• Utilization Management Nurse

    Signature Healthcare (Louisville, KY)
    …Care documentation to facility accurate billing. What you Need to make a Difference + Registered Nurse ( RN ) in good standing with required current state ... communication with leadership, patients, families, internal care givers, and external Utilization Management Nurses. + Coordinate internal and external health… more
    Signature Healthcare (05/18/25)
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  • Dialysis Clinical Manager Registered

    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. + ... of education and experience. + Graduate of an accredited School of Nursing ( RN ). + Current appropriate state licensure. **EXPERIENCE AND SKILLS:** + Required: + 6+… more
    Fresenius Medical Center (04/09/25)
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  • Registered Nurse - Nuclear…

    Veterans Affairs, Veterans Health Administration (Louisville, KY)
    Nurse - Nuclear Cardiology. Responsibilities Specialty Care Outpatient Staff Registered Nurse ( RN ) is responsible for providing competent, ... and coaching on wellness, disease prevention, and chronic care management . The nurse will assist in directing...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
    Veterans Affairs, Veterans Health Administration (06/06/25)
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  • Registered Nurse , Telehealth…

    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
    ChenMed (06/05/25)
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  • Utilization Management Behavioral…

    Humana (Corydon, IN)
    …Family Therapist **(LMFT)** , Licensed Professional Counselor **(LPC)** , Psychologist **(PhD)** , Registered Nurse **( RN )** or other professional license. + ... health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral health knowledge… more
    Humana (05/31/25)
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  • Clinical Appeals Nurse ( RN )

    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
    Molina Healthcare (05/16/25)
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  • RN Clinical Manager, Home Health

    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
    CenterWell (05/02/25)
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  • Care Review Clinician, PA ( RN )…

    Molina Healthcare (Louisville, KY)
    …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States...transplants; the ideal candidate will have experience either in utilization review or case management for transplants.… more
    Molina Healthcare (06/06/25)
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  • Med Mgmt Nurse (US)

    Elevance Health (Louisville, KY)
    **Medical Management Nurse ** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... will drive the future of health care. The **Medical Management Nurse ** is responsible for reviewing the...experience and requires a minimum of 2 years clinical, utilization review, or managed care experience; or any combination… more
    Elevance Health (06/06/25)
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  • Nurse Case Mgr II

    Elevance Health (Louisville, KY)
    …pm EST. The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care needs ... **Telephonic Nurse Case Manager II** **Location:** This role enables...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum** **Requirements:**… more
    Elevance Health (05/30/25)
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