- Elevance Health (Louisville, KY)
- ** Clinical Review Nurse I** **National Government Services** is a proud member of Elevance Health's family of brands. We administer government contracts for ... Friday 8 am - 5 pm EST or CST. Hours are flexible.** The ** Clinical Review Nurse I** is responsible for reviewing and making medical determinations as… more
- Elevance Health (Louisville, KY)
- **Diagnosis Related Group Clinical Validation Auditor-** **Registered Nurse ** **Location:** This position will work a hybrid model (remote and office). Ideal ... miles of one of our PulsePoint locations. The **Diagnosis Related Group Clinical Validation Auditor** is responsible for auditing inpatient medical records to ensure… more
- Elevance Health (Louisville, KY)
- ** Nurse and CPC - Clinical Fraud...opportunities for fraud and abuse prevention and control. + Review and conducts analysis of claims and medical records ... locations. **Hybrid Workplace Strategy:** 1-2 days in office per week The ** Clinical Fraud Investigator II** is responsible for identifying issues and/or entities… more
- Fresenius Medical Center (Radcliff, KY)
- …or federal surveys. + Participates in the completion of the FMS Administrative Clinical Review . **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical ... requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory… more
- Fresenius Medical Center (Louisville, KY)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- Elevance Health (Louisville, KY)
- …outpatient precertification, prior authorization, and post service requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for ... I** will be responsible for coordinating cases for precertification and prior authorization review . **How you will make an impact:** + Managing incoming calls or… more
- ChenMed (Louisville, KY)
- …degree in a related clinical field preferred. + A valid, active Registered Nurse (RN) license in State of employment required. + A minimum of 2 years' ... people to join our team. * The Acute Care Nurse is responsible for achieving positive patient outcomes, managing...diagnosis during acute stay and provide PCP documentation to review and add to patient problem list. + Contacts… more
- ChenMed (Louisville, KY)
- …our team. The Nurse Practitioner (NP) acts as part of the clinical operations team and is responsible for providing direct patient care in ChenMed/Jencare ... This position may require participation in risk and quality management programs, clinical meetings and other meetings. The Nurse Practitioner will adhere… more
- CenterWell (Louisville, KY)
- …clinicians and provides feedback to the clinician. + Works with clinicians to review application of clinical documentation and forms. + Reviews Orientation ... and help us put health first** As an **RN** ** Nurse Preceptor** , you will: + Position is responsible...you will: + Position is responsible for providing practical clinical experience and guidance to field clinicians to include… more
- CenterWell (Louisville, KY)
- …teamwork and providing a positive and welcoming environment for all. Responsibilities: The Nurse Practitioner (NP) works in our team-based care environment. We are a ... team consists of doctors, advanced practice professionals, Pharm D, Care Coach Nurse , MA, Behavioral health specialist, Quality based Coder, Referral Coordinator and… more
- BrightSpring Health Services (Louisville, KY)
- …available immediately Updated Available Schedule: Friday-Sunday 6pm-6am CST This Registered Nurse provides On-Call and Triage for the assigned population in ... (web) chat, or email + Ensure compliance with state/local/payer requirements through review of documentation + Provide coaching and education related to the health… more
- YesCare Corp (Louisville, KY)
- …every 3rd week** Below is a list of your responsibilities as a ** Nurse Practitioner (NP/ARNP)** withYesCare: + Provides typical community standard care based on ... evidenced based medicine for clinical services required including but not limited to sick...in-service education of staff as requested. Participates in monthly review of quality of care and chart reviews as… more
- Fresenius Medical Center (Shepherdsville, KY)
- …regulations at: https://content.intranet.fmcna.com/regulatory-affairs/wp-content/uploads/sites/46/2019/05/Pre-Licensed- Nurse -50-State- Review ... of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a...for other staff members. + Routinely meets with the Clinical Manager to discuss personnel and patient care status,… more
- Elevance Health (Louisville, KY)
- **Telephonic Nurse Case Manager II** **Location: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point location.** ... hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management...a health-related field and minimum of 5 years of clinical experience; or any combination of education and experience,… more
- YesCare Corp (Louisville, KY)
- …**Responsibilities** Below is a list of your responsibilities as a **Registered Nurse Charge** with YesCare at the Louisville Detention Center in Louiville, KY ... and other members of the interdisciplinary team to develop and initiate health review . + Supervises the preparation of records of nursing care and other treatments… more
- CenterWell (Elizabethtown, KY)
- …policies and standards. + Assesses staff education needs based on own the review of clinical documentation in addition to feedback and recommendations by ... us put health first** $10k Sign on Bonus! The ** Clinical Manager** coordinates and oversees all direct care patient...Utilization Review staff. Upon completion of the assessment, creates and… more
- HCA Healthcare (Louisville, KY)
- …in Nursing (BSN) Degree . **Experiential Qualifications:** Minimum of two (2) years of clinical experience as a Registered Nurse **and** per State Board of ... are currently looking for an ambitious Nursing Faculty - Clinical to help us reach our goals. Unlock your...effectively in the healthcare environment. + Participates in the review of the curriculum to ensure integrity, rigor, and… more
- Molina Healthcare (Louisville, KY)
- **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), ... in managed care, medical or behavioral health settings. + Two years of clinical auditing/ review experience. To all current Molina employees: If you are… more
- Molina Healthcare (Louisville, KY)
- **JOB DESCRIPTION** **_For this position we are seeking a (RN) Registered Nurse with previous experience in Hospital Acute Care, Concurrent Review / Utilization ... compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical… more
- Molina Healthcare (Louisville, KY)
- …compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical ... in consistent and efficient manner. + Makes appropriate referrals to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care… more