• Registered Nurse - Case

    Veterans Affairs, Veterans Health Administration (Lexington, KY)
    Summary Registered Nurse Case Managers...productive patient management. The incumbent may serve as the case manager for multiple areas in the ... level degree in Nursing may have opportunity to become registered as a nurse with a state...are not creditable as related degrees. Preferred Experience: Previous case manager experience preferred Reference: For more… more
    Veterans Affairs, Veterans Health Administration (03/22/25)
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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 ... 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 (02/24/25)
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  • Care Manager , Registered

    Sharecare (Frankfort, KY)
    …within a matrix organizational design. **Qualifications:** + Current multi-state compact Registered Nurse licensure in state of residence is required, ... telephonic Case or Care Management with members. The Care Manager partners with members, caregivers, providers, and the interdisciplinary care team to… more
    Sharecare (03/19/25)
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  • Registered Nurse - ICU

    Veterans Affairs, Veterans Health Administration (Lexington, KY)
    Summary The registered nurse (staff nurse ) is directly responsible to the designated manager in the assigned critical care area; the registered ... carrying multi-system failure in the adult population. Responsibilities The registered nurse (staff nurse ) is...(may be extended up to two years on a case -by- case -basis.) NOTE: Grandfathering Provision - All persons… more
    Veterans Affairs, Veterans Health Administration (03/15/25)
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  • Registered Nurse - Emergency…

    Veterans Affairs, Veterans Health Administration (Lexington, KY)
    Summary This position is for a Registered Nurse (RN) in the Emergency Room at the Lexington VA Health Care System. The RN is directly responsible to the ... designated manager and will be accountable for the provision of...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
    Veterans Affairs, Veterans Health Administration (03/18/25)
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  • Assistant Nurse Manager - ICU/PCU

    Veterans Affairs, Veterans Health Administration (Lexington, KY)
    Summary This Assistant Nurse Manager is accountable to the Nurse Manager ICU/PCU. The ANM has 24-hour, 7-days/week shared accountability for the ... performance management leadership skills and clinical skills of a registered nurse at the same grade. The...(may be extended up to two years on a case -by- case -basis.) NOTE: Grandfathering Provision - All persons… more
    Veterans Affairs, Veterans Health Administration (03/22/25)
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  • Case Manager , RN

    CAI (Frankfort, KY)
    …Type** Full time **Worksite Flexibility** Remote **Job Summary** We are looking for a motivated Case Manager , RN ready to take us to the next level! If you ... apply now. **Job Description** We are looking for a Case Manager , RN to provide community-based care...duties as assigned/requested **What You'll Need** Required: + Current Registered Nurse , licensed in the state of… more
    CAI (02/01/25)
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  • Clinical Appeals Nurse (RN): Texas and New…

    Molina Healthcare (Lexington, KY)
    …unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management + Certified ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases… more
    Molina Healthcare (02/09/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Lexington, KY)
    …ASSOCIATION:** Certified Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional Healthcare Management, Certified ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing (RN) license in good standing. **PREFERRED EDUCATION:**… more
    Molina Healthcare (01/25/25)
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  • RN Clinical Manager , Home Health

    CenterWell (Lexington, 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 ... Schedule Career Development A Sense of Purpose 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 (03/22/25)
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  • Manager , Healthcare Services (Remote)

    Molina Healthcare (Lexington, KY)
    …identifying opportunities for improvement. **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 (03/07/25)
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  • Program Manager , HCS RN, LMSW, LMHC, LMFT,…

    Molina Healthcare (Lexington, KY)
    …materials and other related documentations. **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 (03/21/25)
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  • Manager , HCS Clinical Policy - Medicare…

    Molina Healthcare (Lexington, KY)
    …identifying opportunities for improvement. **Job Qualifications** **REQUIRED EDUCATION** : Registered Nurse or equivalent combination of Licensed Vocational ... enhance the continuity of care + Functions as hands-on manager responsible for supervision and coordination of enterprise clinical... Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of RN license… more
    Molina Healthcare (02/14/25)
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  • Field Care Manager , Behavioral Health

    Humana (Frankfort, KY)
    …of post-degree clinical experience in behavioral health **OR** + Active, unrestricted Kentucky Registered Nurse **(RN)** license with at least three years of ... health first** Humana Healthy Horizons in Kentucky is seeking a Field Care Manager , Behavioral Health 2 who will assess and evaluate member's needs and requirements… more
    Humana (03/09/25)
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  • RN Clinical Care Coordinator

    CenterWell (Frankfort, KY)
    …Bachelor's degree + 3 - 5 years of clinical acute care experience + Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action + ... community and help us put health first** The Care Manager , Telephonic Nurse 2 , in a...Milliman or Interqual + Managed care experience + Certified Case Manager (CCM) **Additional Information** **Scheduled Weekly… more
    CenterWell (03/21/25)
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  • Trainer - Clinical Services - Utilization Review…

    Molina Healthcare (Lexington, KY)
    …on the job. Job Qualifications **REQUIRED EDUCATION** : Completion of an accredited Registered Nurse (RN) Program and an Associate's or Bachelor's Degree in ... or State Clinical Social Worker/Counseling (or related field) License Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified… more
    Molina Healthcare (03/13/25)
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