- Evolent (Frankfort, KY)
- …scheduled. + Determines medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all review ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks… more
- Molina Healthcare (Lexington, KY)
- …for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing clinical knowledge and experience, responsible for ... Payment Integrity analytical team; requires decision making pertinent to clinical experience + Documents clinical review...clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review .… more
- Fresenius Medical Center (Louisville, 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
- Fresenius Medical Center (Kuttawa, KY)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture...a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in… more
- HCA Healthcare (Bowling Green, KY)
- …is important to you, we encourage you to apply for our Clinical Nurse Coordinator opening. Our team will promptly review your application. Highly qualified ... colleagues in their positions. Join our Team as a(an) Clinical Nurse Coordinator and access programs to...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
- Elevance Health (Louisville, KY)
- ** Nurse Audit Senior - Payment Integrity Complex and Clinical Audit** **Location:** This role enables associates to work virtually full-time, with the exception ... formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The ** Nurse Audit Senior** will be responsible… more
- Bon Secours Mercy Health (Paducah, KY)
- …as an RN (required) + Experience with discharge planning or utilization review (preferred) **Skills & Abilities:** Hard/Tech/ Clinical Skills _:_ + Discharge ... effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. **Mercy Health** Intro paragraph As a faith-based… 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
- ChenMed (Louisville, KY)
- …JOB FUNCTIONS: The Nurse Practitioner (NP) acts as part of the clinical operations team and is responsible for providing direct patient care in ChenMed/Jencare ... This position may require to participate in risk and quality management programs, clinical meetings and other meetings. The Nurse Practitioner will adhere to… more
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- …patients, when appropriate. 7. Screens telephone calls for the provider, and takes clinical messages, as appropriate. 8. Answers patient inquiries with respect to ... medical questions within the scope of practice and practice...relays proper information about the patient. 15. Maintains all clinical equipment to include sterilizing, as applicable. Evaluates all… more