• Care Manager, Registered Nurse

    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 (02/17/25)
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  • Clinical Appeals Nurse (RN): Texas…

    Molina Healthcare (Lexington, KY)
    …decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical /medical ... 4 weeks Monday-Thursday and Wed - Saturday._** **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical more
    Molina Healthcare (02/09/25)
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  • Registered Nurse - Behavioral Health…

    Veterans Affairs, Veterans Health Administration (Lexington, KY)
    Summary The registered nurse (staff nurse ) is directly responsible to the designated manager of the RRTP/SARTP program; the registered nurse is ... that reflect the educational, experiential and competency requirements. Responsibilities The registered nurse possesses basic knowledge and skills to apply… more
    Veterans Affairs, Veterans Health Administration (03/12/25)
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  • Utilization Management Registered

    Humana (Frankfort, KY)
    …**Use your skills to make an impact** **Required Qualifications** + Active licensed Registered Nurse (RN) in the state of Virginia or obtain a ... and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to...to troubleshoot and resolve basic technical difficulties in a remote environment. + Ability to work independently under general… more
    Humana (03/18/25)
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  • Utilization Management Behavioral Health…

    Humana (Frankfort, KY)
    …**Use your skills to make an impact** **Required Qualifications** + Active unrestricted registered nurse license in the state of Virginia or obtain a ... us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to...to troubleshoot and resolve basic technical difficulties in a remote environment. + Ability to work independently under general… more
    Humana (03/18/25)
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  • Pre-Authorization Registered Nurse

    Humana (Frankfort, KY)
    …**Use your skills to make an impact** **Required Qualifications** + Active Licensed Registered Nurse (RN) in the state of Virginia or obtain a ... of our caring community and help us put health first** The Pre-Authorization Nurse 2 reviews prior authorization requests for appropriate care and setting, following… more
    Humana (03/15/25)
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  • Manager, Utilization Management Registered

    Humana (Frankfort, KY)
    …**Use your skills to make an impact** **Required Qualifications** + Active Licensed Registered Nurse (RN) in Virginia or enhanced compact license, (eNLC) with ... us put health first** The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of… more
    Humana (03/12/25)
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  • Associate Clinical Nurse Editor,…

    RELX INC (Frankfort, KY)
    Associate Clinical Nurse Editor, eLearning Do you excel in validating the clinical accuracy and relevance of point-of-care and educational materials? Would ... evidence integration into content About the role The Associate Clinical Nurse Editor for eLearning plays a...eLearning leadership team. Requirements + Have an unencumbered licensed Registered Nurse and bachelor's degree in nursing… more
    RELX INC (02/07/25)
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  • Manager, HCS Clinical Policy - Medicare…

    Molina Healthcare (Lexington, KY)
    …identifying opportunities for improvement. **Job Qualifications** **REQUIRED EDUCATION** : Registered Nurse or equivalent combination of Licensed Vocational ... **Job Description** **Job Summary** Develops clinical policies to ensure that patients progress toward... Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of RN license… more
    Molina Healthcare (02/14/25)
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  • Clinical Consultant, MI

    Fujifilm (Frankfort, KY)
    …where appropriate. + Participates in professional organizations. + Provides telephone and remote clinical support for customers, sales, and field service via ... **Position Overview** The Clinical Consultant, MI - I shall be responsible...experience in: + MPI + MUGA + PET + (CV) Registered Nurse Cardiac experience in: + Cath,… more
    Fujifilm (02/12/25)
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  • Sr Clinical Consultant, Cardio

    Fujifilm (Frankfort, KY)
    … Nuclear Medicine Technologist experience in: + MPI + MUGA + PET + Registered Nurse Cardiac experience in: + Cath, Peripheral Angiography, Electrophysiology Lab ... **Position Overview** The Senior Clinical Consultant, Cardiology shall be responsible for providing...and standards. **Qualifications:** + Advanced Cardiac Sonographer. Technologist or Nurse + 5+ years of progressive experience in medical… more
    Fujifilm (02/19/25)
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  • Remote Program Manager, HCS - RN…

    Molina Healthcare (Lexington, KY)
    …materials and other related documentations. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... and Eastern time zones. While the position is fully remote , working from home, there will be 25% or...Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of RN license.… more
    Molina Healthcare (03/04/25)
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  • Manager, Healthcare Services ( Remote )

    Molina Healthcare (Lexington, KY)
    …identifying opportunities for improvement. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... the right time and assisting them to achieve optimal clinical , financial, and quality of life outcomes. + Responsible... Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of RN license.… more
    Molina Healthcare (03/07/25)
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  • Sr Specialist, Quality Improvement (RN)…

    Molina Healthcare (Lexington, KY)
    …QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist, Quality Improvement ( Registered Nurse ) contributes to one or more of ... key quality strategies that require a component of near real-time clinical decision-making. These activities may include initiation and management of interventions… more
    Molina Healthcare (03/19/25)
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  • Sr Clinical Performance Consultant

    Molina Healthcare (Lexington, KY)
    …on business need (up to 25%) **Job Qualifications** * Active and unrestricted Registered Nurse (RN) license or independent behavioral health license (LCSW, LPC, ... **Job Description** Looking for a Registrared Nurse or Licensed Social worker to support HealthPlans...AM to 5 PM) - to support business needs Remote Position - Home office with internet connectivity of… more
    Molina Healthcare (03/15/25)
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  • Clinical Supervisor, Access and Patient…

    Cardinal Health (Frankfort, KY)
    …be needed to perform your duties up to 25%. **_Qualifications_** + Current, unrestricted Registered Nurse license, required. + BA, BS or equivalent experience in ... life-changing therapies to patients who need them-faster.** **_Responsibilities_** The Clinical Operations Supervisor leads program staff performing actions including… more
    Cardinal Health (03/13/25)
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  • Inpatient Review (RN): Remote , California…

    Molina Healthcare (Lexington, KY)
    **EMERGENCY ROOM ADMISSIONS REVIEW NURSE ** **_2 openings for 12 hour NIGHT SHIFT: 7:30PM (in the evening) - 08:30AM (in the morning) PACIFIC HOURS NON EXEMPT, 3 days ... compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical more
    Molina Healthcare (02/14/25)
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  • Care Manager RN (Delaware) Remote

    Highmark Health (Frankfort, KY)
    …+ Experience in UM/CM/QA/Managed Care **LICENSES or CERTIFICATIONS** **Required** + United States Registered Nurse (RN) license + Delaware RN license must be ... Master's Degree in Nursing **EXPERIENCE** **Required** + 3 years of related, progressive clinical experience in the area of specialization + Experience in a … more
    Highmark Health (02/20/25)
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  • Manager, Utilization Management Behavioral Health

    Humana (Frankfort, KY)
    …required. **Additional Information:** **Workstyle:** Remote work at Home **Location for Registered Nurse :** must reside in the state of Virginia or reside ... **Must meet** **one** **of the following:** + Active unrestricted registered nurse license in the state of...counseling experience required + Minimum one, (1) year of clinical supervisory such as team lead, charge nurse more
    Humana (03/12/25)
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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 (02/24/25)
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