- Humana (Louisville, 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 ... benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the state of… more
- Signature Healthcare (Louisville, KY)
- …communication with leadership, patients, families, internal care givers, and external Utilization Management Nurses. + Coordinate internal and external health ... billing. What you Need to make a Difference + Registered Nurse (RN) in good standing with...Previous experience with MDS and assessment preferred Hospital Case Management /Hospital Utilization Management . Obtaining… more
- Veterans Affairs, Veterans Health Administration (Louisville, KY)
- …Louisville KY is current recruiting for a Specialty Care Outpatient Staff Registered Nurse - Nuclear Cardiology. Responsibilities Specialty Care Outpatient Staff ... Registered Nurse (RN) is responsible for providing...and coaching on wellness, disease prevention, and chronic care management . The nurse will assist in directing… 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 ... Triage assessments within license and as possible given technology and medium. The registered nurse collaborates with primary caregivers and others on the… more
- Fresenius Medical Center (Louisville, KY)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... + Preferred but not required: + 3+ years supervisory or project/program management experience. + Med/surg or ICU/CCU experience. **PHYSICAL DEMANDS AND WORKING… more
- Molina Healthcare (Louisville, KY)
- … Nurse in good standing. **Preferred Education** Completion of an accredited Registered Nurse (RN) Program or a bachelor's degree in Nursing. **Preferred ... contained in the delegation agreement. **KNOWLEDGE/SKILLS/ABILITIES** The Delegation Oversight Nurse is responsible for ensuring that Molina Healthcare's UM… more
- Molina Healthcare (Louisville, KY)
- …Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + ... as may be required. + Serves as a clinical resource for Utilization Management , Chief Medical Officer, Physicians, and Member/Provider Inquiries/Appeals. +… more
- CenterWell (Louisville, KY)
- …license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home care, ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Molina Healthcare (Louisville, KY)
- …internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital ... requests for transplants; the ideal candidate will have experience either in utilization review or case management for transplants. Preference will be… more