- Trinity Health (Columbus, OH)
- **Employment Type:** Part time **Shift:** **Description:** ** Utilization Review RN , Case Management** **Why Mount Carmel?** With five hospitals ... Mount Carmel College of Nursing **About the job:** The ** RN Case Manager, Utilization Review **...Licensure / Certification: Current license to practice as a Registered Nurse ( RN ) in the… more
- CVS Health (Columbus, OH)
- …could be up to 10% in the event of a clinical audit. As a Utilization Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate ... care more personal, convenient and affordable. **Position Summary** This Utilization Management Nurse Consultant (UMNC) position is...or the ability to obtain a compact license + Utilization Review experience + Managed Care background… more
- Fresenius Medical Center (Columbus, OH)
- …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
- AmeriHealth Caritas (Dublin, OH)
- …+ Assist in preparation, coordination, and participation in and follow up of Utilization Management audits, such as readiness review , Data Validation, CMS ... Current and unrestricted RN license in OH. + 3+ years of utilization /case management experience in relevant scope preferred, one year required. + 3+ years… more
- Prime Therapeutics (Columbus, OH)
- …oversight for this program is provided by the Manager, Patient Programs. **Responsibilities** + Registered Nurse ( RN ). + 5 years of post-degree clinical ... Experience in managed care, specialty drugs, care management and utilization review . + Meets Magellan Credentialing criteria....- Preferred: Bachelors - Nursing **Certifications** Certifications - Required: RN - Registered Nurse , State… more
- Lincoln Financial Group (Columbus, OH)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred ... for** Education * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license...in a career at Lincoln, we encourage you to review our current openings and apply on our website.… more
- CVS Health (Columbus, OH)
- …the first 3 weeks training with 100% participation during 8:30am-5pm Monday-Friday. + A Registered Nurse that must hold an unrestricted license in their state of ... Utilization Management experience within an inpatient/Outpatient setting, concurrent review or prior authorization. + 5+ years of variety clinical experience… more
- Humana (Columbus, OH)
- …community and help us put health first** The RN , Compliance Nurse 2, Quality Assurance Auditor reviews utilization management activities and documentation ... to prevent and detect fraud, waste, and abuse. The RN , Compliance Nurse 2, Quality Assurance Auditor...License the state where you reside + Experience with Utilization Management and Quality assurance audits + Clinical experience… more
- Elevance Health (Columbus, OH)
- …or 1-hour commute each way of a relevant Elevance Health location. The ** Nurse Medical Management II** is responsible to collaborate with healthcare providers and ... but are not limited to: + Conducts precertification, continued stay review , care coordination, or discharge planning for appropriateness of treatment setting… more