- 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
- 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
- Molina Healthcare (Lexington, KY)
- …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
- Humana (Frankfort, KY)
- …part of our caring community and help us put health first** The Compliance Nurse Auditor reviews utilization management activities and documentation to ... to prevent and detect fraud, waste, and abuse. The RN Compliance Nurse 2, Quality Assurance Audit...care, skilled and/or rehabilitation clinical setting + Experience with utilization management , pre-service denials and/or quality assurance… more
- CenterWell (Lexington, 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
- Molina Healthcare (Lexington, KY)
- … Registered Nursing ( RN ) license in good standing. + Utilization Management Certification (CPHM) Certified Professional in Health Care Quality (CPHQ), ... _This position requires an actively licensed Registered Nurse_ **JOB DESCRIPTION** **Job Summary** The mission of Clinical Operations is to drive value through an… more
- Molina Healthcare (Lexington, KY)
- …driver's license **PREFERRED EDUCATION:** **PREFERRED EXPERIENCE:** + 3-5-year experience as a Registered Nurse and/or Nurse Practitioner, ideally in a ... **JOB DESCRIPTION** **Job Summary** The Care Connections Nurse Practitioners focus on screening and preventive primary care services delivered in the home,… more
- LifePoint Health (Versailles, KY)
- …and fosters an environment that encourages professional growth. Initiates weekend case management , Utilization review screening, assists with D/C planning and ... Requirements Minimum EducationX Associate's degree - Required An Active RN License with KBN or a Compact RN...- within 60 days of hire and renewed annuallyTrauma Nurse Core Course (TNCC) - PreferredENPC - preferredNRP -… more
- CVS Health (Frankfort, KY)
- …health care more personal, convenient and affordable. Position Summary: The Complex Nurse Case Manager is responsible for assessing members through regular and ... person or telephonic contact to assess, plan, implement and coordinate all case management activities with members to evaluate the medical and psychosocial needs of… more
- Humana (Frankfort, KY)
- …in a bordering state/district (Washington DC, MD, WV, KY, TN & NC).** + Active Registered Nurse ( RN ) license, or Licensed Mental Health Professional (LMHP) ... in analyzing and interpreting financial trends. + Previous experience in utilization management , discharge planning and/or home health or rehabilitation.… more
- Humana (Frankfort, KY)
- …Training programs may include, but not be limited to, Care Management , Utilization Management , and/or Compliance. RN licensure is required at all ... + Master of Science in Nursing with a focus on nursing education. + Licensed Registered Nurse ( RN ) in the state where you reside with no disciplinary action… more