- Evolent (Columbus, OH)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as... medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all… more
- Fresenius Medical Center (Columbus, OH)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture...a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in… more
- Molina Healthcare (Columbus, OH)
- **Job Description** **Job Summary** The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring ... Michigan RN license is required. **Job Duties** + Facilitates clinical / medical reviews of retrospective medical ...nursing experience, including at least 1 year of utilization review , medical claims review , long-term… more
- CVS Health (Columbus, OH)
- …lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review , you'll play a vital ... to implement, coordinate, monitor and evaluate medical review cases. + Applies the appropriate clinical ...referral as needed. + Assists management with training new nurse reviewers/business partners or vendors to include initial and… more
- OhioHealth (Columbus, OH)
- …Duties:** 1. 25% Screens and processes donors to include phone calls, sending packets, review completed packet, obtain medical release for donor and her baby, ... careers and in our communities. **Job Description Summary:** The Clinical Coordinator supports the day to day operations of...facilitates lab work with results review and transfer of milk to a collection site… more
- Veterans Affairs, Veterans Health Administration (Columbus, OH)
- …preceptor providing didactic and clinical instruction in anesthesia to student nurse anesthetists, medical and dental residents, and other health care ... Summary The Advanced Practice Nurse (APN) Certified Nurse Anesthetist (CNA)...induction, maintenance, and emergence; post anesthesia care; peri-anesthetic and clinical support functions; and emergency response techniques. Develops and… more
- Veterans Affairs, Veterans Health Administration (Columbus, OH)
- …supervision of a Registered Nurse and/or LIP and is directly responsible to the Clinical Nurse Manager or designee. It is the Nurse Manager or designee, ... will work collaboratively with designated providers, nursing staff to provide initial intake, clinical reminders and observe and report reason for the visit to the… more
- Gentiva (Columbus, OH)
- …(LCD) criteria per hospice policy and regulatory requirements. + Communicate clinical findings, review treatment plans, lab results, diagnostics, and ... Partnerships. Transform Hospice Care.** We are seeking a dedicated Hospice Nurse Practitioner to perform Face-to-Face (F2F) encounters essential for hospice… more
- Humana (Columbus, OH)
- …guidance where needed. Follows established guidelines/procedures. **KEY ACCOUNTABILITIES** + Review medical documentation, obtain additional information that may ... community and help us put health first** The Appeals Nurse 2 resolves clinical complaints and appeals....TRICARE, all HGB policies and procedures as well as medical necessity review criteria and privacy requirements… more
- Humana (Columbus, OH)
- …and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis ... independent determination of the appropriate courses of action. The Nurse Auditor 2 validates and interprets medical ...coding experience to conduct a clinical validation review of the inpatient medical record to… more
- Trinity Health (Columbus, OH)
- …clinical and coding expertise to direct efforts toward the integrity of clinical documentation through the roles of reviewer , educator and consultant. ... Facilitates the overall quality, completeness, accuracy, and integrity of medical record documentation through extensive record review . Through extensive… more
- Cardinal Health (Columbus, OH)
- …both scheduled outbound calls and inbound call queue. + Meets regularly with Clinical Supervisor and/or Senior Nurse , Individualized Care to discuss feedback ... who need them-faster.** **_What Individualized Care contributes to Cardinal Health_** Clinical Operations is responsible for providing clinical specialties… more
- Veterans Affairs, Veterans Health Administration (Columbus, OH)
- …based upon data collected and identified patient/family needs. The LPN requires a general review of their work by the Specialty Nurse Manager for appropriateness ... of Endocrinology experience preferred VA Careers - Licensed Practical Nurse : https://youtube.com/embed/Ae85IP1Oiz4 Total Rewards of a Allied Health Professional The… more
- Veterans Affairs, Veterans Health Administration (Columbus, OH)
- …and record relevant patient information. Completed work should need only a general review by a registered nurse (RN) or Licensed Independent Practitioner (LIP) ... will work collaboratively with designated providers, nursing staff to provide initial intake, clinical reminders and observe and report reason for the visit to the… more
- Elevance Health (Columbus, OH)
- …legal, management, and executive leadership by managing State Fair Hearing and External Medical Review requests. .Acts as a resource for both clinical ... ** Nurse Appeals -Licensed Nurse ** **Location** :...accurate entry, investigation, and analysis of state appeals; summarizing medical information for review by medical… more
- OhioHealth (Columbus, OH)
- …to provide care to neuro patients. You will provide patient education support, review medical history and provide surgery follow-up care. In addition, you ... will use your clinical expertise to address triage and medical ...personnel (UAPs) using the criteria written in the Ohio Nurse Practice Act. According to department policies and nursing… more
- Datavant (Columbus, OH)
- …years of CDI experience + 3+ years of clinical experience in an academic medical center + Registered Nurse license, Bachelor's degree in Nursing + CCDS or ... realize our bold vision for healthcare. **What We're Looking For:** As a Clinical Documentation Quality Improvement (CDQI) Specialist, you will play a pivotal role… more
- Highmark Health (Columbus, OH)
- …:** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** This job performs clinical review and data abstraction of patient records to support ... Preferred + Associate's or Bachelor's Degree in Nursing + 1 year performing medical record review and data abstraction for cardiovascular registries + Proficient… more
- Surgery Care Affiliates (Dublin, OH)
- …do it. Each decision we make is rooted in seven core values: + Clinical quality + Integrity + Service excellence + Teamwork + Accountability + Continuous improvement ... package to support your health, well-being, and financial future. Our offerings include medical , dental, and vision coverage, 401k plan with company match, paid time… more
- Select Medical (Columbus, OH)
- …of medical rehabilitation. They assess patients to determine individual care needs, review medical records, and meet with hospital teams to coordinate safe ... **Overview** **Ohio Health Rehabilitation Hospital** A joint venture with Select Medical & Hospital Columbus, OH **Annual Base Salary between $70,000 and $95,000**… more