- Molina Healthcare (Akron, OH)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At least 2… more
- Highmark Health (Columbus, OH)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... data to assure appropriate level of payment and resource utilization . It is also used to identify issues which...experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder… more
- Select Medical (Dublin, OH)
- …within the allotted time frame; assuring payments of services meeting patient-related utilization management criteria, and implementation of safe and appropriate ... + Current Licensure in a clinical discipline per state guidelines required. ( Registered Nurse or Social Work (SW) preferred) **Preferred Qualifications** +… more
- MTC (Marion, OH)
- …individual or group basis, as required. + Practice basic cost containment and utilization management for patient care and facility operations. + Maintain ... Paid holidays + Bereavement, civic duty, and military leave Management & Training Corporation operates the **North Central Correctional...degree in nursing, current, valid nursing license as an RN for the state of Ohio, **and** three (3)… more
- MTC (Marion, OH)
- …clean; utilize appropriate sanitation methods. 7. Practice basic cost containment and utilization management for patient care and facility operations. 8. ... + Civic duty and military leave Impact lives with Management & Training Corporation (MTC)! At the **North Central...productive life. **Essential Duties:** 1. Under direction of the RN on duty and in accordance with approved standing… more
- Cleveland Clinic (Cleveland, OH)
- …stellar care at one of the top healthcare organizations in the nation. As a Registered Nurse ( RN ) Case Manager, you will work collaboratively with ... of professional nursing + Current state licensure as a Registered Nurse ( RN ) + Basic...or AHA) + Two years of recent experience in utilization review, quality or care management +… more
- Cleveland Clinic (Dover, OH)
- …school of Professional Nursing (ADN or BSN program) + Current state licensure as a Registered Nurse ( RN ) + Basic Life Support (BLS) Certification through the ... state-of-the-art technology and provide stellar patient care. As an RN Case Manager, you will collaborate with inter-professional teams...approved entity + Two years of recent experience in utilization review, quality or care management +… more
- Cleveland Clinic (Euclid, OH)
- …from an accredited school of Professional Nursing + Current state licensure as a Registered Nurse ( RN ) + Basic Life Support (BLS) Certification through ... of the most respected healthcare organizations in the world. RN Case Managers work collaboratively with inter-professional teams across...or AHA) + Two years of recent experience in utilization review, quality or care management +… more
- Cleveland Clinic (Warrensville Heights, OH)
- …from an accredited school of Professional Nursing + Current state licensure as a Registered Nurse ( RN ) + Basic Life Support (BLS) Certification through ... of the most respected healthcare organizations in the world. RN Case Managers work collaboratively with inter-professional teams across...or AHA) + Two years of recent experience in utilization review, quality or care management +… more
- Trinity Health (Columbus, OH)
- …in lieu of an RN . + Licensure/Certification: Current license to practice as registered nurse in the State of Ohio. Registered Health Information ... Specialist (CCS) will be considered in lieu of a RN . + Experience: Minimum of 5 years acute care...5 years acute care medical or surgical experience required; Utilization /Case Management , managed care, or Clinical Documentation… more