• SNF Utilization Management RN - Compact Rqd

    Humana (Charleston, WV)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **​Licensed Registered Nurse (RN)** in the (appropriate state)… more
    Humana (12/12/25)
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  • Clinical Reviewer, Nurse (Medical…

    Evolent (Charleston, WV)
    …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals.… more
    Evolent (12/10/25)
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  • Clinical Manager, Home Health

    CenterWell (Chapmanville, WV)
    …+ Graduate of an accredited School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's license, auto insurance ... position comes with a $10K sign-on bonus.** + The ** Clinical Manager** coordinates and oversees all direct care patient...and reliable transportation. + Two years as a Registered Nurse in a home care, with… more
    CenterWell (12/19/25)
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  • Patient Service Coordinator - Clinical

    BrightSpring Health Services (Charleston, WV)
    …unencumbered license to practice as a Licensed Piratical Nurse (LPN), Licensed Vocational Nurse (LVN), or Registered Nurse (RN) About our Line of ... and coordinating patient care under the direction of the Clinical Manager. This role ensures optimal utilization of clinical resources to support care center… more
    BrightSpring Health Services (12/18/25)
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  • Payment Integrity Clinician

    Highmark Health (Charleston, WV)
    …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
    Highmark Health (11/14/25)
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