- Elevance Health (Louisville, KY)
- ** Clinical Review Nurse I** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... for Medicare and Medicaid Services to transform federal health programs. The ** Clinical Review Nurse ** is responsible for reviewing and making medical… more
- HCA Healthcare (Bowling Green, KY)
- …your next step in your career path, we encourage you to apply for our Clinical Nurse Coordinator opening. We review all applications. Qualified candidates ... **Description** **Introduction** Do you have the career opportunities as a Clinical Nurse Coordinator you want in your current role? We invest in what matters… more
- HCA Healthcare (Frankfort, KY)
- …you, we encourage you to apply for our Progressive Care Clinical Nurse Coordinator opening. Our team will promptly review your application. Highly qualified ... our colleagues in their positions. Join our Team as a(an) Progressive Care Clinical Nurse Coordinator and access programs to assist with every stage of your… more
- Molina Healthcare (Bowling Green, KY)
- …decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical /medical ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and...specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service… more
- Bon Secours Mercy Health (Paducah, KY)
- …patients with one of our NPs to cut down on any hospital readmissions. he Clinical Nurse Liaison (CNL) functions in the role of expert clinician, educator, ... cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. Job Description Phone triage for patients as… more
- Elevance Health (Louisville, KY)
- ** Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 ... to recover, eliminate and prevent unnecessary medical-expense spending. The ** Clinical Fraud Investigator II** is responsible for identifying issues and/or… more
- Fresenius Medical Center (Georgetown, KY)
- …or federal surveys. + Participates in the completion of the FMS Administrative Clinical Review . **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical ... requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory… more
- HCA Healthcare (Bowling Green, KY)
- …this opportunity compelling, we encourage you to apply for our Emergency Room Nurse opening. We promptly review all applications. Highly qualified candidates ... and values thrive? Submit your application for our ER Nurse opening with TriStar Greenview Regional Hospital today and...may vary by location. We are seeking a(an) ER Nurse for our team to ensure that we continue… more
- Fresenius Medical Center (Madisonville, KY)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- Molina Healthcare (Lexington, KY)
- …identified by the Payment Integrity analytical team; requires decision making pertinent to clinical experience + Documents clinical review summaries, bill ... Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing clinical... review , and medical coding. **Job Summary** Utilizing clinical knowledge and experience, responsible for review … more
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