- Centene Corporation (Columbus, OH)
- …Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks...position open to candidates nationwide.** **Candidates must have a Registered Nurse ( RN ) license for… more
- Humana (Columbus, OH)
- …areas. **Use your skills to make an impact** **Required Qualifications** + An active, unrestricted Registered Nurse ( RN ) license in the state of Michigan. + ... of our caring community and help us put health first** The Manager, Utilization Management Nursing (LTSS Utilization Management Leader) utilizes clinical… more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- CVS Health (OH)
- …active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, ... **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care...or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing… more
- CVS Health (OH)
- …to hold a Licensed independent Behavioral Health clinician (LISW, LPCC, LMFT) or a Registered Nurse ( RN ) with unrestricted state license in Ohio, and ... **Position Summary** This Clinical Consultant position is with Aetna's Utilization Management (UM) team and is a...independent Behavioral Health clinician (LISW, LPCC, LMFT) or a Registered Nurse ( RN ) with unrestricted… more
- CVS Health (OH)
- … solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. **Position ... times are not permitted. **Required Qualifications** + Active, unrestricted RN license in your state of residence with multistate/compact...in medical healthcare. + 3+ years Medical Review or Utilization Management experience. + 2+ years of… more
- Molina Healthcare (OH)
- …state board licensing mandate. + At least 2 years in case, disease or utilization management ; managed care; or medical/behavioral health settings. + One year of ... or Clinical Social Worker/Counseling License. + Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified Professional in Health Care… more
- CVS Health (Columbus, OH)
- …other events, as directed by their Leader. **Required Qualifications** + Active and unrestricted Registered Nurse in state of residence + 3+ years of experience ... external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set...as a Registered Nurse + 1+ years of clinical… more
- Dayton Children's Hospital (Dayton, OH)
- …timeHours:40Job Details:Under the supervision of the Manager of Utilization Management , the Utilization Review RN conducts medical record ... Epic Systems preferred Education Requirements: Bachelors: Nursing (Required) Certification/License Requirements: [Lic] RN : Registered Nurse ( RN ) - Ohio… more
- Select Medical (Middleburg Heights, OH)
- …Illness Recovery Hospital** **Director of Case Management ** **_Clinical license as a registered nurse or respiratory therapist or master's in social work and ... focus on resource management . + Demonstrating compliance with facility-wide Utilization Management policies and procedures. + Coordinating UR compliance with… more