- Elevance Health (Columbus, OH)
- …an expanding set of clinical domains, including radiology, cardiology and oncology. ** Nurse Reviewer I** **Location:** The selected candidates must reside in ... hours from 9:00 am-6:00 pm, rotating weekend shifts. The ** Nurse Reviewer I** is responsible for conducting...that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or… more
- CVS Health (Columbus, OH)
- …in a collaborative process to implement, coordinate, monitor and evaluate medical review cases . Applies the appropriate clinical criteria/guideline to render a ... thinking, evidenced based clinical criteria and clinical practice guidelines. Med Review nurses use specific criteria to authorize procedures/services or initiate a… more
- ChenMed (Columbus, OH)
- … nurse practitioner role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization, provide family education and identify ... we need great people to join our team. The Nurse Practitioner (NP) acts as part of the clinical...in-depth documentation through written progress notes and summaries. The Nurse Practitioner must demonstrate the ability to function both… more
- Highmark Health (Columbus, OH)
- …Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** The Registered Nurse assesses human responses and plans, implements and evaluates nursing care ... for individuals or families for whom the nurse is responsible. The Registered Nurse is...in on-going interdisciplinary communication specific to each patient with review of patient status and plan of care. +… more
- BrightSpring Health Services (London, OH)
- …ResCare Community Living Overview Works under the supervision of a Registered Nurse . Duties include providing routine care, general observation of client's health ... care and services and reports any changes* Complete a quarterly nursing evaluation/ review of body systems on assigned individuals per program requirements. Refer to… more
- CVS Health (Columbus, OH)
- …of residence.** **Position Summary** RN and certified coder Responsible for the review and evaluation of clinical information and documentation related to SIU ... using Internet Explorer and Google Chrome to effectively utilize review resources and conduct reviews. **Required Qualifications** + 5+...required + 2+ years of experience as a Registered Nurse + Must have active, current and unrestricted RN… more
- CVS Health (Columbus, OH)
- …Weekend, and late rotations. **Required Qualifications** + Active current and unrestricted Registered Nurse in the state of residence + Willing and able to obtain ... require + 3+ years of experience as a Registered Nurse + 1+ years of clinical experience in acute...care experience ie ICU, CCU, NICU, ER** + Utilization review experience + Managed Care experience + Experience working… more
- Lincoln Financial Group (Columbus, OH)
- …Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for ... for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state...in a career at Lincoln, we encourage you to review our current openings and apply on our website.… more
- Trinity Health (Columbus, OH)
- …and guiding behaviors, the clinical educator, within the scope of the Ohio Nurse Practice Act, functions within the standards, policies, procedures and guidelines of ... / Certification: Current licensure to practice as a registered nurse in the State of Ohio; Professional certification preferred...of Class and curriculum . Ongoing Policy and Competency review . Education plan development . Regulatory action plan… more
- Surgery Care Affiliates (Dublin, OH)
- …career opportunities for YOU. Responsibilities We are actively hiring for an Registered Nurse (RN) PreOp PACU. + Promote the mission, vision, and values of SCA ... to care. + Delegate tasks according to the state Nurse Practice Act (if applicable), state board of nursing...with other disciplines as needed. + Participate in quality review and performance improvement projects. + Participate in the… more
- CVS Health (Columbus, OH)
- …working with providers to secure additional information for prior authorization review . CVS health requires eligible colleagues identified as permanent work from ... up front. **Required Qualifications** + 1 year UM, concurrent review or prior authorization + 5 years of clinical...required 100% participation during 8:30am-5pm Monday-Friday. + A Registered Nurse that must hold an unrestricted license in their… more
- Humana (Columbus, OH)
- …community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the coordination, documentation ... medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation… more
- Molina Healthcare (Columbus, OH)
- …meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital or medical ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing (RN) license in good standing. Preferred Experience Previous experience in hospital Acute care, ER or ICU Previous experience with InterQual or… more
- Cardinal Health (Columbus, OH)
- …and other global competent authorities and regulators. + Serve as expert reviewer for European and Canadian Medical Device Regulation documents. + Participate in ... Procedures. **Qualifications:** + Bachelor's degree in nursing required, Advanced Practice Nurse , master's level degree preferred. + Active nursing license. + CPPS… more
- Fresenius Medical Center (Columbus, OH)
- …effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with FMCNA policies procedures and training and in compliance ... well-being since their last treatment. Report any complaints or observations to the nurse supervisor. + Evaluate vascular access for patency and report any unusual… more
- Fresenius Medical Center (Columbus, OH)
- …dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance ... significant information and/or change in patient condition directly to the registered nurse or supervisor. + Observe patient and conduct machine safety checks… more
- CVS Health (Columbus, OH)
- …through integration. - Through the use of clinical tools and information/data review , conducts an evaluation of member's needs and benefit plan eligibility and ... health needs based on key questions and conversation. **Required:** - A Registered Nurse that must hold an unrestricted license in their state of residence,… more
- Molina Healthcare (Columbus, OH)
- …be supporting our Appeals and Grievances department. We are seeking a Registered Nurse with previous Appeals and Grievances experience and a clinical background. The ... and production levels are maintained + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management… more
- Option Care Health (Dublin, OH)
- …managing, and reporting nursing operational and financial data to the Regional Nurse Manager, Area Director of Nursing, and/or Director of Operations. Supports the ... Director of Operations, Area Director of Nursing and/or the Nurse Manager in the recruitment, development, and monitoring of...using find and replace, undo, spell check, track changes, review pane and/or print functions). + Basic level skill… more
- Molina Healthcare (Columbus, OH)
- …and medical records to document relevant findings of a post pay clinical review . This position manages documents and prioritizes case load to ensure timely turn ... guidelines, internal policies, and contract requirements. This position completes a medical review to facilitate a referral to law enforcement or for payment… more