- Insight Global (Cincinnati, OH)
- …Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ . Skills and Requirements Registered Nurse * 2 years experience of neuro, ... Global Health is looking for an experienced Trauma OR Nurse for one of our large Level 1 Trauma...Trauma Center clients in the Cincinnati, OH area! The Medical Center is opening brand new facility and adding… more
- Elevance Health (Mason, OH)
- **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role enables associates to work virtually ... opportunities for fraud and abuse prevention and control. + Review and conducts analysis of claims and medical...Skills, Qualifications, and Experiences:** + Fraud and Abuse experienced Nurse with a CPC are highly desired. For candidates… more
- Molina Healthcare (Covington, KY)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support...licensure, Diagnosis-Related Group (DRG) experience, 2 years of Utilization Review and/or Medical Claims Review … more
- Molina Healthcare (Covington, KY)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Covington, KY)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Molina Healthcare (Cincinnati, OH)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and… more
- Fresenius Medical Center (Cincinnati, OH)
- **PURPOSE AND SCOPE:** Functions as part of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a Staff ... Registered Nurse , to ensure provision of quality patient care on a daily basis in accordance with FMS policies, procedures, and training. Supports the FMCNA's… more
- Elevance Health (Mason, OH)
- …and efficiency recommendations. **Minimum Requirements:** + Requires current, active, unrestricted Registered Nurse license in applicable state(s). + Requires a ... is granted as required by law. The **Diagnosis Related Group Clinical Validation Auditor- RN ** is responsible for auditing inpatient medical records to ensure… more
- Fresenius Medical Center (Cincinnati, OH)
- …effective dialysis therapy for assigned patients under the direct supervision of a registered nurse . Participates in the implementation and evaluation of patient ... as your own._ **Connect with your goals and change lives** **with Fresenius Medical Care North America.** Here, we make connections that empower patients, their… more
- IQVIA (Cincinnati, OH)
- Our **MedTech Registered Nurse Liaison** experiences a unique opportunity and leverage your clinical expertise in a dynamic role that goes beyond bedside care. ... with healthcare professionals and advocate for the well-being of patients through medical device technology. You will be responsible for assisting the service team… more
- Elevance Health (Cincinnati, OH)
- …benefits. Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or ... CST, with a comp day during the week) The ** Nurse Reviewer I** is responsible for conducting preauthorization, out...meets medical necessity criteria or requires additional medical necessity review . + Conducts initial … more
- Elevance Health (Mason, OH)
- …formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The ** Nurse Audit Senior** will be responsible ... ** Nurse Auditor Senior - Payment Integrity Complex and...impact:** + Investigates potential fraud and over-utilization by performing medical reviews via prepayment claims review and… more
- Elevance Health (Mason, OH)
- **Telephonic Nurse Case Manager II** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management...management plan and modifies as necessary. + Interfaces with Medical Directors and Physician Advisors on the development of… more
- Elevance Health (Cincinnati, OH)
- **Telephonic Nurse Case Manager II** **Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management...management plan and modifies as necessary. + Interfaces with Medical Directors and Physician Advisors on the development of… more
- Fresenius Medical Center (Florence, KY)
- …Report any significant information and/or change in patient condition directly to the registered nurse or supervisor. + Observe patient and conduct machine ... policy. Report any change or unusual findings to the registered nurse or supervisor. + Perform and...+ Monitors patients performing self-care under the supervision of RN . **Staff Related** + Assists in training of applicable… more
- Elevance Health (Mason, OH)
- ** Medical Management Clinician Senior** **Location:** This role enables...do not require the training or skill of a registered nurse . Acts as a resource for ... Monday - Friday 8a - 5p EST (with weekend rotation)** The ** Medical Management Clinician Senior** is responsible for ensuring appropriate, consistent administration… more
- Deloitte (Cincinnati, OH)
- …degree in nursing, medical degree, or physician assistant required + Current Registered Nurse ( RN ) license required + Certified Clinical Documentation ... (CRC, CCA, CCS-P, CCS, CPC, CDIP, CCM) + Experience as clinical registered nurse , physician, physician assistant, case manager, clinical documentation… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …notifies/pages charge nurse or designate of witnessed changes. Documents changes for review RN (ie, saves, times, strips). Sets and checks alarm system. ... Tech is responsible for directing the flow of information between nursing and medical staff, patient and family, and healthcare team and support services. +… more