• RN , Utilization Management

    Humana (Lexington, KY)
    …and help us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Nurse 2 who will utilize clinical nursing skills to ... benefit administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work...30 miles of Lexington or Louisville, Kentucky.** + Licensed Registered Nurse ( RN ) in the… more
    Humana (12/03/24)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Mount Sterling, KY)
    …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... of education and experience. + Graduate of an accredited School of Nursing ( RN ). + Current appropriate state licensure. **EXPERIENCE AND SKILLS:** + Required: + 6+… more
    Fresenius Medical Center (01/11/25)
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  • Lead, Auditor ( RN ) Appeals & Grievances…

    Molina Healthcare (Lexington, KY)
    …and production levels are maintained + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case ... Management (CM), Member Assessment Team (MAT), Health Management (HM), and/or Disease Management (DM) and...them.. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ) Program and… more
    Molina Healthcare (01/13/25)
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  • RN Clinical Manager, Home Health

    CenterWell (Lexington, KY)
    …license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home care, ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
    CenterWell (11/12/24)
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  • COE CM Director, ( RN required)

    Molina Healthcare (Lexington, KY)
    Registered Nursing ( RN ) license in good standing. + Utilization Management Certification (CPHM) Certified Professional in Health Care Quality (CPHQ), ... _This position requires an actively licensed Registered Nurse_ **JOB DESCRIPTION** **Job Summary** The mission of Clinical Operations is to drive value through an… more
    Molina Healthcare (12/12/24)
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  • Field Family Nurse Practitioner (Pikeville,…

    Molina Healthcare (Lexington, KY)
    …driver's license **PREFERRED EDUCATION:** **PREFERRED EXPERIENCE:** + 3-5-year experience as a Registered Nurse and/or Nurse Practitioner, ideally in a ... **JOB DESCRIPTION** **Job Summary** The Care Connections Nurse Practitioners focus on screening and preventive primary care services delivered in the home,… more
    Molina Healthcare (01/02/25)
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  • RN -House Supervisor

    LifePoint Health (Versailles, KY)
    …and fosters an environment that encourages professional growth. Initiates weekend case management , Utilization review screening, assists with D/C planning and ... Requirements Minimum EducationX Associate's degree - Required An Active RN License with KBN or a Compact RN...- within 60 days of hire and renewed annuallyTrauma Nurse Core Course (TNCC) - PreferredENPC - preferredNRP -… more
    LifePoint Health (12/09/24)
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  • CKY Capacity Management Coordinator,…

    LifePoint Health (Georgetown, KY)
    …EducationAssociate's Degree Nursing (ADN) RequiredBachelor's Degree Nursing (BSN) Preferred Required SkillsLicenses: Registered Nurse in State of KY Three years ... . Bereavement Leave . 401(k) Match . Free Parking CKY Capacity Management Coordinator (Weekends) Essential Functions Determines patient priority and the ability to… more
    LifePoint Health (12/14/24)
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