- Trinity Health (Columbus, OH)
- …information technology, financial analysis, audit, provider relations and more. **Position Purpose** RN Utilization Review MCHP is responsible for the ... Sr. Director of Medical Management. + Coordinates with the utilization review , case management, discharge planning staff...Licensure / Certification: Current license to practice as a Registered Nurse in their home state or… more
- Sharecare (Columbus, OH)
- …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals and… more
- Centene Corporation (Columbus, OH)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and… more
- Molina Healthcare (Columbus, OH)
- **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse who must have a RN OHIO license, or compact RN license The Care ... substance use disorders and familiarity with ASAM criteria. Familiarity with utilization management and experience using MCG, PEGA. Excellent computer multi-tasking… more
- Highmark Health (Columbus, OH)
- …Inc. **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 management,… more
- Molina Healthcare (Cincinnati, OH)
- …Practical Nurse in good standing. **Preferred Education** Completion of an accredited Registered Nurse ( RN ) Program or a bachelor's degree in Nursing. ... Practical Nurse (LPN) Program **Required Experience** + Minimum two years Utilization Review experience. + Knowledge of audit processes and applicable state… more
- Medical Mutual of Ohio (OH)
- …Ohio State Nursing Board. Bachelor's degree preferred. + 3 years experience as a Registered Nurse in acute care, critical care, emergency medical or medical ... medical coding or medical documentation investigation preferred. **Professional Certification(s):** + Registered Nurse with current State of Ohio unrestricted… more
- Lincoln Financial (Columbus, OH)
- …as indicated **What we're looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where the ... **Alternate Locations:** Work from Home **Work Arrangement:** Remote : Work at home employee **Relocation assistance:**...Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's it like… more
- Battelle Memorial Institute (Columbus, OH)
- …critical care or a related area is required. + Licensure to practice as a Registered Nurse in Ohio is required. + Must be capable of using respiratory ... experiences and welcome all qualified individuals to apply. **Job Summary** The nurse provides clinical and administrative support for the operation of a… more