- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Columbus, OH)
- …to make health care more personal, convenient and affordable. This is a full-time remote position. Utilization management is a 24/7 operation. Work schedules ... **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current...clinical experience in acute or post acute setting + Utilization management is a 24/7 operation. Work… more
- Sharecare (Columbus, OH)
- …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... and their Primary Care Provider according to the disease management program intervention guidelines. An RN is...the disease management program intervention guidelines. An RN is supervised by an Operations Manager (OM). All… more
- Veterans Affairs, Veterans Health Administration (Grove City, OH)
- Summary The Outpatient Mental Health (MH) Registered Nurse ( RN ) promotes personal growth and development of psychiatric-mental health nursing practice. ... for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care....level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- CVS Health (Columbus, OH)
- …care more personal, convenient and affordable. **Position Summary** This is a fulltime remote Utilization Review opportunity. Working hours are four 10hr days ... external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set...by their Leader. **Required Qualifications** + Active and unrestricted Registered Nurse in state of residence +… more
- Humana (Columbus, OH)
- …Family Therapist **(LMFT)** , Licensed Professional Counselor **(LPC)** , Psychologist **(PhD)** , Registered Nurse **( RN )** or other professional license. + ... us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral health… more
- CVS Health (Columbus, OH)
- …convenient and affordable. **Position Summary:** This Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can live in ... of the department.** **No travel is required.** As a Utilization Management Nurse Consultant, you...the coordination and administration of the utilization /benefit management function. **Required Qualifications** + RN with… more
- Highmark Health (Columbus, OH)
- …Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care ... depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS** + Working knowledge of… more
- Guardian Life (Columbus, OH)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...plan and length of disability. Plan for ongoing case management through proactive partnering with treating providers to move… more
- Highmark Health (Columbus, OH)
- … - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health care ... Experience in a clinical setting **Preferred** + Certification in utilization management or a related field +...and Family Therapist (LMFT) + Licensed Behavior Specialist + Registered Nurse . **Preferred** + None **SKILLS** +… more
- CVS Health (Columbus, OH)
- …+ 5+ years of clinical experience required + 2+ years of experience as a Registered Nurse + Must have active, current and unrestricted RN licensure ... reimbursement policy. + 1+ year of Coding experience **Preferred Qualifications** + Utilization Management review + Managed Care experience **Education** +… 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