- Elevance Health (Cincinnati, OH)
- …an expanding set of clinical domains, including radiology, cardiology and oncology. ** Nurse Reviewer I** **Location:** The selected candidates must reside in ... hours from 9:00 am-6:00 pm, rotating weekend shifts. The ** Nurse Reviewer I** is responsible for conducting...that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or… more
- Dialysis Clinic, Inc. (Cincinnati, OH)
- …with a lower caregiver-to-patient ratio than other providers. The **Dialysis Charge Nurse ** supervises nursing personnel to ensure every patient receives the safest ... set upon hiring. **Benefits:** + Paid training with preceptor + Charge nurse continuing education classes + Comprehensive medical, dental and vision benefits +… more
- Gentiva (Cincinnati, OH)
- …care for everyone, so we offer ongoing professional training, lower nurse -to-patient ratios, and comprehensive benefits for eligible employees. Here, you'll join ... difference in people's lives every day. **Overview** We're looking for a **Hospice Nurse Practitioner** to join our team.You will report directly to the Executive… more
- Insight Global (Cincinnati, OH)
- Job Description Insight Global Health is looking for an experienced Trauma OR Nurse for one of our large Level 1 Trauma Center clients in the Cincinnati, OH area! ... brand new facility and adding 8 new operating rooms. This Trauma OR Nurse will be responsible for providing high-level emergency care to patients suffering from… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …Primary Function/General Purpose of Position** In the capacity of a Registered Nurse , the Ambulatory Care Manager will provide clinical care management services to ... care plans to maximize healthcare outcomes and facilitate wellness with periodic review and update according to department protocols. + Perform medication review… more
- Elevance Health (Cincinnati, OH)
- **Telephonic Nurse Case Manager II** **Location: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point location.** ... the assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of… more
- Elevance Health (Cincinnati, OH)
- **Diagnosis Related Group Clinical Validation Auditor-** **Registered Nurse ** **Location:** This position will work a hybrid model (remote and office). Ideal ... documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims. **How you will make… more
- CommuniCare Health Services Corporate (Cincinnati, OH)
- Registered Nurse (RN), Mobile MDS Coordinator CommuniCare Health Services is currently looking for a Registered Nurse to fill the key position of RN Mobile MDS ... + Weekly visits to facilities for intervention, audit and training + Review resident clinical records for coverage, utilization, errors, assessments and accurate… more
- Elevance Health (Mason, OH)
- ** Nurse and CPC - Clinical Fraud Investigator II - SIU Fraud & Abuse** **Location:** This position will work a hybrid model (remote and office). The ideal candidate ... opportunities for fraud and abuse prevention and control. + Review and conducts analysis of claims and medical records...Skills, Qualifications, and Experiences:** + Fraud and Abuse experienced Nurse with a CPC are highly desired. For candidates… more
- Insight Global (Cincinnati, OH)
- …team strives to create a supportive, team-oriented environment. Responsibilities The Registered Nurse (RN) is an individual who holds a current state license to ... we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ . Skills… more
- Insight Global (Cincinnati, OH)
- …shifts ONLY -13 week contract with extension possibilities Job Responsibilities The Registered Nurse is an individual who holds a current state license to practice ... we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ . Skills… more
- Molina Healthcare (Covington, KY)
- **JOB DESCRIPTION** **_For this position we are seeking a (RN) Registered Nurse with previous experience in Hospital Acute Care, Concurrent Review / Utilization ... Review / Utilization Management and knowledge of Interqual / MCG guidelines. WI or COMPACT RN LICENSURE IS REQUIRED within 30 days of employment._** **_Ability/knowledge to cross train, inpatient medical to inpatient BH or inpatient Medical to PA is… more
- Molina Healthcare (Cincinnati, OH)
- …meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital or medical ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing (RN) license in good standing. Preferred Experience Previous experience in hospital Acute care, ER or ICU Previous experience with InterQual or… more
- Elevance Health (Cincinnati, OH)
- …precertification, prior authorization, and post service requests. + Refers cases requiring clinical review to a Nurse reviewer . + Responsible for the ... I** will be responsible for coordinating cases for precertification and prior authorization review . **How you will make an impact:** + Managing incoming calls or… more
- Fresenius Medical Center (Florence, KY)
- …dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance ... significant information and/or change in patient condition directly to the registered nurse or supervisor. + Observe patient and conduct machine safety checks… more
- Molina Healthcare (Cincinnati, OH)
- …be supporting our Appeals and Grievances department. We are seeking a Registered Nurse with previous Appeals and Grievances experience and a clinical background. The ... and production levels are maintained + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management… more
- Molina Healthcare (Cincinnati, OH)
- …and medical records to document relevant findings of a post pay clinical review . This position manages documents and prioritizes case load to ensure timely turn ... guidelines, internal policies, and contract requirements. This position completes a medical review to facilitate a referral to law enforcement or for payment… more
- HCA Healthcare (Cincinnati, OH)
- …to function effectively in the healthcare environment. + Participates in the review of the curriculum to ensure integrity, rigor, and currency. Participates in ... **Active, Current, Unencumbered Licensure:** Applicable state as a Registered Nurse and per State Board of Nursing . **Education...two (2) years of clinical experience as a Registered Nurse **and** per State Board of Nursing . **Physical/Mental… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …daily and/or shift work schedules, which reflect forecasted needs in collaboration with nurse managers + Approve or deny all schedule requests based on skill mix ... electronic staffing system. Effectively communicates critical or immediate staffing needs to nurse manager or their designee. + Approve or deny all timecard requests… more
- Insight Global (Cincinnati, OH)
- Job Description An employer in the Cincinnati, OH is seeking a Licensed Practical Nurse or a Certified Medical Assistant for a contract to hire opportunity. This ... and completing all the prep work before the patient is seen by the Nurse Practitioner. They will also draw blood, upload results into mychart, make phone calls… more