- Cognizant (Columbus, OH)
- …you need to have to be considered** + Educational background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
- CVS Health (Columbus, OH)
- …Qualifications** + Registered Nurse + 3+ years of experience as a Registered Nurse , 1+ years of clinical experience in acute or post-acute setting, ... training sessions, or other events as directed. **Position Summary** Utilize your clinical experience and skills in a collaborative process to assess, plan,… more
- CVS Health (Columbus, OH)
- …+ Effective communication skills, both verbal and written **Required Qualifications** **3+ years of clinical experience as a Registered Nurse in adult acute ... work schedules will include weekends, holidays, and evening hours._ + Utilizes clinical experience and skills in a collaborative process to assess, plan, implement,… 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 ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- 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 ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN)** in the (appropriate state)… more
- Evolent (Columbus, OH)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals.… more
- OhioHealth (Pickerington, OH)
- …Heart Association, BLS - Basic Life Support - American Heart Association, RN - Registered Nurse - Ohio Board of Nursing **Additional Job Description:** Current ... careers and in our communities. **Job Description Summary:** The RN Clinical Leader provides leadership and coordinates the design, development, implementation and… more
- Battelle Memorial Institute (Columbus, OH)
- …at a local MTF + Current, full, active, and unrestricted license to practice as a Registered Nurse in one of any US State, the District of Columbia, Guam, Puerto ... common acute conditions, chronic illnesses, or minor trauma within accepted protocols, clinical practice guidelines, Nurse Practice Acts, and/or in consultation… more
- Trinity Health (Columbus, OH)
- …in lieu of a RN.** **Licensure / Certification: Current license to practice as registered nurse in the State of Ohio.** ** Registered Health Information ... Minimum of 5 years acute care medical or surgical experience required;** ** Utilization /Case Management, managed care, or Clinical Documentation and experience… more
- Molina Healthcare (Columbus, OH)
- …and experience. * At least 5 years health care management/leadership required. * Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical ... * Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Registered Nurse (RN). License must be active and unrestricted… 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 in ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for...to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications *… 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 of ... authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in… more
- Trinity Health (Westerville, OH)
- …for:** + Associates degree from an accredited RN program + Current license to practice as registered nurse in the State of Ohio + Minimum of 3-5 years recent ... transfer or discharge. This is done with the intentions of cost-effective utilization of hospital resources, minimizing out of pocket expenses for patients,… more
- Trinity Health (Westerville, OH)
- …for:** + Associates degree from an accredited RN program + Current license to practice as registered nurse in the State of Ohio + Minimum of 3-5 years recent ... transfer or discharge. This is done with the intentions of cost-effective utilization of hospital resources, minimizing out of pocket expenses for patients,… more
- Trinity Health (Westerville, OH)
- …+ Associates degree from an accredited RN program + Current license to practice as registered nurse in the State of Ohio + Minimum of 3-5 years recent ... or discharge. This is done with the intentions of cost effective utilization of hospital resources, minimizing out of pocket expenses for patients, providing… more
- Trinity Health (Canal Winchester, OH)
- …with the mission of Diley Ridge Medical Center, under the direction of a Registered Nurse , the Multi-skilled Technician, will provide direct and indirect patient ... service focus. **Job Relationships** _Reports to:_ Clinical Manager, Assistant Clinical Manager/Educator, Charge Nurse or designee _Supervises:_ N /A **Job… more
- OhioHealth (Columbus, OH)
- …And Duties:** **Minimum Qualifications:** Bachelor's Degree (Required)APRN - Advanced Practice Registered Nurse License - State of Ohio Board of ... Basic Life Support - American Heart Association, RN - Registered Nurse - Ohio Board of Nursing...Computer skill and data entry. Knowledge and skill in clinical assessment and disease management. BLS issued by American… 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 in ... **JOB DESCRIPTION** Provides support for clinical member services review assessment processes. Responsible for...to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications *… more
- Highmark Health (Columbus, OH)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
- CVS Health (Columbus, OH)
- …conditions. + **Diabetes education experience** is required. + Current, unrestricted ** Registered Nurse (RN) license** ; multi-state licensure preferred. + ... health outcomes by engaging telephonically with individuals living with diabetes. This nurse will guide members through actionable steps to close gaps in care,… more