• 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...alignment with established editorial standards. + Participating in the clinical review process by providing feedback on… more
    RELX INC (02/07/25)
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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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  • Dialysis Clinical Manager Registered…

    Fresenius Medical Center (Louisville, KY)
    **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
    Fresenius Medical Center (01/04/25)
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  • Utilization Management Representative II

    Elevance Health (Louisville, KY)
    …Provider Finder and follows up with provider on referrals given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for ... specialty care. + Processes incoming requests, collection of information needed for review from providers, utilizing scripts to screen basic and complex requests for… more
    Elevance Health (03/06/25)
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  • Utilization Management Rep I (US)

    Elevance Health (Louisville, KY)
    …outpatient precertification, prior authorization, and post service requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for ... I** will be responsible for coordinating cases for precertification and prior authorization review . **How you will make an impact:** + Managing incoming calls or… more
    Elevance Health (03/06/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Louisville, KY)
    …identified by the Payment Integrity analytical team; requires decision making pertinent to clinical experience + Documents clinical review summaries, bill ... **JOB DESCRIPTION** **Job Summary** Utilizing clinical knowledge and experience, responsible for review...Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate… more
    Molina Healthcare (01/25/25)
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  • Trainer - Clinical Services - Utilization…

    Molina Healthcare (Louisville, KY)
    **Job Description** Job Summary Creates and delivers clinical training programs for clinical staff across the enterprise to orient employees to Molina ... clinical methodology, along with policies, processes and systems. Ensures...Qualifications **REQUIRED EDUCATION** : Completion of an accredited Registered Nurse (RN) Program and an Associate's or Bachelor's Degree… more
    Molina Healthcare (03/13/25)
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  • Nurse Practitioner

    ChenMed (Louisville, KY)
    …our team. The Nurse Practitioner (NP) acts as part of the clinical operations team and is responsible for providing direct patient care in ChenMed/Jencare ... This position may require participation in risk and quality management programs, clinical meetings and other meetings. The Nurse Practitioner will adhere… more
    ChenMed (03/04/25)
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  • Float Pool Nurse

    HCA Healthcare (Frankfort, KY)
    …is important to you, we encourage you to apply for our Float Pool Nurse opening. Our team will promptly review your application. Highly qualified candidates ... their positions. Join our Team as a Float Pool Nurse and access programs to assist with every stage...skill of the staff. Serve as role models and clinical resource for the staff. Respond in a timely… more
    HCA Healthcare (03/11/25)
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  • Licensed Practical Nurse - PACT Greenwood…

    Veterans Affairs, Veterans Health Administration (Louisville, KY)
    Summary The Licensed Practical Nurse (LPN) works collaboratively in an interdisciplinary coordinated care delivery model (ie, patient aligned care team). The ... at the Greenwood Outpatient Clinic, Louisville, KY. Responsibilities This Licensed Practical Nurse (LPN) position is located within Primary Care at the Greenwood VA… more
    Veterans Affairs, Veterans Health Administration (03/15/25)
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  • Labor and Delivery Nurse PRN

    HCA Healthcare (Frankfort, KY)
    …is important to you, we encourage you to apply for our Labor and Delivery Nurse PRN opening. Our team will promptly review your application. Highly qualified ... positions. Join our Team as a(an) Labor and Delivery Nurse PRN and access programs to assist with every...skill of the staff. Serve as role models and clinical resource for the staff. Respond in a timely… more
    HCA Healthcare (02/14/25)
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  • Nurse Audit Sr

    Elevance Health (Louisville, KY)
    ** Nurse Audit Sr** **Location:** This position will work virtual. Ideal candidates will live within 50 miles of one of our Pulse Point locations. Carelon Payment ... determined to recover, eliminate and prevent unnecessary medical-expense spending." The ** Nurse Audit Sr** is responsible for identifying, monitoring, and analyzing… more
    Elevance Health (03/15/25)
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  • Delegation Oversight Nurse (Must Reside…

    Molina Healthcare (Louisville, KY)
    …contained in the delegation agreement. **KNOWLEDGE/SKILLS/ABILITIES** The Delegation Oversight Nurse is responsible for ensuring that Molina Healthcare's UM ... as well as Molina Healthcare business needs. In addition, the Delegation Oversight Nurse will assist the Delegation Oversight Manager with additional duties of the… more
    Molina Healthcare (03/06/25)
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  • Pre-Authorization Registered Nurse

    Humana (Frankfort, KY)
    …services using clinical judgment and refers to internal stakeholders for review depending on case findings. + Educates providers on utilization and medical ... 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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  • Step Down Nurse

    HCA Healthcare (Frankfort, KY)
    …$25,000 Sign-On Bonus Do you have the career opportunities as a(an) Step Down Nurse you want with your current employer? We have an exciting opportunity for you ... Do you want to work as a(an) Step Down Nurse where your passion for creating positive patient interactions...skill of the staff. Serve as role models and clinical resource for the staff. Respond in a timely… more
    HCA Healthcare (03/11/25)
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  • Radiology Nurse

    HCA Healthcare (Frankfort, KY)
    …worth of each individual is recognized. Submit your application for our Radiology Nurse opening with Frankfort Regional Medical Center today and find out what it ... may vary by location._** We are seeking a(an) Radiology Nurse for our team to ensure that we continue...skill of the staff. Serve as role models and clinical resource for the staff. Respond in a timely… more
    HCA Healthcare (02/12/25)
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  • Step Down Nurse

    HCA Healthcare (Frankfort, KY)
    …$25,000 Sign-On Bonus** Do you have the career opportunities as a(an) Step Down Nurse you want with your current employer? We have an exciting opportunity for you ... Do you want to work as a(an) Step Down Nurse where your passion for creating positive patient interactions...skill of the staff. Serve as role models and clinical resource for the staff. Respond in a timely… more
    HCA Healthcare (01/28/25)
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  • Tele-Triage Registered Nurse - RN

    BrightSpring Health Services (Louisville, KY)
    …PART TIME Schedule: Friday, Saturday, Sunday 6a-2p CST (7a-3p EST) This Registered Nurse provides On-Call and Triage for the assigned population in accordance with ... (web) chat, or email + Ensure compliance with state/local/payer requirements through review of documentation + Provide coaching and education related to the health… more
    BrightSpring Health Services (03/13/25)
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  • Complex Nurse Field Case Manager - Must…

    CVS Health (Louisville, KY)
    …8am-5pm, is required. **Evaluation of Members:** + Through the use of clinical assessment tools and evaluating information/data review , conducts a comprehensive ... health care more personal, convenient and affordable. **Position Summary:** The Complex Nurse Case Manager is responsible for assessing members through regular and… more
    CVS Health (03/08/25)
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  • New Graduate Nurse Resident

    Fresenius Medical Center (Campbellsville, KY)
    …regulations at: https://content.intranet.fmcna.com/regulatory-affairs/wp-content/uploads/sites/46/2019/05/Pre-Licensed- Nurse -50-State- Review ... of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a...for other staff members. + Routinely meets with the Clinical Manager to discuss personnel and patient care status,… more
    Fresenius Medical Center (03/14/25)
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