- 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
- ChenMed (Louisville, KY)
- …We're rapidly expanding and we need great people to join our team. The Registered Nurse , Care Line, is responsible for providing telephonic triage directional ... Triage assessments within license and as possible given technology and medium. The registered nurse collaborates with primary caregivers and others on the… more
- Molina Healthcare (Louisville, KY)
- …knowledge on the job. Job Qualifications **REQUIRED EDUCATION** : Completion of an accredited Registered Nurse ( RN ) Program and an Associate's or Bachelor's ... Responsible for the development, implementation, and delivery of training curriculum for Utilization Management , Case Management , and LTSS staff. Leads… more
- Molina Healthcare (Louisville, KY)
- …Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + ... as may be required. + Serves as a clinical resource for Utilization Management , Chief Medical Officer, Physicians, and Member/Provider Inquiries/Appeals. +… more
- Elevance Health (Louisville, KY)
- RN Nurse Case Manager II (10:30am - 7:00pm Central Time) JR144435 **Work Hours:** Monday - Friday, 10:30am - 7pm Central Time **Locations** : This position is ... with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + BA/BS in… 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
- Molina Healthcare (Louisville, KY)
- …materials and other related documentations. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of ...years in one or more of the following areas: utilization management , case management , care… more
- Molina Healthcare (Louisville, KY)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States...transplants; the ideal candidate will have experience either in utilization review or case management for transplants.… more
- Molina Healthcare (Louisville, KY)
- …Practical Nurse in good standing. **Preferred Education** Completion of an accredited Registered Nurse ( RN ) Program or a bachelor's degree in Nursing. ... contained in the delegation agreement. **KNOWLEDGE/SKILLS/ABILITIES** The Delegation Oversight Nurse is responsible for ensuring that Molina Healthcare's UM… 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)
- …with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures **Minimum Requirements:** + Requires ... ** Nurse Case Manager II** **Location:** Alternate locations may... Case Manager II** will be responsible for care management within the scope of licensure for members with… more
- Elevance Health (Louisville, KY)
- …with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires ... **Telephonic Nurse Case Manager II** **Location: This is a... Case Manager II** is responsible for performing care management within the scope of licensure for members with… more
- Elevance Health (Louisville, KY)
- **Telephonic Nurse Disease Management II** **$2000 Sign on Bonus** **Federal Employee Program - FEP** , a proud member of the Elevance Health, Inc. family of ... EST or 2:30 pm - 11 pm EST.** The **Telephonic** **N** **urse Disease Management II** will be responsible for telephonic outreach, enrollment, and management of… more
- Molina Healthcare (Louisville, KY)
- …performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), ... identifying opportunities for improvement. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational… more
- Molina Healthcare (Louisville, KY)
- …integrated) performing one or more of the following activities: utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.). ... identifying opportunities for improvement. **Job Qualifications** **REQUIRED EDUCATION** : Registered Nurse or equivalent combination of Licensed Vocational… more
- Molina Healthcare (Louisville, KY)
- …on business need (up to 25%) **Job Qualifications** * Active and unrestricted Registered Nurse ( RN ) license or independent behavioral health license ... **Job Description** Looking for a Registrared Nurse or Licensed Social worker to support HealthPlans...experience in health care * Understanding of clinical operations: utilization management , case management , etc.… more