• Clinical Registered Nurse

    Sharecare (Frankfort, KY)
    …for all Sharecare clinicians. **Essential Job** **Functions:** **Achievement of Clinical Objectives** + Reviews status of participant's preventive health exams ... impact of the health care delivery system on the clinical and financial outcomes of the member population and...+ Minimum of 3 years recent experience in a clinical setting. + Basic knowledge of physiology and chronic… more
    Sharecare (01/08/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Louisville, KY)
    **Diagnosis Related Group Clinical Validation Auditor-** ** Registered Nurse ** **Location:** This position will work a hybrid model ( remote and office). ... and efficiency recommendations. **Minimum Requirements:** + Requires current, active, unrestricted Registered Nurse license in applicable state(s). + Requires a… more
    Elevance Health (01/01/25)
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  • RN - Remote Utilization Management…

    Humana (Frankfort, KY)
    …to make an impact** Additional Job Description **Required Qualifications** + Licensed Registered Nurse (RN) with compact license with no disciplinary action ... and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication… more
    Humana (01/08/25)
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  • RN, Utilization Management Nurse

    Humana (Louisville, KY)
    …+ **Must live within 30 miles of Lexington or Louisville, Kentucky.** + Licensed Registered Nurse (RN) in the state of Kentucky with no disciplinary action ... put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Nurse 2 who will utilize clinical nursing skills to support the… more
    Humana (12/03/24)
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  • 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)
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  • Care Manager Behavioral Health - Part Time…

    Highmark Health (Frankfort, KY)
    …+ Licensed Marriage and Family Therapist (LMFT) + Licensed Behavior Specialist + Registered Nurse . **Preferred** + None **SKILLS** + Working knowledge of ... **Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** **Fully Remote - Part Time - Weekends Required.** This job implements the effective utilization… more
    Highmark Health (12/12/24)
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  • 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 (12/04/24)
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  • Tele-Triage LPN - SNF

    BrightSpring Health Services (Louisville, KY)
    …of Business Starting Point Nursing Services is staffed 100% by a team of remote Registered Nurses trained to support the Post-Acute Continuum with clinical ... Living Providers. Our services are tailored to our partners, including remote physical/chart assessments, predictive care modeling, clinical programming… more
    BrightSpring Health Services (01/09/25)
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  • 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)
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  • Care Review Clinician, Inpatient Review (RN)

    Molina Healthcare (Louisville, KY)
    **JOB DESCRIPTION** **_For this position we are seeking a (RN) Registered Nurse with previous experience in Hospital Acute Care, Concurrent Review/ Utilization ... flexible and willing to work holidays. This is a remote position, and you may work from home._** **_Further...all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence… more
    Molina Healthcare (01/01/25)
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  • 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)
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  • 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)
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