• Clinical Reviewer , Nurse

    Evolent (Columbus, OH)
    …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
    Evolent (10/21/25)
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  • Nurse Practitioner (Acute Care), Physician…

    Cleveland Clinic (Cleveland, OH)
    …and the Governing Body of the applicable hospitals. **CNS** + Currently licensed as a Clinical Nurse Specialist in applicable state(s). + Must be licensed as an ... medical care may be in a variety of clinical settings. PA's are privileged by the Board of...RN in applicable state(s). + National certification as a Clinical Nurse Specialist by nationally accredited organization… more
    Cleveland Clinic (09/30/25)
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  • Nurse Practitioner (Acute Care), Physician…

    Cleveland Clinic (Akron, OH)
    …and the Governing Body of the applicable hospitals. **CNS** + Currently licensed as a Clinical Nurse Specialist in applicable state(s). + Must be licensed as an ... Clinic Akron General is looking for an Acute Care Nurse Practitioner or Physician Assistant for the Medical...RN in applicable state(s). + National certification as a Clinical Nurse Specialist by nationally accredited organization… more
    Cleveland Clinic (10/02/25)
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  • Nurse Practitioner, Physician Assistant,…

    Cleveland Clinic (Willoughby Hills, OH)
    …and the Governing Body of the applicable hospitals. **CNS** + Currently licensed as a Clinical Nurse Specialist in applicable state(s). + *Must be licensed as an ... RN in applicable state(s). + National certification as a Clinical Nurse Specialist by nationally accredited organization recognized by state Board of Nursing. +… more
    Cleveland Clinic (08/19/25)
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  • Clinical Review Nurse

    Centene Corporation (Columbus, OH)
    …be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... some experience in the following areas: acute care, utilization management (UM)/ medical necessity review , InterQual knowledge, and discharge planning.**… more
    Centene Corporation (10/30/25)
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  • Nurse Practitioner (Acute Care), Physician…

    Cleveland Clinic (Cleveland, OH)
    …12-month program with a mission to train post-graduate Acute Care Nurse Practitioners and Physician Assistants to provide comprehensive critical care services ... to the most acutely ill Medical ICU patients. Fellows of the program will graduate...program will graduate with the critical thinking, diagnostic, and clinical skills necessary for the management of complex … more
    Cleveland Clinic (10/02/25)
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  • Nurse Practitioner, Physician Assistant…

    Cleveland Clinic (Cleveland, OH)
    …program with a mission to safely transition Certified Pediatric Acute Care Nurse Practitioners (CPNP-AC) and Physician Assistants (PA) to practice within the ... This program provides a robust infrastructure to build not only clinical competency, but also role proficiency through mentorship, professional development,… more
    Cleveland Clinic (10/24/25)
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  • Medical Claim Review Nurse

    Molina Healthcare (Akron, OH)
    …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
    Molina Healthcare (09/06/25)
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  • Nurse Practitioner, Physician Assistant…

    Cleveland Clinic (Cleveland, OH)
    …Hospital Care Institute is currently seeking a motivated and qualified Physician Assistant, Clinical Nurse Specialist, or Nurse Practitioner (Adult or Family ... medical care may be in a variety of clinical settings. PA's are privileged by the Board of...the applicable hospitals. **CNS** + Currently licensed as a Clinical Nurse Specialist in applicable state(s). +… more
    Cleveland Clinic (09/03/25)
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  • Nurse Practitioner, Physician Assistant…

    Cleveland Clinic (Cleveland, OH)
    …and the Governing Body of the applicable hospitals. **CNS** + Currently licensed as a Clinical Nurse Specialist in applicable state(s). + Must be licensed as an ... RN in applicable state(s). + National certification as a Clinical Nurse Specialist by nationally accredited organization recognized by state Board of Nursing. +… more
    Cleveland Clinic (10/08/25)
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