- Humana (Lexington, 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
- Signature Healthcare (Louisville, KY)
- …Care documentation to facility accurate billing. What you Need to make a Difference + Registered Nurse ( RN ) in good standing with required current state ... communication with leadership, patients, families, internal care givers, and external Utilization Management Nurses. + Coordinate internal and external health… more
- Humana (Frankfort, KY)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Bon Secours Mercy Health (Paducah, KY)
- …, to help our nurses grow, professionally and personally. **Tier 3 - System Flex Team traveler Registered Nurse ( RN )** A Tier 3 - System Flex Team Traveler ... Registered Nurse ( RN ) is expected...* Inter-professional collaboration and leadership + * Understanding and utilization of office and clinical technologies + * Compassionate,… more
- AdventHealth (Mckee, KY)
- …or Clay County depending on RN . **The role you'll contribute:** The Home Health Registered Nurse ( RN ) Care Manager is a professional nurse who ... and directs the home care patient's care based on individual patient needs. The RN Care Manager is responsible for independent management of the Home Health… more
- Fresenius Medical Center (Radcliff, KY)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Fresenius Medical Center (Lexington, KY)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... of education and experience. + Graduate of an accredited School of Nursing ( RN ). + Current appropriate state licensure. **EXPERIENCE AND SKILLS:** + Required: + 6+… more
- Bon Secours Mercy Health (Paducah, KY)
- …partnership * Interprofessional collaboration and leadership * Understanding and utilization of office and clinical technologies * Compassionate, relationship-based ... for professional actions * Effective stewardship of available resources * Conflict management and resilience * Authority for delegating activities to others, while… more
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- The RN working in L/D is responsible for promoting...be licensed by the state of Kentucky as a Registered Nurse , as well as NRP/BLS/ACLS certified. ... conducting medical screens on patients presenting to L/D for monitoring/observation. The RN has knowledge of the admission, discharge, transfer and fetal monitoring… more
- Sharecare (Frankfort, KY)
- …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
- Baylor Scott & White Health (Frankfort, KY)
- …of staff, resource management , and budget control. Departments involved are Utilization Management , Case Management , and Disease Management . ... Success Factors** + Demonstrable knowledge in discharge planning, case management , utilization review and different care levels....work experience + Hold a valid registration as a Registered Nurse As a health care system… more
- CVS Health (Frankfort, KY)
- …Health clinician with Kentucky state licensure (LCSW, LPCC, LMFT, LPAT, LP) or a Registered Nurse ( RN ) with active current and unrestricted Kentucky state ... to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking...Health licensure (LCSW, LPCC, LMFT, LPAT, LP) or a Registered Nurse ( RN ) with unrestricted… more
- Humana (Frankfort, KY)
- …Family Therapist **(LMFT)** , Licensed Professional Counselor **(LPC)** , Psychologist **(PhD)** , Registered Nurse **( RN )** or other professional license. + ... health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral health knowledge… more
- Centene Corporation (Frankfort, KY)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- Molina Healthcare (Lexington, KY)
- …and production levels are maintained + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case ... Management (CM), Member Assessment Team (MAT), Health Management (HM), and/or Disease Management (DM) and...them.. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ) Program and… more
- Molina Healthcare (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
- CenterWell (Elizabethtown, KY)
- …license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home care, ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Bon Secours Mercy Health (Paducah, KY)
- …**Summary of Primary Function/General Purpose of Position** The New-to-Practice Critical Care Registered Nurse ( RN ) provides, coordinates, plans, and ... standards, and organizational policies/philosophies under the guidance of a competent experienced RN . The New-to-Practice RN demonstrates the ability to care for… 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 (Covington, 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