- 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
- 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
- CVS Health (Frankfort, KY)
- …both verbal and written **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active ... work schedules will include weekends, holidays, and evening hours._ + Utilizes clinical experience and skills in a collaborative process to assess, plan, implement,… more
- CVS Health (Frankfort, KY)
- …good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult inpatient… 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 (Mayfield, 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
- CVS Health (Frankfort, 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
- ChenMed (Louisville, KY)
- …We're rapidly expanding and we need great people to join our team. The Registered Nurse , Care Line, is responsible for providing telephonic triage directional ... on-call coverage, the incumbent in this role provides remote clinical advice and assessments within license and as possible...license and as possible given technology and medium. The registered nurse collaborates with primary caregivers and… 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
- Molina Healthcare (KY)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support...hearings as may be required. * Serves as a clinical resource for utilization management, chief medical… 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
- 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)
- …+ Bachelor's degree in nursing (preferred) **Required** **Licensing & Certifications:** + Licensed Registered Nurse in state of practice (required) + BLS Basic ... at BSMH; required at hire for RSFH) + Oncology Nurse Navigator - Certified Generalist (ONN-CG) - Academy of...an RN (required) + Experience with discharge planning or utilization review (preferred) **Skills & Abilities:** Hard/Tech/ Clinical … more
- CVS Health (Frankfort, KY)
- …a member's overall wellness through integration. - Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and ... functions as well as smooth transition to programs and plans. - Applies clinical judgment to the incorporation of strategies designed to reduce risk factors 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
- Humana (Frankfort, KY)
- …help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation ... of action. The Utilization Management Behavioral Health Nurse uses clinical knowledge, communication skills, and...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) Compact license, with no… 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 ... we make is rooted in seven core values: + Clinical quality + Integrity + Service excellence + Teamwork...applicable state statutory and regulatory requirements concerning advanced practice registered nursing. + Graduate of a nurse … more
- Molina Healthcare (Louisville, KY)
- …and electronic medical record (EMR) experience. Preferred Qualifications * Experience as a registered nurse or nurse practitioner in a home health, ... primary care and medical care services to members - primarily in non- clinical settings where members feel most comfortable, including in-home, community and nursing… more