- Molina Healthcare (Cleveland, OH)
- **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This position will support ... Chief Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. +… more
- Molina Healthcare (Dayton, 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
- Bon Secours Mercy Health (Warren, OH)
- …operational excellence. **Summary of Primary Function/General Purpose of Position** The RN Outpatient Wound Care performs and documents complete patient assessments, ... as required by their supervisor, subject to reasonable accommodation. **Licensing/Certification** Current RN license in state they are working or covered by compact… 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
- 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
- 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
- Dayton Children's Hospital (Dayton, OH)
- …of 3 years management experience in a similar department preferred Certifications + Registered Nurse with current Ohio RN license required + Current ... Education Requirements: Bachelors: Health Administration (Required), Masters Certification/License Requirements: [Lic] RN : Registered Nurse ( RN ) -… more
- Molina Healthcare (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
- Cleveland Clinic (Cleveland, OH)
- …include: + Graduate from an accredited school of nursing + Ohio licensure as a Registered Nurse ( RN ) + Additional Multistate License (MSL) or eligible for ... coding standards, billing practices and Care Guidelines, Medical Necessity Criteria and/or Utilization management criteria set + Proficiency in Microsoft Office… more
- Select Medical (Middleburg Heights, OH)
- …licensure in a clinical discipline either as a Registered Nurse , Nurse or a Respiratory Therapist ( RN preferred) OR current license / certified Social ... current licensure in a clinical discipline either as a Nurse ( RN /LPN/LVN) or a Respiratory Therapist (RT)...the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates… more