- Humana (Louisville, KY)
- …and help us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Nurse 2 who will utilize clinical nursing skills to ... benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work...30 miles of Lexington or Louisville, Kentucky.** + Licensed Registered Nurse ( RN ) in the… more
- Molina Healthcare (Louisville, KY)
- **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case ... them. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ) Program and...years of experience in case management , disease management or utilization management in… more
- ChenMed (Louisville, KY)
- …RN with bachelor's degree in a related clinical field preferred. + A valid, active Registered Nurse ( RN ) license in State of employment required. + A ... people to join our team. * The Acute Care Nurse is responsible for achieving positive patient outcomes, managing...experience required. + A minimum of 1 year of utilization review and/or case management , home health,… 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 Review / Utilization Management ...care/medical experience. **Required License, Certification, Association** Active, unrestricted Wisconsin Registered Nursing ( RN ) license in good standing.… 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)
- …is provided during regular business hours, 8:30 am - 5:00 pm.** **The Transplant Nurse II** is responsible for providing case management and/or medical ... problem solving with providers, claims or service issues. Assists with development of utilization /care management policies and procedures. + Within the medical … more
- Elevance Health (Louisville, KY)
- ** Nurse Case Manager II** **National Management and Support** **Location** : This will be a work from home positions with the ideal candidate residing in the ... state of Kentucky. The ** Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care needs… more
- Elevance Health (Louisville, KY)
- …Mon - Friday 8am - 5pm CST or 8am - 5pm EST** The Med Mgmt Nurse is responsible for review of the most complex or challenging cases that require nursing judgment, ... to Medical Director on particularly peculiar or complex cases as the nurse deems appropriate. May make recommendations on alternate types, places, or levels… more