• Care Manager, Registered Nurse

    Sharecare (Frankfort, KY)
    …within a matrix organizational design. **Qualifications:** + Current multi-state compact Registered Nurse licensure in state of residence is required, ... + Actively participate in team huddles and contribute to clinical learning. + Remain current on clinical ...to clinical learning. + Remain current on clinical knowledge via self-directed learning. **Specific Skills/ Attributes:** +… more
    Sharecare (02/17/25)
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  • Clinical Appeals Nurse (RN): Texas…

    Molina Healthcare (Louisville, KY)
    …decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical /medical ... 4 weeks Monday-Thursday and Wed - Saturday._** **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical more
    Molina Healthcare (02/09/25)
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  • Utilization Management Registered

    Humana (Frankfort, KY)
    …**Use your skills to make an impact** **Required Qualifications** + Active licensed Registered Nurse (RN) in the state of Virginia or obtain a ... and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to...to troubleshoot and resolve basic technical difficulties in a remote environment. + Ability to work independently under general… more
    Humana (03/18/25)
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  • Utilization Management Behavioral Health…

    Humana (Frankfort, KY)
    …**Use your skills to make an impact** **Required Qualifications** + Active unrestricted registered nurse license in the state of Virginia or obtain a ... us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to...to troubleshoot and resolve basic technical difficulties in a remote environment. + Ability to work independently under general… more
    Humana (03/18/25)
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  • Pre-Authorization Registered Nurse

    Humana (Frankfort, KY)
    …**Use your skills to make an impact** **Required Qualifications** + Active Licensed Registered Nurse (RN) in the state of Virginia or obtain a ... of our caring community and help us put health first** The Pre-Authorization Nurse 2 reviews prior authorization requests for appropriate care and setting, following… more
    Humana (03/15/25)
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  • Manager, Utilization Management Registered

    Humana (Frankfort, KY)
    …**Use your skills to make an impact** **Required Qualifications** + Active Licensed Registered Nurse (RN) in Virginia or enhanced compact license, (eNLC) with ... us put health first** The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of… more
    Humana (03/12/25)
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  • Associate Clinical Nurse Editor,…

    RELX INC (Frankfort, KY)
    Associate Clinical Nurse Editor, eLearning Do you excel in validating the clinical accuracy and relevance of point-of-care and educational materials? Would ... evidence integration into content About the role The Associate Clinical Nurse Editor for eLearning plays a...eLearning leadership team. Requirements + Have an unencumbered licensed Registered Nurse and bachelor's degree in nursing… more
    RELX INC (02/07/25)
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  • Manager, HCS Clinical Policy - Medicare…

    Molina Healthcare (Louisville, KY)
    …identifying opportunities for improvement. **Job Qualifications** **REQUIRED EDUCATION** : Registered Nurse or equivalent combination of Licensed Vocational ... **Job Description** **Job Summary** Develops clinical policies to ensure that patients progress toward... Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of RN license… more
    Molina Healthcare (02/14/25)
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  • Licensed Practical Nurse - PACT Greenwood…

    Veterans Affairs, Veterans Health Administration (Louisville, KY)
    …specialized Licensed Practical Nurse activities under the direction of a Registered Nurse , requiring a broad work experience and demonstrated skill ... care decision making with minimal periodic supervision by the Registered Nurse . Duties include but are not...risk factors and/or signs and symptoms of withdrawal. Complete clinical reminders and reports of data findings to clinician,… more
    Veterans Affairs, Veterans Health Administration (03/18/25)
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  • Clinical Consultant, MI

    Fujifilm (Frankfort, KY)
    …where appropriate. + Participates in professional organizations. + Provides telephone and remote clinical support for customers, sales, and field service via ... **Position Overview** The Clinical Consultant, MI - I shall be responsible...experience in: + MPI + MUGA + PET + (CV) Registered Nurse Cardiac experience in: + Cath,… more
    Fujifilm (02/12/25)
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  • Sr Clinical Consultant, Cardio

    Fujifilm (Frankfort, KY)
    … Nuclear Medicine Technologist experience in: + MPI + MUGA + PET + Registered Nurse Cardiac experience in: + Cath, Peripheral Angiography, Electrophysiology Lab ... **Position Overview** The Senior Clinical Consultant, Cardiology shall be responsible for providing...and standards. **Qualifications:** + Advanced Cardiac Sonographer. Technologist or Nurse + 5+ years of progressive experience in medical… more
    Fujifilm (02/19/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Louisville, KY)
    …and efficiency recommendations. **Minimum Requirements:** + Requires current, active, unrestricted Registered Nurse license in applicable state(s). + Requires a ... are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation… more
    Elevance Health (03/04/25)
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  • Remote Program Manager, HCS - RN…

    Molina Healthcare (Louisville, KY)
    …materials and other related documentations. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... and Eastern time zones. While the position is fully remote , working from home, there will be 25% or...Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of RN license.… more
    Molina Healthcare (03/04/25)
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  • Manager, Healthcare Services ( Remote )

    Molina Healthcare (Louisville, KY)
    …identifying opportunities for improvement. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... the right time and assisting them to achieve optimal clinical , financial, and quality of life outcomes. + Responsible... Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of RN license.… more
    Molina Healthcare (03/07/25)
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  • Sr Specialist, Quality Improvement (RN)…

    Molina Healthcare (Louisville, KY)
    …QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist, Quality Improvement ( Registered Nurse ) contributes to one or more of ... key quality strategies that require a component of near real-time clinical decision-making. These activities may include initiation and management of interventions… more
    Molina Healthcare (03/19/25)
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  • Sr Clinical Performance Consultant

    Molina Healthcare (Louisville, KY)
    …on business need (up to 25%) **Job Qualifications** * Active and unrestricted Registered Nurse (RN) license or independent behavioral health license (LCSW, LPC, ... **Job Description** Looking for a Registrared Nurse or Licensed Social worker to support HealthPlans...AM to 5 PM) - to support business needs Remote Position - Home office with internet connectivity of… more
    Molina Healthcare (03/15/25)
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  • Clinical Supervisor, Access and Patient…

    Cardinal Health (Frankfort, KY)
    …be needed to perform your duties up to 25%. **_Qualifications_** + Current, unrestricted Registered Nurse license, required. + BA, BS or equivalent experience in ... life-changing therapies to patients who need them-faster.** **_Responsibilities_** The Clinical Operations Supervisor leads program staff performing actions including… more
    Cardinal Health (03/13/25)
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  • Inpatient Review (RN): Remote , California…

    Molina Healthcare (Louisville, KY)
    **EMERGENCY ROOM ADMISSIONS REVIEW NURSE ** **_2 openings for 12 hour NIGHT SHIFT: 7:30PM (in the evening) - 08:30AM (in the morning) PACIFIC HOURS NON EXEMPT, 3 days ... compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical more
    Molina Healthcare (02/14/25)
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  • Care Manager RN (Delaware) Remote

    Highmark Health (Frankfort, KY)
    …+ Experience in UM/CM/QA/Managed Care **LICENSES or CERTIFICATIONS** **Required** + United States Registered Nurse (RN) license + Delaware RN license must be ... Master's Degree in Nursing **EXPERIENCE** **Required** + 3 years of related, progressive clinical experience in the area of specialization + Experience in a … more
    Highmark Health (02/20/25)
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  • Manager, Utilization Management Behavioral Health

    Humana (Frankfort, KY)
    …required. **Additional Information:** **Workstyle:** Remote work at Home **Location for Registered Nurse :** must reside in the state of Virginia or reside ... **Must meet** **one** **of the following:** + Active unrestricted registered nurse license in the state of...counseling experience required + Minimum one, (1) year of clinical supervisory such as team lead, charge nurse more
    Humana (03/12/25)
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