• 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 ... data to assess potential stop loss and managed care claim liability, utilizing Case Management oversight techniques to ensure front line case management and… more
    Highmark Health (11/25/24)
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  • Registered Nurse (RN)

    Addiction Recovery Care (Owensboro, KY)
    …entrepreneurship, and stewardship are key elements of every thing we do! We are hiring a Registered Nurse for our growing team! As a Registered Nurse ... team-oriented, environment helping individuals overcome substance abuse addiction. The Registered Nurse is a vital member of...health. + Have the ability to communicate with the Case Manager and assist in ensuring the… more
    Addiction Recovery Care (01/04/25)
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  • Registered Nurse , Home Health Per…

    CenterWell (Hopkinsville, KY)
    …community and help us put health first** As a **Home Health Registered Nurse ** , you will: + Provide admission, case management, and follow-up skilled ... for home health patients. + Administer on-going care and case management for each patient, provide necessary follow-up as...Home Health experience a plus + Current and unrestricted Registered Nurse licensure + Current CPR certification… more
    CenterWell (12/21/24)
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  • Case Manager RN- Behavioral Health…

    Molina Healthcare (KY)
    …level of the assigned members, particular state-specific regulations, or whether the Case Manager position is located within Molina's Central Programs unit. ... (LPC/LPCC), LMFT + License must be active, unrestricted and in good standing. + Registered Nurse license required. + Must have valid driver's license with good… more
    Molina Healthcare (11/12/24)
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  • RN Case Manager Home Health Full…

    CenterWell (Lexington, KY)
    …of our caring community and help us put health first** As a **Home Health RN Case Manager ** , you will: + Provide admission, case management, and follow-up ... for home health patients. + Administer on-going care and case management for each patient, provide necessary follow-up as...Health experience is a plus + Current and unrestricted Registered Nurse licensure + Current CPR certification… more
    CenterWell (11/19/24)
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  • RN, Field Care Manager Nurse

    Humana (Frankfort, KY)
    …us put health first** Humana Healthy Horizons in Kentucky is seeking a Field Care Manager Nurse 2 who will assess and evaluate member's needs and requirements to ... the care and wellbeing of members. The Field Care Manager Nurse 2 work assignments are varied...in the state of Kentucky. + An active, unrestricted Registered Nurse (RN) license in the state… more
    Humana (11/19/24)
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  • Acute Care Nurse

    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 minimum of ... requires possession and maintenance of a valid driver's license. + Certified Case Manager certification is preferred. Certification through the Commission for… more
    ChenMed (10/21/24)
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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 ... Healthy Horizons in Kentucky is seeking a Utilization Management Nurse 2 who will utilize clinical nursing skills to...acute care, skilled or Rehabilitation clinical setting. + Certified Case Manager (CCM) + Health Plan experience.… more
    Humana (12/03/24)
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  • RN Clinical Manager , Home Health

    CenterWell (Elizabethtown, KY)
    …+ Graduate of an accredited School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's license, auto insurance ... put health first** $10k Sign on Bonus! The **Clinical Manager ** coordinates and oversees all direct care patient services...and reliable transportation. + Two years as a Registered Nurse with at least one-year of… more
    CenterWell (12/20/24)
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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, ... **Job Description:** **Job Summary:** The Care Manager supports the implementation of the Value Based...an appropriate and efficient manner by providing high-quality telephonic Case or Care Management with CareFirst members. The Care… more
    Sharecare (12/04/24)
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  • Clinical Value Program Manager , HCS

    Molina Healthcare (KY)
    …program/process execution to achieve goals **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of RN license....**Preferred License, Certification, Association** Any of the following: Certified Case Manager (CCM), Certified Professional in Healthcare… more
    Molina Healthcare (12/15/24)
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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 ... resource utilization, identification of opportunities for referral to a Health Coach/ case management, and identification and resolution of quality issues. Monitors… more
    Highmark Health (12/12/24)
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  • Field Care Manager , Behavioral Health

    Humana (Frankfort, KY)
    …of post-degree clinical experience in behavioral health **OR** an active, unrestricted Kentucky Registered Nurse **(RN)** license with at least three years of ... Healthy Horizons in Kentucky is seeking a Field Care Manager , Behavioral Health 2 who will assess and evaluate...Abuse Disorder (SUD) patients. + Managed Care Experience. + Case Management Certification (CCM). + Experience with behavioral change,… more
    Humana (11/20/24)
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  • Lead, Auditor (RN) Appeals & Grievances Remote

    Molina Healthcare (Lexington, KY)
    …will be supporting our Appeals and Grievances department. We are seeking a Registered Nurse with previous Appeals and Grievances experience and a clinical ... align with Molina auditing policy and protocols + Assists Manager with data for team member performance reviews +...production levels are maintained + Performs monthly auditing of registered nurse and other clinical functions in… more
    Molina Healthcare (01/13/25)
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  • PRN RN

    HCA Healthcare (Lexington, KY)
    …Basic Cardiac Life Support must be obtained within 30 days of employment start date + Registered Nurse + Drivers License + Associate Degree, or Registered ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...physician's orders and under the supervision of the Clinical Manager . **What you will do in this role:** +… more
    HCA Healthcare (01/04/25)
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  • Auditor, Clinical Services (KY RN License…

    Molina Healthcare (KY)
    **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management ... resolve/correct them. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN) Program and Associate's or bachelor's… more
    Molina Healthcare (11/28/24)
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  • Mgr Utilization Review RN

    Baylor Scott & White Health (Frankfort, KY)
    …at least five years of relevant work experience + Hold a valid registration as a Registered Nurse As a health care system committed to improving the health of ... may vary based on position type and/or level **Job Summary** As a Manager for Utilization Review, you guide and supervise staff. You oversee care coordination… more
    Baylor Scott & White Health (01/10/25)
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  • Divisional Outreach Care Navigator RN…

    CenterWell (Lexington, KY)
    …control and attendance **Use your skills to make an impact** **Required Qualifications** + Registered Nurse (RN license) + Minimum of 4 years of experience ... care with experience in transition of care, discharge planning, etc + Case Management + Familiarity with state Medicaid guidelines and application processes… more
    CenterWell (12/06/24)
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