- Trinity Health (Columbus, OH)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** ** RN , Utilization Review Case Manager** **Why Mount Carmel?** With five hospitals ... www.experiencecolumbus.com ! **About the job:** The ** RN Case Manager, Utilization Review ** ensures...Licensure / Certification: Current license to practice as a Registered Nurse ( RN ) in the… more
- Molina Healthcare (Columbus, OH)
- **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States who has a compact, multi-state license. This team reviews the prior ... authorization requests for transplants; the ideal candidate will have experience either in utilization review or case management for transplants. Preference… more
- Bon Secours Mercy Health (Lorain, OH)
- …and operational excellence. **Primary Function/General Purpose of Position** The Admissions Coordinator Registered Nurse ( RN ) is responsible for the ... to acute rehab unit. Maintains expertise in clinical field, utilization review and case management;...of Science Nursing (required) **Work Experience** 3 years of Registered Nurse ( RN ) clinical experience… more
- Help at Home (Cleveland, OH)
- …a clinically safe and fiscally responsible level of home care personnel utilization + Perform patient visits during peak periods or during staffing shortages ... presenting any required disciplinary action + Responsible for the interdisciplinary team case conferences, staff meetings and in the decision to accept patient care… more
- Cleveland Clinic (Mayfield Heights, OH)
- …from an accredited school of Professional Nursing + Current state licensure as a Registered Nurse ( RN ) + Basic Life Support (BLS) Certification through ... and appreciation, and build a rewarding career. As an RN Case Manager, you will collaborate with...approved entity + Two years of recent experience in utilization review , quality or care management +… more
- Cleveland Clinic (Cleveland, 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...or AHA). + 2 years of recent experience in utilization review , quality or care management. +… more
- Premier Health (Dayton, OH)
- …5 years of job related experience** **Prior job title or occupational experience: Case management, Utilization review ** Preferred experience: Knowledge of ... Bachelor's degree** Additional requirements: Type of degree: Nursing Licensure/Certification/Registration ** Registered nurse with valid Ohio license. Certification… more
- Guardian Life (Columbus, OH)
- … case management to facilitate collaboration toward RTW goals. Utilization of independent vendors to perform independent medical assessments. Specifically define ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… more
- Highmark Health (Columbus, OH)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. ... **EXPERIENCE** **Required** + 7 years in any combination of clinical, case / utilization management and/or disease/condition management experience, or provider… more
- Molina Healthcare (OH)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied… more
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