• Clinical Registered Nurse

    Sharecare (Frankfort, KY)
    …for all Sharecare clinicians. **Essential Job** **Functions:** **Achievement of Clinical Objectives** + Reviews status of participant's preventive health exams ... impact of the health care delivery system on the clinical and financial outcomes of the member population and...+ Minimum of 3 years recent experience in a clinical setting. + Basic knowledge of physiology and chronic… more
    Sharecare (01/08/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Louisville, KY)
    **Diagnosis Related Group Clinical Validation Auditor-** ** Registered Nurse ** **Location:** This position will work a hybrid model ( remote and office). ... and efficiency recommendations. **Minimum Requirements:** + Requires current, active, unrestricted Registered Nurse license in applicable state(s). + Requires a… more
    Elevance Health (01/01/25)
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  • Registered Nurse - Assistant Chief…

    Veterans Affairs, Veterans Health Administration (Lexington, KY)
    …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... Summary This Assistant Chief Nurse (ACN) reports to the Chief of Operations...policies, and objectives for the enhancement of administrative and clinical programs organization-wide, (3) Assist in policy-making activities as… more
    Veterans Affairs, Veterans Health Administration (01/03/25)
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  • Utilization Management Clinical Consultant…

    CVS Health (Frankfort, KY)
    …clinician with Kentucky state licensure (LCSW, LPCC, LMFT, LPAT, LP) or a Registered Nurse (RN) with active current and unrestricted Kentucky state license ... convenient and affordable. **Position Summary** This is a fully remote Utilization Review Clinical Consultant. **MUST RESIDE...Health licensure (LCSW, LPCC, LMFT, LPAT, LP) or a Registered Nurse (RN) with unrestricted state license… more
    CVS Health (01/11/25)
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  • RN, Utilization Management Nurse

    Humana (Lexington, KY)
    …+ **Must live within 30 miles of Lexington or Louisville, Kentucky.** + Licensed Registered Nurse (RN) in the state of Kentucky with no disciplinary action ... put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Nurse 2 who will utilize clinical nursing skills to support the… more
    Humana (12/03/24)
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  • Consultant, Nurse Disability

    Lincoln Financial Group (Frankfort, KY)
    …as indicated **What we're looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where the ... Carolina); Omaha, NE (Nebraska); Work from Home **Work Arrangement:** Remote : Work at home employee residing outside of...We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization.… more
    Lincoln Financial Group (01/03/25)
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  • Lead, Auditor (RN) Appeals & Grievances…

    Molina Healthcare (Lexington, KY)
    …adequate staffing and production levels are maintained + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management ... our Appeals and Grievances department. We are seeking a Registered Nurse with previous Appeals and Grievances...to ensure member needs are being met. + Assesses registered nurses and other clinical staff regarding… more
    Molina Healthcare (01/13/25)
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  • Care Manager Behavioral Health - Part Time…

    Highmark Health (Frankfort, KY)
    …+ Licensed Marriage and Family Therapist (LMFT) + Licensed Behavior Specialist + Registered Nurse . **Preferred** + None **SKILLS** + Working knowledge of ... **Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** **Fully Remote - Part Time - Weekends Required.** This job implements the effective utilization… more
    Highmark Health (12/12/24)
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  • Investigator, Coding SIU ( Remote )

    Molina Healthcare (Covington, KY)
    …Excel (edit/save spreadsheets, sort/filter) **Required License, Certification, Association** Licensed registered nurse (RN), Licensed practical nurse ... benefits, and medical records to document relevant findings of a post pay clinical review. This position manages documents and prioritizes case load to ensure timely… more
    Molina Healthcare (01/13/25)
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  • Care Manager- Remote

    Sharecare (Frankfort, KY)
    …within a matrix organizational design. **Qualifications:** + Current multi-state compact Registered Nurse licensure in state of residence is required, ... + Actively participate in team huddles and contribute to clinical learning. + Remain current on clinical ...to clinical learning. + Remain current on clinical knowledge via self-directed learning. **Specific Skills/ Attributes:** +… more
    Sharecare (12/04/24)
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  • LPN-RN Bridge Float Pool

    Bon Secours Mercy Health (Paducah, KY)
    …collaboration with the interdisciplinary team and under the supervision of the professional Registered Nurse , the Licensed Practical Nurse (LPN) provides ... * Under the direction of a Licensed Professional (eg, Physician, Physician Assistant, Nurse Practitioner, or Registered Nurse ), participates in the nursing… more
    Bon Secours Mercy Health (12/07/24)
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  • RN 3B Med Surg Tele FT Days

    Catholic Health Initiatives (Lexington, KY)
    …Integrated Care to Saint Joseph. + The new model consists of a team with a registered nurse , licensed practical nurse and an advanced patient care technician ... Care model.** **Benefits of Virtually Integrated Care (VIC) for Clinical Staff Members are outlined below:** Saint Joseph Hospital...in Nursing (ADN) from an accredited program + Active Registered Nurse Licensure in Kentucky (KY) or… more
    Catholic Health Initiatives (01/06/25)
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  • LPN-RN Bridge Acute Care Float Pool - Lourdes…

    Bon Secours Mercy Health (Paducah, KY)
    …nursing care and assists with care of the patient at the direction of a Registered Nurse , Licensed Physician, Physician Assistant, or Advanced Practice Nurse ... cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. **Mercy Health** **About Us** As a faith-based… more
    Bon Secours Mercy Health (12/07/24)
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  • Travel Med Surg RN - Nights - Henderson, KY Auto…

    Amergis (Henderson, KY)
    …and other variable factors. Amergis Healthcare Staffing is seeking a Medical/Surgical Registered Nurse to assume responsibility and accountability for the ... the nursing process andthe delivery of patient care. The nurse demonstrates ability to make clinical judgments...in the management of patient care. Requirements: + Current Registered Nurse License for the state in… more
    Amergis (12/17/24)
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  • Tele-Triage LPN - SNF

    BrightSpring Health Services (Louisville, KY)
    …of Business Starting Point Nursing Services is staffed 100% by a team of remote Registered Nurses trained to support the Post-Acute Continuum with clinical ... Living Providers. Our services are tailored to our partners, including remote physical/chart assessments, predictive care modeling, clinical programming… more
    BrightSpring Health Services (01/09/25)
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  • Excess Risk Managed Care Clinician

    Highmark Health (Frankfort, KY)
    …+ Bachelor's degree in Nursing **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Case Manager (CCM) **Language ... Group **Job Description :** **JOB SUMMARY** This job is responsible for analyzing clinical data to assess potential stop loss and managed care claim liability,… more
    Highmark Health (11/25/24)
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  • Care Review Clinician, Inpatient Review (RN)

    Molina Healthcare (Covington, KY)
    **JOB DESCRIPTION** **_For this position we are seeking a (RN) Registered Nurse with previous experience in Hospital Acute Care, Concurrent Review/ Utilization ... flexible and willing to work holidays. This is a remote position, and you may work from home._** **_Further...all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence… more
    Molina Healthcare (01/01/25)
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  • Field Care Manager, Behavioral Health

    Humana (Frankfort, KY)
    clinical experience in behavioral health **OR** an active, unrestricted Kentucky Registered Nurse **(RN)** license with at least three years of experience ... Virginia, or West Virginia.** + An active, unrestricted Licensed Masters Clinical Social Worker **(LCSW),** Licensed Professional Clinical Counselor **(LPCC)**… more
    Humana (11/20/24)
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  • Utilization Review Clinician - Behavioral Health

    Centene Corporation (Frankfort, KY)
    …required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required Pay Range: ... changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
    Centene Corporation (01/10/25)
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  • Utilization Management Behavioral Health…

    Humana (Frankfort, KY)
    …Therapist **(LMFT)** , Licensed Professional Counselor **(LPC)** , Psychologist **(PhD)** , Registered Nurse **(RN)** or other professional license. + Three (3) ... independent determination of the appropriate courses of action. + Utilizes clinical knowledge, communication skills, and independent critical thinking skills towards… more
    Humana (11/13/24)
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