- CVS Health (Columbus, OH)
- …and work schedule may include weekends, holidays and evening hours._ This is a full-time remote Utilization Management opportunity. As a Utilization ... zone + 3+ years of clinical experience as a Registered Nurse in a hospital setting including...of 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
- CVS Health (Columbus, OH)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... first 3 weeks training required 100% participation during 8:30am-5pm Monday-Friday. + A Registered Nurse that must hold an unrestricted license in their state… 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
- 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