- Humana (Louisville, 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
- Signature Healthcare (Louisville, KY)
- …Care documentation to facility accurate billing. What you Need to make a Difference + Registered Nurse ( RN ) in good standing with required current state ... communication with leadership, patients, families, internal care givers, and external Utilization Management Nurses. + Coordinate internal and external health… more
- Humana (Frankfort, KY)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Fresenius Medical Center (Shelbyville, 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
- CVS Health (Frankfort, KY)
- …Health clinician with Kentucky state licensure (LCSW, LPCC, LMFT, LPAT, LP) or a Registered Nurse ( RN ) with active current and unrestricted Kentucky state ... to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking...Health licensure (LCSW, LPCC, LMFT, LPAT, LP) or a Registered Nurse ( RN ) with unrestricted… more
- Humana (Frankfort, KY)
- …Family Therapist **(LMFT)** , Licensed Professional Counselor **(LPC)** , Psychologist **(PhD)** , Registered Nurse **( RN )** or other professional license. + ... health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral health knowledge… more
- Molina Healthcare (Louisville, 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 (Louisville, KY)
- **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case ... them. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ) Program and...years of experience in case management , disease management or utilization management in… more
- CenterWell (Louisville, 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
- ChenMed (Louisville, KY)
- …RN with bachelor's degree in a related clinical field preferred. + A valid, active Registered Nurse ( RN ) license in State of employment required. + A ... people to join our team. * The Acute Care Nurse is responsible for achieving positive patient outcomes, managing...experience required. + A minimum of 1 year of utilization review and/or case management , home health,… more
- 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 Review / Utilization Management ...care/medical experience. **Required License, Certification, Association** Active, unrestricted Wisconsin Registered Nursing ( RN ) license in good standing.… more
- Wellpath (La Grange, KY)
- …Surgical experience preferred Licenses/Certifications + Have and maintain current licensure as a Registered Nurse within the state of employment. + Obtain and ... maintain CPR certification **Additional Details** -Candidate needs to be licensed as a Registered Nurse in the state of KY **We are an Equal Employment… more
- Molina Healthcare (Louisville, 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
- Intermountain Health (Frankfort, KY)
- …/Professional Nursing program. + Required Licensure/Certification: State licensure as a Registered Nurse ( RN ). Preferred Qualifications + Bachelor's ... cost-effective outcomes. Provides focused support to various areas such as utilization management , emergency department, acute, ambulatory and specialty care.… more
- Molina Healthcare (Louisville, 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
- 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
- Elevance Health (Louisville, KY)
- …criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Location: This is a...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- Highmark Health (Frankfort, KY)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health care ... Experience in a clinical setting **Preferred** + Certification in utilization management or a related field +...and Family Therapist (LMFT) + Licensed Behavior Specialist + Registered Nurse . **Preferred** + None **SKILLS** +… more