- Humana (Columbus, OH)
- …where your clinical expertise and passion for accuracy will make a meaningful impact. As the Nurse Audit Manager , you will spearhead audit and validation ... relevant coding. + Identifies the root cause analysis of audit findings and submits recommendations for appropriate change management....skills to make an impact** **Required Qualifications** + Registered nurse (RN). + 5 or more years of clinical… more
- Elevance Health (Columbus, OH)
- **Field Nurse - Nurse Case Manager II** **Work location:** This field-based role located in the Columbus, OH area enables associates to primarily operate in ... **Work schedule:** Monday-Friday 9am to 5:30pm EST The **Field Nurse - Nurse Case Manager ...for new care management staff. + Participates in department audit activities. **Minimum requirements:** + Requires BA/BS in a… more
- Elevance Health (Columbus, OH)
- **Telephonic Nurse Case Manager Senior** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person ... in different states; therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager Senior** is responsible for care management within… more
- Trinity Health (Columbus, OH)
- …call your own in Columbus. Learn more at www.experiencecolumbus.com The Registered Nurse Clinical Lead will supervise all clinical staff and assist physicians with ... person's physical, emotional, social and spiritual needs within the scope of the Ohio Nurse Practice Act. The Registered Nurse functioning in the spirit of… more
- Molina Healthcare (Columbus, OH)
- …**PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Certified Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional ... to clinical experience + Documents clinical review summaries, bill audit findings and audit details in the database + Provides supporting documentation for… more
- Molina Healthcare (Columbus, OH)
- …following: + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases… more
- CVS Health (Columbus, OH)
- …travel if a plan sponsor requests pharmacist attendance for an onsite visit/assessment/ audit . The Pharmacy Program Manager role includes: -Collaborate with an ... with heart, each and every day. The Pharmacy Program Manager is an individual contributor (non-people manager )...interdisciplinary care management team ( nurse case managers, medical directors, dietitians, social workers) to… more