- Evolent Health (Columbus, OH)
- …results, and collaborating with others. **Collaboration Opportunities** : The Lead Nurse of Utilization Management is responsible for assisting the ... UM Manager in supervising the operational productivity of the Utilization Management nurses by implementing and maintaining...flow of information through the UM department. The UM Lead , in collaboration with the UM Manager and Director,… more
- Trinity Health (Columbus, OH)
- …Associates degree from an accredited RN program + Current license to practice as registered nurse in the State of Ohio + Minimum of 3-5 years recent clinical ... **Employment Type:** Part time **Shift:** Day Shift **Description:** ** RN Case Manager - Casual / PRN** Our...This is done with the intentions of cost effective utilization of hospital resources, minimizing out of pocket expenses… more
- Elevance Health (Columbus, OH)
- ** RN Hospital Bill Audit/Appeal Lead ** **Supports the Carelon Payment Integrity line of business** _Location: This position will work a hybrid model (remote and ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** RN Hospital Audit/Appeal Lead ** is responsible for leading a team… more
- Trinity Health (Dublin, OH)
- …Bachelor's degree from an accredited RN program + Current license to practice as registered nurse in the State of Ohio + Minimum of 3-5 years recent clinical ... **Employment Type:** Full time **Shift:** Day Shift **Description:** RN Case Manager - Full-time **About Mount Carmel Dublin:** Mount Carmel Dublin will be an… more
- Trinity Health (Columbus, OH)
- …lieu of a RN ..** **Licensure / Certification: Current license to practice as registered nurse in the State of Ohio.** ** Registered Health Information ... Specialist (CCS) will be considered in lieu of a RN .** **Experience: Minimum of 5 years acute care medical...5 years acute care medical or surgical experience required;** ** Utilization /Case Management , managed care, or Clinical Documentation… more
- CVS Health (Columbus, OH)
- …OhioRISE program. Health Services strategies, policies, and programs are comprised of utilization management , quality management , network management ... LPPC, LPPC-S, LISW, LISW-S) **Education** Master's degree in behavioral health field; or Registered Nurse (BSN preferred) **Pay Range** The typical pay range for… more
- Elevance Health (Columbus, OH)
- …for managing a team of physical and/or responsible for coordinating member service, utilization , access, care management and/or concurrent review to ensure cost ... minimum of 5 years of experience in Health Care Management ; or any combination of education and experience, which...which would provide an equivalent background. Current active unrestricted RN , PA, LSW, LCSW, LPC, LMHC or other accepted… more
- Trinity Health (Canal Winchester, OH)
- …a community and customer service focus. **Job Relationships** _Reports to:_ Clinical Nurse Manager, Assistant Clinical Manager, Charge Nurse or designee ... Patient Care** : + Under the direction of an RN , or other licensed staff member. + Delivers patient...other licensed staff member, performs: + EKG & Monitor lead placement. + Phlebotomy. + Orthopedic skills (ie) splinting,… more
- Elevance Health (Columbus, 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
- Trinity Health (Westerville, OH)
- …Responsible for quality and standards of patient care, performance improvement, program management , business operations, budget and resource utilization , and ... areas, focusing on optimal patient outcomes, regulatory, compliance, risk management , and continuous quality and process improvement. **Minimum Qualifications:** +… more