- Molina Healthcare (Louisville, KY)
- **Job Description** **Job Summary** The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring ... nursing experience, including at least 1 year of utilization review , medical claims review , long-term...or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must… more
- Fresenius Medical Center (Clarksville, IN)
- …communicated to and implemented by the facility staff. + Maintains integrity of medical records and other FMS administrative and operational records. + Complies with ... as pertinent. **STAFF:** + Responsible for implementation of FMS staffing, and medical supply models, to provide quality patient care, and makes recommendations. +… more
- Surgery Care Affiliates (New Albany, IN)
- …you join our team, they will. Responsibilities We are actively hiring for an Registered Nurse ( RN ) Inpatient. Nightshift 6:45pm-7:15am. Rate includes shift ... your health, well-being, and financial future. Our offerings include medical , dental, and vision coverage, 401k plan with company...to care. + Delegate tasks according to the state Nurse Practice Act (if applicable), state board of nursing… more
- Elevance Health (Louisville, KY)
- …states; therefore, Multi-State Licensure will be required.** The ** Medical Management Nurse ** is responsible for review of the most complex or challenging ... ** Medical Management Nurse ** **Location: Virtual: This...Skills and Experiences:** + ACMP experience is preferred. + Medical Management experience is preferred, + Utilization Review… more
- YesCare Corp (Louisville, KY)
- …+ Work alongside physicians and interdisciplinary team members to initiate and review healthcare plans. + **Communication and Reporting:** + Act as a liaison ... Emergency Care:** + Plan and supervise nursing care techniques and emergency medical responses per facility policies. + Lead CPR procedures during emergencies and… more
- Molina Healthcare (Louisville, KY)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Louisville, KY)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...specific programs supported by the plan such as utilization review , medical claims review , long-term… more
- Molina Healthcare (Louisville, KY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Molina Healthcare (Louisville, KY)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
- Molina Healthcare (Louisville, KY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary… more
- Veterans Affairs, Veterans Health Administration (Louisville, KY)
- …specialized Licensed Practical Nurse activities under the direction of a Registered Nurse , requiring a broad work experience and demonstrated skill ... a VHA Patient Aligned Care Team (PACT), a patient-centered medical home model of care that is accessible, timely,...care decision making with minimal periodic supervision by the Registered Nurse . Duties include but are not… more
- Surgery Care Affiliates (New Albany, IN)
- …change. If you join our team, they will. Responsibilities We are actively hiring for an Registered Nurse ( RN ) PreOp PACU. + Promote the mission, vision, and ... your health, well-being, and financial future. Our offerings include medical , dental, and vision coverage, 401k plan with company...to care. + Delegate tasks according to the state Nurse Practice Act (if applicable), state board of nursing… more
- ChenMed (Louisville, KY)
- …to join our team. The Community Care team is a multidisciplinary service including Registered Nurse ( RN ) Community Care nurses, Licensed Practical Nurse ... patients and their primary care physicians to meet their medical and social needs with the aims of fully...has completed their episode of care management the register nurse ( RN ) will review patient… more
- Elevance Health (Louisville, KY)
- …and efficiency recommendations. **Minimum Requirements:** + Requires current, active, unrestricted Registered Nurse license in applicable state(s). + Requires a ... **Diagnosis Related Group Clinical Validation Auditor- RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This role enables associates to work virtually full-time,… more
- Signature Healthcare (Louisville, KY)
- …with all changes and as appropriate. What you Need to make a Difference + Registered Nurse with required current state licensure. + Minimum three (3) years of ... assessment and meeting with families. Knowledgeable of nursing and medical practices and procedures, as well as laws, regulations,...end meetings to assure federal billing requirements are met. Review Plan of Care at least quarterly and with… more
- Elevance Health (Louisville, KY)
- **Telephonic Nurse Case Manager II** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management...management plan and modifies as necessary. + Interfaces with Medical Directors and Physician Advisors on the development of… more
- Fresenius Medical Center (New Albany, IN)
- …Report any significant information and/or change in patient condition directly to the registered nurse or supervisor. + Observe patient and conduct machine ... policy. Report any change or unusual findings to the registered nurse or supervisor. + Perform and...+ Monitors patients performing self-care under the supervision of RN . **Staff Related** + Assists in training of applicable… more
- Elevance Health (Louisville, KY)
- ** Nurse Case Manager II** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... 48 hours of receipt and meet the criteria._** The ** Nurse Case Manager II** is responsible for care management...management plan and modifies as necessary. + Interfaces with Medical Directors and Physician Advisors on the development of… more
- Fresenius Medical Center (Louisville, KY)
- …DUTIES AND RESPONSIBILITIES:** Providespatient care under the directsupervision of Hemodialysis Registered Nurse for assignedpatient(s) in the dialysissuite in ... the individual patient record to include the hospital Electronic Medical System (EMS) and the Acute Care Electronic System...patientprior to dischargeand reports any unusualfindings to the FMCNA RN + Review and comply with the… more
- Molina Healthcare (Louisville, KY)
- …Microsoft Excel (edit/save spreadsheets, sort/filter) **Required License, Certification, Association** Licensed registered nurse ( RN ), Licensed practical ... CPT guidelines, internal policies, and contract requirements. This position completes a medical review to facilitate a referral to law enforcement or for payment… more