- Molina Healthcare (Cleveland, OH)
- **Job Summary** **_For this position we are seeking a (RN) Registered Nurse who must be licensed for the state of KENTUCKY or have a compact license._** Provides ... bills, and claims data to ensure appropriate payment levels, optimize resource utilization , and maintain compliance with state and federal laws. All reviews must… more
- ProMedica Health System (Toledo, OH)
- … Nursing and Therapy Leadership to coordinate the timely management of insurance precertification, recertification, authorizations and appeals, length of stay, ... record review and interaction with internal and external physicians, nursing , therapists, leadership, coding and clinical documentation specialists, patients,… more
- Sedgwick (Columbus, OH)
- …needs, gives appropriate clinical options, and provides education to clients, nurse team, and treating physicians; develops specialized training for nurses to ... with client. + Maintains accurate record system of pharmacy utilization review and complex pharmacy reviews to include cost...complex review of cases to identify referral for case management as needed. + Participates in client meetings and… more
- Veterans Affairs, Veterans Health Administration (Cincinnati, OH)
- …for clinical and operational oversight of the CLC. The CLC is a nursing home clinical setting that provides long term care, short term rehabilitation, short ... term skilled nursing , respite and hospice services. The 64-bed CVAMC CLC...to patient care. Provide direct patient/resident care including comprehensive management of the physical, psychological, emotional, social, and spiritual… more
- OhioHealth (Columbus, OH)
- …and or provider group. **Minimum Qualifications:** Bachelor's Degree (Required)RN - Registered Nurse - Ohio Board of Nursing **Additional Job Description:** + ... or equivalent work Experience Excellent communication and presentation skills. Utilization of effective communication strategies. Knowledge of EMR applications or… more
- Elevance Health (Columbus, OH)
- …or face-to-face assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social ... RN, member and the health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will be based upon the current… more
- Elevance Health (Norwood, OH)
- …state(s) required. **Preferred Skills, Capabilities and Experiences:** + BA/BS in Health/ Nursing preferred. + Strong preference for case management experience ... by law._ The **LTSS Service Coordinator-RN Clinician** is responsible for overall management of member's case within the scope of licensure, develops, monitors,… more
- City of Cincinnati (Cincinnati, OH)
- …students and residents, as required. Collaborates with the Primary Health Care Nursing Supervisor and the clinic administrators to coordinate and implement changes ... studies and surveys with technical staff; for the purpose of quality assurance, utilization review and the overall improvement of medical programs of the Health… more
- Trinity Health (Canal Winchester, OH)
- …mission of Diley Ridge Medical Center, under the direction of a Registered Nurse , the Multi-skilled Technician, will provide direct and indirect patient care, in an ... and customer service focus. Job Relationships Reports to: Assistant Clinical Manager, Clinical Nurse Manager, Charge Nurse or designee Supervises: N /A Job… more
- Trinity Health (Canal Winchester, OH)
- …of Diley Ridge Medical Center, under the direction of a Registered Nurse , the Emergency Services Technician (Paramedic), will provide direct and indirect patient ... a community and customer service focus. Job Relationships Reports to: Clinical Nurse Manager, Assistant Clinical Manager/Educator, Charge Nurse or designee… more