- Molina Healthcare (Columbus, OH)
- **Job Description** **Job Summary** The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring ... nursing experience, including at least 1 year of utilization review , medical claims review , long-term...or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must… 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 operations. ... a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in...+ Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. +… 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 ... skills in a collaborative process to implement, coordinate, monitor and evaluate medical review cases. + Applies the appropriate clinical criteria/guideline and… more
- OhioHealth (Columbus, OH)
- …**Minimum Qualifications:** Associate's Degree: NursingBLS - Basic Life Support - American Heart Association, RN - Registered Nurse - Ohio Board of Nursing ... to neuro patients. You will provide patient education support, review medical history and provide surgery follow-up...continuum of care in diverse health care settings. The RN is accountable for the practice of nursing as… more
- Surgery Care Affiliates (Dublin, OH)
- …change. If you join our team, they will. Responsibilities We are actively hiring for an Registered Nurse ( RN ) PreOp PACU. + Promote the mission, vision, and ... your health, well-being, and financial future. Our offerings include medical , dental, and vision coverage, 401k plan with company...to care. + Delegate tasks according to the state Nurse Practice Act (if applicable), state board of nursing… more
- MTC (Marion, OH)
- …and confidentiality of all medical records; observe applicable HIPAA rules. 15. Review medical files to determine all provided services are documented. 16. ... Full-Time, Monday - Friday, 8:00am - 3:00pm **Benefit package includes:** + Medical , vision, and prescription drug benefits + Dental benefits + Life insurance… more
- Molina Healthcare (Columbus, OH)
- 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
- 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 and ... ** Nurse Appeals -Licensed Nurse ** **Location** :...accurate entry, investigation, and analysis of state appeals; summarizing medical information for review by medical… more
- Molina Healthcare (Columbus, OH)
- …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 (Columbus, OH)
- …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
- Evolent (Columbus, OH)
- …the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... are performed within the ** RN /LVN/LPN** scope of practice, under the Medical ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate,… more
- CenterWell (Marion, OH)
- …+ Graduate of an accredited School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's license, auto insurance ... sit on-site at our Marion, OH branch location.** The ** RN Clinical Manager** coordinates and oversees all direct care...and reliable transportation. + Two years as a Registered Nurse with at least one-year of… more
- Humana (Columbus, OH)
- …an impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and… more
- BrightSpring Health Services (Columbus, OH)
- Our Company ResCare Community Living Overview Works under the supervision of a Registered Nurse . Duties include providing routine care, general observation of ... .* Ensures incidents are recorded, the individual is safe, receives required medical care, communicates to RN , operations leadership timely* Transcribes… more
- Veterans Affairs, Veterans Health Administration (Columbus, OH)
- …information. Completed work should need only a general review by a registered nurse ( RN ) or Licensed Independent Practitioner (LIP) for appropriateness ... and observe and report reason for the visit to the provider and/or RN in the clinic. Responsibilities Preferred Experience: 1-2 years of Renal experience preferred… more
- OhioHealth (Columbus, OH)
- …to ensure holistic patient needs are met. **Minimum Qualifications:** Bachelor's Degree: Nursing (Required) RN - Registered Nurse - Ohio Board of Nursing ... to prepare patients and families for transplantation; gather and review medical and social history. Coordinate pre-transplant...**SPECIALIZED KNOWLEDGE** Minimum 2 years of experience as a nurse in transplant or at least 5 years of… more
- Veterans Affairs, Veterans Health Administration (Columbus, OH)
- …of practice: The Licensed Practical Nurse functions under the supervision of a Registered Nurse and/or LIP and is directly responsible to the Clinical ... and observe and report reason for the visit to the provider and/or RN in the clinic. Responsibilities **1-2 years Cardiology experience preferred** VA Careers -… more
- Fresenius Medical Center (Marion, 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
- Humana (Columbus, OH)
- …each day between 6AM and 9AM in their home time zone. **Required Qualifications** + Active Registered Nurse ( RN ) license in the state they reside. + Minimum ... independent determination of the appropriate courses of action. The Nurse Auditor 2 validates and interprets medical ...clinical and coding experience to conduct a clinical validation review of the inpatient medical record to… more
- Veterans Affairs, Veterans Health Administration (Columbus, OH)
- …Practice Nurse (APN) Certified Nurse Anesthetist (CNA) is a Certified Registered Nurse Anesthetist (CRNA). The CRNA provides a full range of services ... mentor or preceptor providing didactic and clinical instruction in anesthesia to student nurse anesthetists, medical and dental residents, and other health care… more