- Catholic Health Initiatives (Bardstown, KY)
- …+ **Must be able to demonstrate advanced skills and abilities of a registered nurse , practicing within the nursing scope of practice.** + **Must have ability ... to define problems, collect data, establish facts, and draw valid conclusions.** + **Also, be able to interpret an extensive variety of instructions and deliver successful results.** + **Critical thinking and problem solving skills and must be moderately… more
- HCA Healthcare (Frankfort, KY)
- …in 21 states and the United Kingdom. We are looking for a Medical Surgical Nurse Manager for our Frankfort Regional Medical Center team where excellence creates ... an influencer in healthcare? Apply for our Medical Surgical Nurse Manager role today! **Job Summary and...of budget and marketing functions, in conjunction with the Inpatient Services Director. The Manager displays positive… more
- Molina Healthcare (Louisville, KY)
- …including DRG Validation, Itemized Bill Review, Appropriate Level of Care, Inpatient Readmission, and any opportunity identified by the Payment Integrity analytical ... per policy/protocol. **JOB QUALIFICATIONS** Graduate from an Accredited School of Nursing **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** + Minimum 3 years… more
- Molina Healthcare (Louisville, KY)
- …of illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Healthcare Services provides operational management and oversight of integrated ... of the following activities: care review/utilization management (prior authorizations, inpatient /outpatient medical necessity, etc.), case management, transition of care,… more
- Molina Healthcare (Louisville, KY)
- …of the following activities: utilization management (prior authorizations, inpatient /outpatient medical necessity, etc.). Makes recommendation for enterprise ... collaboration to enhance the continuity of care + Functions as hands-on manager responsible for supervision and coordination of enterprise clinical policy to drive… more
- Signature Healthcare (Louisville, KY)
- …long-term care facility is noted for its Center for Advanced Diabetes Care, inpatient and outpatient rehab, in-house dialysis, wound care, as well as 24-hour skilled ... nursing care for recently hospitalized and chronically ill patients....being met while also supervising and supporting our Certified Nurse Assistants (CNAs) and other staff in the delivery… more
- Humana (Frankfort, KY)
- …between nursing facilities, hospitals, and other acute care settings, inpatient rehabilitation, and other institutional settings and into the community. The ... support for members identified as being at risk of nursing facility placement. The Manager , Transition Care...MD, WV, KY, TN & NC).** + Active Registered Nurse (RN) license, **OR** Licensed Mental Health Practitioner (LHMP)… more
- Elevance Health (Louisville, KY)
- …Related Group Clinical Validation Auditor** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions ... coding and documentation patterns such as inappropriate billing for readmissions, inpatient admission status, and Hospital-Acquired Conditions (HACs). + Suggests and… more
- Elevance Health (Louisville, KY)
- …+ Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service ... requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Louisville, KY)
- …+ Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service ... given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. +...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Louisville, KY)
- …+ Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service ... requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more