- Trinity Health (Columbus, OH)
- …with the Plan's UM and QM Program and the review of the Plan's Medical Management Plan. **What we are looking for:** + Education: Associate Degree in ... analysis, audit, provider relations and more. **Position Purpose:** The RN Case Manager MCHP is responsible for the coordination...Manager MCHP is responsible for the coordination of the medical care provided to Plan members with Plan providers,… more
- OhioHealth (Columbus, OH)
- …Resuscitation - American Red Cross, DL - Driver's License - Department of Motor Vehicles, RN - Registered Nurse - Ohio Board of Nursing **Additional Job ... to promote patients' optimal health through disease prevention and management strategies. Evidence-based interventions are applied to populations for...Description:** RN from an accredited school of Nursing with a… more
- Molina Healthcare (OH)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- OhioHealth (Columbus, OH)
- …Resuscitation - American Red Cross, DL - Driver's License - Department of Motor Vehicles, RN - Registered Nurse - Ohio Board of Nursing **Additional Job ... continuum to promote patients' optimal health through disease prevention and management strategies. Evidence-based interventions are applied to populations for cost… more
- Molina Healthcare (Cleveland, OH)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications * At least 2… more
- Molina Healthcare (Akron, OH)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... multidisciplinary teams to promote the Molina care model. * Adheres to utilization management ( UM ) policies and procedures. Required Qualifications * At least 2… more
- Cleveland Clinic (Cleveland, OH)
- …Program ( RN ) + Current valid license in the State of Florida as a Registered Nurse ( RN ) + Basic Life Support (BLS) certification through the American ... healthcare organizations in the world. As a Concurrent Denial Nurse , you will support the Utilization Management ...necessity criteria is met. We are looking for a Registered Nurse who is a subject matter… more
- Evolent (Columbus, OH)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... precertification and prior approvals. Tasks are performed within the ** RN /LVN/LPN** scope of practice, under the Medical ...InterQual) + Minimum of one year of experience with medical management activities in a managed care… more
- Humana (Columbus, OH)
- …the design, implementation, and advancement of strategic initiatives within the Utilization Management ( UM ) function. This role is responsible for leveraging ... or program management . + Advanced degree or professional certification (eg, RN , LPN, MBA, PMP, ASA/FSA). + Experience with designing and implementing clinical… more
- CVS Health (Columbus, OH)
- …solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management ( UM ) Nurse to join our remote team **Position ... Holding, Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective… more