- Cognizant (Columbus, OH)
- …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 (Columbus, OH)
- **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 (Columbus, OH)
- …/benefit management function. **Required Qualifications** 3+ years of experience as an Registered Nurse Active and unrestricted RN licensure in state of ... Office Applications (Outlook, Teams, Excel) **Preferred Qualifications** Prior authorization utilization experience preferred Outpatient Clinical experience Knowledge… more
- CVS Health (Columbus, OH)
- …good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- Bon Secours Mercy Health (Springfield, OH)
- … clinical and operational excellence. **Mercy Health - Springfield Regional Medical Center - Registered Nurse ( RN ) - ICU ( Critical Care )** **Summary of ... Primary Functions** The Critical Care Registered Nurse (RN) provides, coordinates, plans, and...safety and privacy of all persons. * Understanding and utilization of office and clinical technologies. *… more
- Bon Secours Mercy Health (Springfield, OH)
- … and operational excellence. **Summary of Primary Functions** The Critical Care Registered Nurse (RN) provides, coordinates, plans, and evaluates the care ... TNCC Trauma Nursing Core Course (preferred) CCRN Critical Care Registered Nurse (preferred) PCCN Progressive Care Certified...safety and privacy of all persons. * Understanding and utilization of office and clinical technologies. *… more
- Bon Secours Mercy Health (Springfield, OH)
- … and operational excellence. **Summary of Primary Function/General Purpose of Position** The Registered Nurse Medical/Surgical functions as a care provider of a ... Cardiac Life Support acceptable in lieu of BLS) Medical-Surgical Nursing Certification RN-BC ( Registered Nurse - Board Certified) (preferred) CCRN Critical Care … more
- CVS Health (Columbus, OH)
- …+ 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 (Columbus, OH)
- **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
- Bon Secours Mercy Health (Springfield, OH)
- …excellence. **Summary of Primary Function/General Purpose of Position** The Stepdown Registered Nurse (RN) delivers patient care utilizing the nursing ... ACLS Advanced Cardiac Life Support (preferred) CCRN Critical Care Registered Nurse (preferred) PCCN Progressive Care Certified...safety and privacy of all persons. * Understanding and utilization of office and clinical technologies. *… more
- CVS Health (Columbus, OH)
- …Service/Health Services (as applicable to hiring program) or Associates degree with a Registered Nurse with Behavioral Health experience/ background with 3 years ... 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
- Bon Secours Mercy Health (Springfield, OH)
- …**Summary of Primary Function/General Purpose of Position** The New-to-Practice Stepdown Registered Nurse (RN) provides, coordinates, plans, and evaluates ... the safety and privacy of all persons. * Understanding and utilization of office and clinical technologies. * Ability to communicate with patients in a manner… more
- Trinity Health (Columbus, OH)
- …+ Associates degree from an accredited RN program + Current license to practice as registered nurse in the State of Ohio + Minimum of 3-5 years recent ... This is done with the intentions of cost effective utilization of hospital resources, minimizing out of pocket expenses... clinical experience in an acute care setting. **Position Highlights… more
- Bon Secours Mercy Health (Springfield, OH)
- … and operational excellence. **Summary of Primary Function** The Obstetrics (OB) Registered Nurse (RN) addresses the care provided to healthcare consumers ... the safety and privacy of all persons. Understanding and utilization of office and clinical technologies. Ability to communicate with patients in a manner… more
- OhioHealth (Columbus, OH)
- …Heart Association, BLS - Basic Life Support - American Heart Association, RN - Registered Nurse - Ohio Board of Nursing **Additional Job Description:** Current ... careers and in our communities. **Job Description Summary:** The RN Clinical Leader provides leadership and coordinates the design, development, implementation and… more
- Evolent (Columbus, OH)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are… more
- Bon Secours Mercy Health (Urbana, OH)
- …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
- CVS Health (Columbus, OH)
- …performance. **Education** Bachelor's degree preferred/specialized training/relevant professional qualification. Registered Nurse (RN) required. **Prior Relevant ... utilization reviews and assessments, applying evidence-based criteria and clinical knowledge to evaluate the medical necessity and appropriateness of requested… more
- Molina Healthcare (Columbus, OH)
- …or equivalent combination of relevant education and experience. * Advanced Practice Registered Nurse (APRN) license. License must be active and unrestricted ... * At least 8 years of health care experience, including 5 years of clinical practice experience, 3 years utilization /quality program management experience, and 2… more
- CVS Health (Columbus, OH)
- … resolutions with internal and external support areas. **Required Qualifications** + A Registered Nurse that must hold an unrestricted license in their state ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more