• Pre-Authorization Registered Nurse

    Humana (Frankfort, KY)
    …professional onsite, field, or remote based opportunities. The Prior Authorization, Registered Nurse , RN, Intern will utilize Humana's Medicaid training and ... the goal to put health first? The Prior Authorization, Registered Nurse , RN, Intern will review prior...to complete medical necessity reviews for requested services using clinical judgment and refers to internal stakeholders for review… more
    Humana (01/15/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Clinical Consultant…

    CVS Health (Frankfort, KY)
    …clinician with Kentucky state licensure (LCSW, LPCC, LMFT, LPAT, LP) or a Registered Nurse (RN) with active current and unrestricted Kentucky state license ... convenient and affordable. **Position Summary** This is a fully remote Utilization Review Clinical Consultant. **MUST RESIDE...Health licensure (LCSW, LPCC, LMFT, LPAT, LP) or a Registered Nurse (RN) with unrestricted state license… more
    CVS Health (01/24/25)
    - Save Job - Related Jobs - Block Source
  • Consultant, Nurse Disability

    Lincoln Financial Group (Frankfort, KY)
    …as indicated **What we're looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where the ... Carolina); Omaha, NE (Nebraska); Work from Home **Work Arrangement:** Remote : Work at home employee residing outside of...We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization.… more
    Lincoln Financial Group (01/03/25)
    - Save Job - Related Jobs - Block Source
  • Care Manager- Remote

    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 (01/17/25)
    - Save Job - Related Jobs - Block Source
  • Excess Risk Managed Care Clinician

    Highmark Health (Frankfort, KY)
    …+ Bachelor's degree in Nursing **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Case Manager (CCM) **Language ... Group **Job Description :** **JOB SUMMARY** This job is responsible for analyzing clinical data to assess potential stop loss and managed care claim liability,… more
    Highmark Health (11/25/24)
    - Save Job - Related Jobs - Block Source
  • Director, Compliance Operations

    WelbeHealth (Frankfort, KY)
    …compliance with regulatory standards **Job Requirements:** + Bachelor's degree required + Registered Nurse (RN), master's degree, or other relevant advanced ... 100% REMOTE OPPORTUNITY At WelbeHealth, each participant of our...is guided by our interdisciplinary team (IDT), composed of clinical and non- clinical members who work cohesively… more
    WelbeHealth (01/23/25)
    - Save Job - Related Jobs - Block Source
  • Field Care Manager, Behavioral Health

    Humana (Frankfort, KY)
    clinical experience in behavioral health **OR** an active, unrestricted Kentucky Registered Nurse **(RN)** license with at least three years of experience ... Virginia, or West Virginia.** + An active, unrestricted Licensed Masters Clinical Social Worker **(LCSW),** Licensed Professional Clinical Counselor **(LPCC)**… more
    Humana (11/20/24)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Behavioral Health…

    Humana (Frankfort, KY)
    …Therapist **(LMFT)** , Licensed Professional Counselor **(LPC)** , Psychologist **(PhD)** , Registered Nurse **(RN)** or other professional license. + Three (3) ... independent determination of the appropriate courses of action. + Utilizes clinical knowledge, communication skills, and independent critical thinking skills towards… more
    Humana (11/13/24)
    - Save Job - Related Jobs - Block Source