- Elevance Health (Columbus, OH)
- …coverage (Sat & Sun 8am-12pm CST, with a comp day during the week) The ** Nurse Reviewer I** is responsible for conducting preauthorization, out of network and ... on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. Partners with… more
- Evolent (Columbus, OH)
- …peer clinical review activities while located in a state or territory of the United States . Acts with honor and integrity, serving as a role model for the ... mission. Stay for the culture. **What You'll Be Doing:** The Nurse Practitioner/Physician Assistant (ARNP/NP/PA) Cardiology is responsible for support and assistance… more
- CVS Health (Columbus, OH)
- …the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review , you'll play a vital role ... 8:00am-5:00pm EST (Shift times may vary based on business needs) Location: 100% Remote ( US only) **About Us ** American Health Holding, Inc. (AHH), a division of… more
- Veterans Affairs, Veterans Health Administration (Columbus, OH)
- …practice as a CNA or equivalent, in a State, Territory or Commonwealth of the United States or in the District of Columbia. Basic Certification. All APN (CNAs) ... determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.… more
- Cognizant (Columbus, OH)
- …role's business requirements, this is a remote position open to qualified applicants in United States . Regardless of your working arrangement, we are here to ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...position who are legally authorized to work in the United States without requiring company sponsorship now… more
- Elevance Health (Columbus, OH)
- …within the scope of licensure in applicable state(s) or territory of the United States required. **Preferred Skills, Capabilities, & Experiences:** .AS or BS ... ** Nurse Appeals -Licensed Nurse ** **Location** :...leadership by managing State Fair Hearing and External Medical Review requests. .Acts as a resource for both clinical… more
- BrightSpring Health Services (Columbus, OH)
- …ResCare Community Living Overview Works under the supervision of a Registered Nurse . Duties include providing routine care, general observation of client's health ... care and services and reports any changes* Complete a quarterly nursing evaluation/ review of body systems on assigned individuals per program requirements. Refer to… more
- Surgery Care Affiliates (Dublin, OH)
- …the patients we serve, the physicians we support and the teammates who push us forward. Behind every successful facility, procedure or innovation is a team of ... will. Responsibilities We are actively hiring for an Registered Nurse (RN) PreOp PACU. + Promote the mission, vision,...with other disciplines as needed. + Participate in quality review and performance improvement projects. + Participate in the… more
- Datavant (Columbus, OH)
- …platform is powered by the largest, most diverse health data network in the US , enabling data to be secure, accessible and usable to inform better health decisions. ... tangible difference in the accuracy of healthcare data. Join us in this critical role where your efforts will...clinical experience in an academic medical center + Registered Nurse license, Bachelor's degree in Nursing + CCDS or… more
- OhioHealth (Columbus, OH)
- …1. 25% Screens and processes donors to include phone calls, sending packets, review completed packet, obtain medical release for donor and her baby, facilitates lab ... work with results review and transfer of milk to a collection site...Board of Lactation Consultant Examiners (IBLCE), RN - Registered Nurse - Ohio Board of Nursing **Additional Job Description:**… more
- Fresenius Medical Center (Columbus, OH)
- …care about, and support our people. We are there when you may need us most, from tuition reimbursement to support your education goals, granting scholarships to ... for all, which is a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly...+ Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. +… more
- CenterWell (Columbus, OH)
- **Become a part of our caring community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in ... actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that… more
- Highmark Health (Columbus, OH)
- …to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, corporate, state, and ... site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application… more
- Trinity Health (Columbus, OH)
- …largest Catholic healthcare delivery systems, our network of caring spans 22 states , 94 hospitals, and 133,000 colleagues nationwide. We know that exceptional ... call your own in Columbus. Learn more at www.experiencecolumbus.com ! The Peer Review Specialist provides leadership and coordination for the provider peer review… more
- Oracle (Columbus, OH)
- …of a team dedicated to supporting a single, prominent client in the midwestern United States , known for the excellent care they provide to primarily ... made up of employees in both India and the United States , and is divided into two...alignments, Critical Care workflow implementation, Multi-Disciplinary Rounding, and various nurse chart review and documentation optimizations. The… more
- Elevance Health (Columbus, OH)
- …within the scope of licensure in applicable state(s) or territory of the United States required. + Multi-state licensure is required if this individual ... be based at any Pulse Point available in Ohio, US . _Please note that per our policy on hybrid/virtual...not require the training or skill of a registered nurse . **How you will make an impact.** Primary duties… more
- Datavant (Columbus, OH)
- …platform is powered by the largest, most diverse health data network in the US , enabling data to be secure, accessible and usable to inform better health decisions. ... is to effectively defend utilization of available health services, review of admissions for medical necessity and necessity of...expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in… more
- ChenMed (Columbus, OH)
- … nurse practitioner role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization, provide family education and identify ... we need great people to join our team. The Nurse Practitioner (NP) acts as part of the clinical...ANCC is preferred but may be required for certain States + Current DEA number from the DEA for… more
- ChenMed (Columbus, OH)
- …visits. Once a patient has completed their episode of care management the register nurse (RN) will review patient chart for discharge and conduct final discharge ... The Intensive Community Care Manager (ICCM) is a Registered Nurse (RN) who works with our highest complexity patients,...patients and outreach to patients who are assigned to us but are not engaged in care. This person… 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 ... medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation… more