• Appeals Registered Nurse

    Evolent (Columbus, OH)
    …focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and procedures ... Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company...and Preferred:** + 1-3 years' experience and as an RN - **Required** + Minimum of 5 years in… more
    Evolent (08/08/25)
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  • SNF Utilization Management RN

    Humana (Columbus, OH)
    **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... determination of the appropriate courses of action. The SNF Utilization Management Registered Nurse 2...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
    Humana (08/09/25)
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  • Utilization Management Clinical Consultant…

    CVS Health (Columbus, OH)
    …Qualifications** + Licensed independent Behavioral Health clinician (LISW, LPCC, LMFT) or a Registered Nurse ( RN ) with unrestricted Ohio state license with ... to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is...Behavioral Health licensure (LISW, LMFT, LPCC) or if a Registered Nurse Associates degree required and BSN… more
    CVS Health (08/09/25)
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  • Utilization Management Clinical Consultant

    CVS Health (Columbus, OH)
    …+ Active and good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in clinically… more
    CVS Health (07/31/25)
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  • Utilization Management Nurse

    CVS Health (Columbus, OH)
    …verbal and written **Required Qualifications** + 3+ years of clinical experience as a Registered Nurse in adult care/critical care setting + Must have active ... current and unrestricted RN licensure in state of residence + Utilization management is a 24/7 operation. Work schedules will include weekends, holidays and… more
    CVS Health (08/08/25)
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  • RN Case Manager

    Cleveland Clinic (Cleveland, OH)
    …from an accredited school of professional nursing. + Current state licensure as a Registered Nurse ( RN ). + Basic Life Support (BLS) certification through ... approved entity + Two years of recent experience in utilization review, quality or care management + Knowledge of...personal protective equipment as required for procedures Keywords: : RN , Registered Nurse , Case Management,… more
    Cleveland Clinic (07/26/25)
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  • Utilization Review Case Manager

    Holzer Health System (Gallipolis, OH)
    …by the Ohio Board of Nursing. . A minimum of three years experience as a registered nurse in acute care for adult or pediatric patients required. Past Hospital ... or observation. Monitors the plan of care to ensure the efficient utilization of resources. Collaborates with the multidisciplinary team to improve clinical care,… more
    Holzer Health System (07/24/25)
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  • Utilization Management Nurse

    CenterWell (Columbus, OH)
    …community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... a team that focuses on excellent service to others. **Required Qualifications** + Active RN license + Possession of or ability to obtain Compact Nursing License + A… more
    CenterWell (08/08/25)
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  • Utilization Management Nurse

    CenterWell (Columbus, OH)
    …and the healthcare industry as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... San Antonio, TX **Use your skills to make an impact** **Role Essentials** + Active RN license + Possession of or ability to obtain Compact Nursing License + A… more
    CenterWell (08/02/25)
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  • RN Care Manager, Ambulatory Grant Medical

    OhioHealth (Columbus, OH)
    …Resuscitation - American Red Cross, DL - Driver's License - Department of Motor Vehicles, RN - Registered Nurse - Ohio Board of Nursing **Additional Job ... And Duties:** **Minimum Qualifications:** Bachelor's Degree (Required)APRN - Advanced Practice Registered Nurse License - State of Ohio Board of… more
    OhioHealth (07/16/25)
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