- Molina Healthcare (Covington, KY)
- …are seeking a Registered Nurse or Licensed Social Worker with PSYCH / BH Utilization Review / Utilization Management and knowledge of Interqual / MCG ... for this role. We can consider a RN (Registered Nurse ), LCSW, LMFT, or LPCC._** **_WORK SCHEDULE: SUNDAY thru...requests within required timelines. + Refers appropriate cases to Medical Directors and presents them in a consistent and… more
- Elevance Health (Cincinnati, OH)
- **Title: Utilization Management Representative I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 ... miles of one of our PulsePoint locations. The ** Utilization Management Representative I** will be responsible...requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data… more
- Elevance Health (Mason, OH)
- …Elevance Health office.** **HOURS** **: Monday - Friday, 8am - 5pm, EST.** The Nurse Medical Management I is responsible to collaborate with healthcare ... to ensure medically appropriate, high quality, cost effective care throughout the medical management process. + Collaborates with providers to assess member's… more
- Elevance Health (Cincinnati, OH)
- ** Nurse Medical Management II**...of 3 years acute care clinical experience or case management , utilization management or managed ... within 50 miles of one of our Elevance Health PulsePoint locations. The ** Nurse Medical Management II** will be responsible to collaborate with healthcare… more
- Ciena Healthcare (Hamilton, OH)
- …Medicare days and RUGs utilization in the absence of the Care Management Coordinator **Qualifications:** + Registered Nurse , RN + Knowledge of the Resident ... the industry. This includes:** + Comprehensive health insurance - medical , dental and vision + 401K with matching funds...guests under the direction and supervision of a registered nurse or a licensed practical nurse . Some… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …nurses grow, professionally and personally. **Tier 3 - System Flex Team traveler Registered Nurse (RN)** A Tier 3 - System Flex Team Traveler Registered Nurse ... through the relevant Standards and Scope of Practice for the Registered Nurse by analyzing, planning, implementing and evaluating patient care following established… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …operational excellence. **Summary of Primary Function/General Purpose of Position** The Registered Nurse Medical /Surgical functions as a care provider of a ... prior to direct patient care) ACLS Advanced Cardiac Life Support (preferred) Medical -Surgical Nursing Certification RN-BC (Registered Nurse - Board Certified)… more
- Fresenius Medical Center (Cincinnati, OH)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. ... a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in...Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and… more
- Elevance Health (Mason, OH)
- …skills, problem-solving skills, facilitation skills, and analytical skills. + Knowledge of the medical management process and the ability to interpret and apply ... EST.** The **Telephonic** ** Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care… more
- Elevance Health (Mason, OH)
- …in office setting. The ** Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care needs ... with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …clinicians are recognized for clinical and operational excellence. PRN Registered Nurse - Interventional Radiology - Anderson Hospital **Summary of Primary ... partnership * Interprofessional collaboration and leadership * Understanding and utilization of office and clinical technologies * Compassionate, relationship-based… more
- Bon Secours Mercy Health (Green Township, OH)
- …Moon, Bundle letters, and Conditions of Participation for DC Planning and Utilization Management , and address opportunities or potential concerns with ... management , readmission prevention, supports denial prevention related to medical necessity through addressing/removing barriers to progression of care,… more
- ZOLL Medical Corporation (Cincinnati, OH)
- …treat patients suffering from serious cardiopulmonary and respiratory conditions.The Cardiac Management Solutions division of ZOLL Medical Corporation develops ... innovative technologies that make a meaningful difference in people's lives. Our medical devices, software and related services are used worldwide to diagnose and… more
- Molina Healthcare (Covington, KY)
- …REMOTE** **_For this position we are seeking a Registered Nurse with previous Utilization Review / Utilization Management and knowledge of Interqual / ... , or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina… more
- Molina Healthcare (Covington, KY)
- … Nurse with previous experience in Hospital Acute Care, Concurrent Review/ Utilization Review / Utilization Management and knowledge of Interqual ... 30 days of employment._** **_Ability/knowledge to cross train, inpatient medical to inpatient BH or inpatient Medical ...inpatient medical to inpatient BH or inpatient Medical to PA is preferred._** **_Excellent computer skills and… more
- Elevance Health (Mason, OH)
- …required.** **The Transplant Nurse II** is responsible for providing case management and/or medical management (UM/UR) for members receiving transplant ... issues. + Assists with development of utilization /care management policies and procedures. + Within the medical... management policies and procedures. + Within the medical management role will collaborate with healthcare… more
- Bayer (Cincinnati, OH)
- …with sales consultants, key account executives, radiation therapy specialists, oncology nurse educators, , medical affairs, and other internal partners, ... need; 3. Contribute to overall speaker bureau maintenance, including training, utilization tracking, and new speaker identification; 4. Harvest insights during… more