- Elevance Health (Mason, OH)
- …policies when making medical necessity decisions. + Brings to their supervisors attention, any case review decisions that require + Medical Director review ... Associate Medical Director** **Carelon Medical Benefits Management** **Radiology Benefit** **Management/ Utilization ** ** Review ** **Virtual:** This role enables associates… more
- Elevance Health (Mason, OH)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... clinical reviews with attending physicians or other providers to discuss review determinations, and patients office visits with providers and external physicians.… more
- Sharecare (Columbus, OH)
- …techniques, the nurse helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also ... A Disease Management Nurse is supervised by an Operations Manager (OM). All Sharecare clinicians are required to participate...and to take the pre and post tests to review competency during orientation. Yearly competency tests are required… more
- ChenMed (Columbus, OH)
- …and explain nurse practitioner role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... the office. + Engages with the transitional care team and others including case managers, acute and transitional-care physicians, and other resources that may be… more
- ChenMed (Columbus, OH)
- …and explain nurse practitioner role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... of the nursing plan of care, health education, physician referrals, case management referrals, follow-up and clear documentation according to ChenMed standards… more
- Elevance Health (Independence, OH)
- …or equivalent. Requires a minimum of 4 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted LPN/LVN ... May collaborate with healthcare providers. Focuses on moderately complex case types that do not require the training or...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more