• Quality Review Nurse

    Sedgwick (Frankfort, KY)
    …line of business experience in telephonic case management (TCM) and/or utilization review or equivalent combination of education and experience required. ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance Quality Review Nurse **PRIMARY PURPOSE** : To monitor team and colleague technical and… more
    Sedgwick (08/15/25)
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  • Disease Management Nurse - Remote

    Sharecare (Frankfort, KY)
    utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification ... To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and objectives of the… more
    Sharecare (08/13/25)
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  • Case Manager, Registered Nurse - Fully…

    CVS Health (Frankfort, KY)
    …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
    CVS Health (08/15/25)
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  • Case Manager Registered Nurse - Two Rivers…

    CVS Health (Franklin, KY)
    …+ Discharge Planning Experience + Motivational Interviewing skills + Managed Care/ Utilization Review Experience + Clinical experience and demonstrated knowledge ... do it all with heart, each and every day. **Position Summary** The Complex Nurse Case Manager is responsible for assessing members through regular and consistent in… more
    CVS Health (07/31/25)
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  • Case Manager Registered Nurse -Field

    CVS Health (Frankfort, KY)
    …coordination of psychosocial wrap around services to promote effective utilization of available resources and optimal, cost-effective outcomes. **Position ... Responsibilities:** + Responsible for telephonic and/or face to face assessment, planning, implementing and...+ Through the use of clinical tools and information/data review , conducts comprehensive assessments of member's needs and recommends… more
    CVS Health (08/15/25)
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  • Care Management Associate- Must Reside…

    CVS Health (Frankfort, KY)
    …supporting the implementation of care plans to promote effective utilization of healthcare services. Promotes/supports quality effectiveness of Healthcare Services. ... and administrative duties. **Fundamental Components:** + Responsible for initial review and triage of Care Team tasks. + Identifies...for health care service delivery under the direction of nurse or medical director in the most appropriate setting… more
    CVS Health (07/16/25)
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