- Elevance Health (Louisville, KY)
- ** Medical Management Nurse ** **Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training ... members in different states; therefore, Multi-State Licensure will be required.** The ** Medical Management Nurse ** is responsible for review of the most… more
- Humana (Frankfort, KY)
- …of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require ... and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to support the… more
- HCA Healthcare (Frankfort, KY)
- …or limits? Our Frankfort Regional Medical Center team is looking for a Medical Surgical Nurse Director. HCA Healthcare is an advanced healthcare network that ... provider dedicated to its patients, colleagues and communities. Help guide our team as a Medical Surgical Nurse Director and help us improve more lives in more… more
- Molina Healthcare (Louisville, KY)
- **Job Description** **Job Summary** The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring alignment ... supporting our Appeals and Grievances department. We are seeking a Registered Nurse with previous Appeals experience. The candidate must have strong organizational… more
- HCA Healthcare (Frankfort, KY)
- …**Are you passionate about delivering patient-centered care?** Submit your application for Medical Surgical Nurse position and spend more time at the ... clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at Frankfort...within 30 days of employment start date + Registered Nurse + Associate Degree Frankfort Regional Medical … more
- Evolent (Frankfort, KY)
- …of direct clinical patient care + Minimum of one year of experience with medical management activities in a managed care environment + Schedule: Monday-Friday, ... 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
- Fresenius Medical Center (Louisville, KY)
- …care to dialysis patients, in either a chronic or acute setting. + Medical /surgical nursing preferred. + Supervisory or management experience preferred. + ... compliance, and regulatory requirements and programs. As the Charge Nurse , manages the daily decisions to ensure continuity of...direct patient care staff + Promote efficient use of medical supplies. + Attend and participate in monthly Quality… more
- CenterWell (Frankfort, KY)
- …collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria ... clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work… more
- CenterWell (Frankfort, KY)
- …collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria ... experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work… more
- ChenMed (Louisville, KY)
- … management programs, clinical meetings and other meetings. The Nurse Practitioner will adhere to strict departmental goals/objectives, standards of performance, ... we need great people to join our team. The Nurse Practitioner (NP) acts as part of the clinical...is responsible for providing direct patient care in ChenMed/Jencare medical centers, nursing homes, skilled nursing facilities (SNF) and… more
- Fresenius Medical Center (Louisville, KY)
- …communicated to and implemented by the facility staff. + Maintains integrity of medical records and other FMS administrative and operational records. + Complies with ... the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member...**STAFF:** + Responsible for implementation of FMS staffing, and medical supply models, to provide quality patient care, and… more
- Veterans Affairs, Veterans Health Administration (Louisville, KY)
- …Kentucky is currently recruiting for a Mental Health Intensive Case Management Registered Nurse Louisville, Kentucky 603. Responsibilities The Outpatient ... Mental Health (MH) Registered Nurse (RN) executes position responsibilities to improve patient and...program outcomes, and directs team response to psychiatric and medical emergencies. The MH RN executes position responsibilities that… more
- HCA Healthcare (Frankfort, KY)
- …and serving over 31.2 million patient interactions every year, nurses at Frankfort Regional Medical Center have the opportunity to make a real impact. As a(an) Step ... Down Unit Nurse you can be a part of change. **Benefits** Frankfort Regional Medical Center, offers a total rewards package that supports the health, life,… more
- CVS Health (Frankfort, KY)
- …in the US with virtual training.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in ... URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management services that support… more
- HCA Healthcare (Frankfort, KY)
- …and serving over 31.2 million patient interactions every year, nurses at Frankfort Regional Medical Center have the opportunity to make a real impact. As a(an) ICU ... Nurse PRN you can be a part of change. **Benefits** Frankfort Regional Medical Center, offers a total rewards package that supports the health, life, career and… more
- HCA Healthcare (Frankfort, KY)
- …obtained within 30 days of employment start date + (RN) Registered Nurse + Associate Degree Frankfort Regional Medical Center (https://frankfortregional.com/) ... million patient interactions every year, nurses at Frankfort Regional Medical Center have the opportunity to make a real...make a real impact. As a(an) Med Surg Clinical Nurse Coordinator you can be a part of change.… more
- BrightSpring Health Services (Louisville, KY)
- …of HIPAA and OSHA regulations + Demonstrated proficiency in computer-based data management programs, electronic medical record (EMR) systems, and Microsoft ... Company Abode Care Partners Overview Are you a licensed nurse practitioner (NP) looking for a new opportunity? We...structure, you will have the opportunity to grow your medical skills while providing personalized care to seniors and… more
- HCA Healthcare (Frankfort, KY)
- …celebrated for being on the front line, empathetic for patients. At Frankfort Regional Medical Center our nurses set us apart from any other healthcare provider. We ... are seeking a(an) ICU Nurse to join our healthcare family. Benefits Frankfort Regional Medical Center, offers a total rewards package that supports the health,… more
- HCA Healthcare (Frankfort, KY)
- …and serving over 31.2 million patient interactions every year, nurses at Frankfort Regional Medical Center have the opportunity to make a real impact. As a(an) ICU ... Nurse you can be a part of change. **Benefits** Frankfort Regional Medical Center, offers a total rewards package that supports the health, life, career and… more
- HCA Healthcare (Frankfort, KY)
- …$25,000 Sign-On Bonus Do you have the career opportunities as a(an) Step Down Nurse you want with your current employer? We have an exciting opportunity for you ... to join Frankfort Regional Medical Center which is part of the nation's leading...Do you want to work as a(an) Step Down Nurse where your passion for creating positive patient interactions… more