• RN , Utilization Review

    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
    Trinity Health (07/30/25)
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  • Utilization Review Case

    Holzer Health System (Gallipolis, OH)
    …organizational and financial outcomes. Serves as a clinical expert and resource in Utilization Review and Case Management. Partners with Social Workers ... . A minimum of three years experience as a registered nurse in acute care for adult...will be taken into consideration. . Professional experience with case management, utilization review , or… more
    Holzer Health System (07/24/25)
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  • Registered Nurse ( RN )…

    Bon Secours Mercy Health (Lorain, OH)
    …Bargaining Unit Position.** **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
    Bon Secours Mercy Health (07/22/25)
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  • Registered Nurse ( RN )…

    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
    Bon Secours Mercy Health (05/19/25)
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  • Case Manager Registered Nurse

    CVS Health (Columbus, OH)
    …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... in a hospital setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
    CVS Health (07/30/25)
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  • Registered Nurse RN

    Bon Secours Mercy Health (Youngstown, OH)
    …and operational excellence. **Summary of Primary Function** In the capacity of a Registered Nurse , the Ambulatory Care Manager will provide clinical care ... Bachelor's Degree Specialty/Major Nursing (BSN) **Licensing/ Certification** Licensure/Certification **Required** Registered Nurse with active License in State… more
    Bon Secours Mercy Health (07/17/25)
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  • Registered Nurse - Call Center…

    Option Care Health (Columbus, OH)
    …and/or Experience Requirements:** + Graduate of an accredited school of nursing + Current Registered Nurse ( RN ) licensure in the state of practice + ... relate to telephonic nursing support and management. + Provide excellent communication to nurse colleagues regarding patients on service with review of current… more
    Option Care Health (07/25/25)
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  • RN Case Manager

    Cleveland Clinic (Cleveland, OH)
    Nurse , Case Management, Case Manager, RN Case Manager, Registered Nurse Case Manager, Critical Care RN , Critical Care Registered ... of professional nursing. + Current state licensure as a Registered Nurse ( RN ). + Basic...approved entity + Two years of recent experience in utilization review , quality or care management +… more
    Cleveland Clinic (07/26/25)
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  • Clinical Appeals Nurse ( RN )

    Molina Healthcare (OH)
    **JOB DESCRIPTION** _For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state of UTAH or have a compact license._ _This ... Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support,… more
    Molina Healthcare (07/20/25)
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  • Care Manager RN - (Remote)

    Highmark Health (Columbus, OH)
    …Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/ case more
    Highmark Health (07/12/25)
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