- Bon Secours Mercy Health (Springfield, OH)
- …clinical and operational excellence. **Summary of Primary Function** In the capacity of a Registered Nurse ( RN ), the Ambulatory Care Manager will provide ... RN compact license, or Multi-State License (required) Case Management certification (preferred) **Minimum Qualifications** 2-3 years acute care, home health… more
- Fresenius Medical Center (Cleveland, OH)
- …staff training, equipment, physician and patient relations, cost containment, supply management , medical records, patient billing, OSHA and all company, state and ... quality of patient care, as defined by the quality goals, by working with management to ensure that policies and procedures are followed. + Assists with implementing… more
- Molina Healthcare (Akron, OH)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
- Fresenius Medical Center (Youngstown, OH)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... of education and experience. + Graduate of an accredited School of Nursing ( RN ). + Current appropriate state licensure. **EXPERIENCE AND SKILLS:** + Required: + 6+… more
- MetroHealth (Brooklyn Heights, OH)
- …Coordinates the care of selected patients. Integrates and coordinates access and utilization management , proactive patient panel management , care ... RN licensure. Three to Five years of case management or managed care experience. Ability to work independently...Minimum 5 years of clinical practice experience. Oncology Certified Nurse (OCN) or Blood & Marrow Transplant Certified … more
- Bon Secours Mercy Health (Warren, OH)
- …partnership * Interprofessional collaboration and leadership * Understanding and utilization of office and clinical technologies * Compassionate, relationship-based ... for professional actions * Effective stewardship of available resources * Conflict management and resilience * Authority for delegating activities to others, while… more
- Molina Healthcare (Cincinnati, OH)
- …Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + ... as may be required. + Serves as a clinical resource for Utilization Management , Chief Medical Officer, Physicians, and Member/Provider Inquiries/Appeals. +… more
- Molina Healthcare (OH)
- …performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), ... identifying opportunities for improvement. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational… more
- CVS Health (OH)
- …license. + 3+ years of clinical experience required. + 2+ years of Utilization Management experience required + 2+ years' experience using personal computer, ... all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit… more
- Fresenius Medical Center (Dayton, OH)
- …under the direction of the Facility Manager, Director of Nursing and/or Charge Registered Nurse , utilizing standard nursing techniques to assist the physician in ... on adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other organization administrative… more