- Molina Healthcare (Lexington, KY)
- …outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied ... these guidelines. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
- Molina Healthcare (Lexington, KY)
- …state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing. ... Certified Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional Healthcare Management, Certified Professional… more
- Fresenius Medical Center (Mount Sterling, KY)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. ... leading your business, and advanced leadership. As a Clinical Manager , you may advance your career into an Area...to be a vital part of the future of healthcare , apply today. **PRINCIPAL RESPONSIBILITIES AND DUTIES** CLINIC OPERATIONS:… more
- Public Consulting Group (Frankfort, KY)
- …learn more, visit www.publicconsultinggroup.com . PCG is currently seeking a qualified Registered Nurse to perform as a Case Manager . The Case Manager ... , assisting families and program recipients through prior approval of certain healthcare services , and collaborating with the claim's administration team.… more
- Sharecare (Frankfort, KY)
- …to the disease management program intervention guidelines. A Clinical Registered Nurse is supervised by an Operations Manager (OM). All Sharecare clinicians ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals and… more
- Public Consulting Group (Frankfort, KY)
- …of case management plans. + Current license, certification or registration as a Registered Nurse or Social Worker **Working Conditions** + Office Setting **The ... improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986, PCG...Proven working experience in case management, including as a nurse , medical, mental health care manager or… more
- Sharecare (Frankfort, KY)
- …within a matrix organizational design. **Qualifications:** + Current multi-state compact Registered Nurse licensure in state of residence is required, ... 2025** **Salary:** **$85,000 annually, plus comprehensive benefits package** The Care Manager supports the implementation of the Value Based Care Management program… more
- CenterWell (Lexington, KY)
- …and help patients get back to the life they love. As a **Home Health Registered Nurse ** , you will: + Provide admission, case management, and follow-up skilled ... Home Health experience a plus + Current and unrestricted Registered Nurse licensure + Current CPR certification...care, one of the largest providers of home health services , and fourth largest pharmacy benefit manager ,… more
- Molina Healthcare (Lexington, KY)
- …Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs; ensures maintenance of ... accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Health Plan Quality Interventions is responsible for developing,… more
- Molina Healthcare (Lexington, KY)
- **JOB DESCRIPTION** **Job Summary** Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan ... behavioral health settings. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must… more
- CenterWell (Lexington, KY)
- …excellence **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) without restriction in applicable state + ... nursing experience + Proven work experience as a HEDIS Nurse or similar role in healthcare quality...care, one of the largest providers of home health services , and fourth largest pharmacy benefit manager ,… more
- Highmark Health (Frankfort, KY)
- …of disease processes + Understanding of healthcare costs and the broader healthcare service delivery system + Proficiency in MS Excel and strong analytic ... dialectical behavior therapy (DBT) + Experience working with the healthcare needs of diverse populations + Understanding of the...in addressing targeted populations **LICENSES AND CERTIFICATIONS** **Required** + RN license in PA or WV or DE or… more
- Option Care Health (Lexington, KY)
- …the best and brightest talent in healthcare . **Job Description Summary:** An Infusion Nurse II is a licensed registered nurse who coordinates and ... is the largest independent home and alternate site infusion services provider in the United States. With over 8,000...the Supervisor in the absence of the Supervisor or Nurse Manager as applicable in accordance with… more
- Catholic Health Initiatives (Lexington, KY)
- …Associate's Degree (ADN) in Nursing from an accredited nursing college or program + Active Registered Nurse ( RN ) license cleared by the Kentucky Board of ... the assigned department, working under the direction of the Nurse Manager on assigned shifts. Responsible for...Qualifications:** + Bachelor's Degree in Nursing (BSN) + Previous RN experience within Womens Care, Labor and Delivery, or… more
- Highmark Health (Frankfort, KY)
- …management** strategies including: review of appropriateness of health care services , application of criteria to ensure appropriate resource utilization, ... of quality issues. Monitors and analyzes the delivery of health care services ; educates providers and members on a proactive basis; and analyzes qualitative… more
- Catholic Health Initiatives (Lexington, KY)
- …Associate's Degree (ADN) in Nursing from an accredited nursing college or program + Active Registered Nurse ( RN ) license cleared by the Kentucky Board of ... the assigned department, working under the direction of the Nurse Manager on assigned shifts. Responsible for...**About Us:** Welcome to Saint Joseph East, a 217-bed, full- service , community hospital located in a convenient setting in… more
- Catholic Health Initiatives (Lexington, KY)
- …care operations of the assigned department, working under the direction of the Nurse Manager on assigned shifts. Responsible for daily patient care assignments, ... supporting the care team. Supports the activities of the Nurse Manager . Maintains positive inter- and intra-departmental...in Nursing (ADN) from an accredited program + Active Registered Nurse Licensure in Kentucky (KY) or… more
- Catholic Health Initiatives (Lexington, KY)
- …care operations of the assigned department, working under the direction of the Nurse Manager on assigned shifts. Responsible for daily patient care assignments, ... supporting the care team. Supports the activities of the Nurse Manager . Maintains positive inter- and intra-departmental...in Nursing (ADN) from an accredited program + Active Registered Nurse Licensure in Kentucky (KY) or… more
- Catholic Health Initiatives (Lexington, KY)
- …care operations of the assigned department, working under the direction of the Nurse Manager on assigned shifts. Responsible for daily patient care assignments, ... supporting the care team. Supports the activities of the Nurse Manager . Maintains positive inter- and intra-departmental...in Nursing (ADN) from an accredited program + Active Registered Nurse Licensure in Kentucky (KY) or… more
- Catholic Health Initiatives (Lexington, KY)
- …Abstracts and navigates data and outcomes. Expands the Cardiovascular and Thoracic services within Saint Joseph Healthcare through the development and ... contact for programs to facilitate the collaboration and coordination of patient care services to provide the highest level of care possible. Primary role is that… more