,… more
- Humana (Frankfort, KY)
- …private practice or other healthcare settings Must be one of the following: + Registered Nurse , licensed in Kentucky without restrictions + Licensed Masters ... Utilization Management Behavioral Health Professional 2: + Uses clinical knowledge, communication skills, and independent critical thinking skills towards… more
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- …Emergency Department. Provide care to patients within the scope of practice of a Registered Nurse as defined by the Kentucky Board of Nursing. ESSENTIAL ... appropriate care. * Delegates duties based on complexity of patient needs. * Utilization of critical thinking skills in prioritization of care. * Develops and… more
- CenterWell (Frankfort, KY)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... skills to make an impact** **Required Qualifications** + Licensed Registered Compact Nurse license (RN) with no...Lung or Critical Care Nursing experience required + Prior clinical experience preferably in an acute care, skilled or… more
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- To ensure the delivery of competent, high quality clinical care in a caring compassionate environment. * Completes nursing HX and assessment accurately within ... appropriate care. * Delegates duties based on complexity of patient needs. * Utilization of critical thinking skills in prioritization of care. * Develops and… more
- Bon Secours Mercy Health (Paducah, KY)
- …and partnership * Interprofessional collaboration and leadership * Understanding and utilization of office and clinical technologies * Compassionate, ... effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. **Summary of Primary Function** Delivers patient care… more
- Surgery Care Affiliates (Owensboro, KY)
- …requirements for CRNA practice. Qualifications + Holds current active state licensure as a registered nurse in the state of KY/IN and complies with any ... applicable state statutory and regulatory requirements concerning advanced practice registered nursing. + Graduate of a nurse anesthesia educationalprogram… more
- Sharecare (Frankfort, KY)
- …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… more
