- Humana (Louisville, KY)
- …and help us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Nurse 2 who will utilize clinical nursing skills to ... benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work...30 miles of Lexington or Louisville, Kentucky.** + Licensed Registered Nurse ( RN ) in the… more
- Signature Healthcare (Louisville, KY)
- …Care documentation to facility accurate billing. What you Need to make a Difference + Registered Nurse ( RN ) in good standing with required current state ... communication with leadership, patients, families, internal care givers, and external Utilization Management Nurses. + Coordinate internal and external health… more
- Fresenius Medical Center (Louisville, KY)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... of education and experience. + Graduate of an accredited School of Nursing ( RN ). + Current appropriate state licensure. **EXPERIENCE AND SKILLS:** + Required: + 6+… more
- Molina Healthcare (Louisville, KY)
- …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
- CenterWell (Louisville, KY)
- …license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home care, ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- ChenMed (Louisville, KY)
- …RN with bachelor's degree in a related clinical field preferred. + A valid, active Registered Nurse ( RN ) license in State of employment required. + A ... people to join our team. * The Acute Care Nurse is responsible for achieving positive patient outcomes, managing...experience required. + A minimum of 1 year of utilization review and/or case management , home health,… more
- Molina Healthcare (Louisville, 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 ...care/medical experience. **Required License, Certification, Association** Active, unrestricted Wisconsin Registered Nursing ( RN ) license in good standing.… more
- Wellpath (La Grange, KY)
- …Surgical experience preferred Licenses/Certifications + Have and maintain current licensure as a Registered Nurse within the state of employment. + Obtain and ... maintain CPR certification **Additional Details** -Candidate needs to be licensed as a Registered Nurse in the state of KY **We are an Equal Employment… more
- Molina Healthcare (Louisville, KY)
- …driver's license **PREFERRED EDUCATION:** **PREFERRED EXPERIENCE:** + 3-5-year experience as a Registered Nurse and/or Nurse Practitioner, ideally in a ... **JOB DESCRIPTION** **Job Summary** The Care Connections Nurse Practitioners focus on screening and preventive primary care services delivered in the home,… more
- Elevance Health (Louisville, KY)
- **Medical Management Nurse ** **Federal Employee Program - FEP** , a proud member of the Elevance Health, Inc. family of companies, it is a powerful combination, ... pm (EST) shift rotation twice a month.** The **Medical Management Nurse ** is responsible for reviewing the...experience and requires a minimum of 2 years clinical, utilization review, or managed care experience; or any combination… more