- Humana (Frankfort, KY)
- …part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse uses behavioral health knowledge and ... licensed in a Compact State** The Utilization Management Behavioral Health Nurse completes...Qualifications** + Minimum of Associate Degree in Nursing + Registered Nurse ( RN ) licensure with… more
- CVS Health (Frankfort, KY)
- … health clinician with Kentucky state licensure (LCSW, LPCC, LMFT, LPAT) or a Registered Nurse ( RN ) with active current and unrestricted Kentucky state ... and communicate all aspects of the utilization /benefit management program. **Required Qualifications** + Licensed independent behavioral...OR Minimum of an Associate's in Nursing or Diploma RN for Registered Nurses **Pay Range** The… more
- Molina Healthcare (Lexington, KY)
- **_For this position we are seeking a ( RN ) Registered Nurse with previous experience in Hospital Acute Care, Concurrent Review/ Utilization Review / ... Medical, or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina… more
- Catholic Health Initiatives (Lexington, KY)
- …of nursing. **Required Licensure and Certifications** Kentucky state licensure as a Registered Nurse . **Required Minimum Knowledge, Skills and Abilities** Prefer ... health working with Medicare/Medicaid and other federal guidelines or 2 years Utilization management in hospital setting. Also desirable, experience in discharge… more
- Veterans Affairs, Veterans Health Administration (Lexington, KY)
- …patients as necessary. Notes changes in patient's nutritional needs, and reports to Registered Nurse . Changes bed lines as needed. Positions, holds, turns, ... weight, intake and output. Reports changes in the patient's condition to the Registered Nurse . Documents patient care provided and patient response to treatment.… more
- Highmark Health (Frankfort, KY)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... data to assure appropriate level of payment and resource utilization . It is also used to identify issues which...experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder… more