• Utilization Management Nurse…

    Humana (Columbus, OH)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied… more
    Humana (01/16/26)
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  • SNF Utilization Management RN…

    Humana (Columbus, OH)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied… more
    Humana (12/12/25)
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  • Clinical UM Nurse

    CenterWell (Columbus, OH)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, ... **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no disciplinary action and ability...volume and fast paced environment + Previous experience in utilization management + Education: BSN or bachelor's… more
    CenterWell (01/14/26)
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  • Utilization Management Nurse…

    CVS Health (OH)
    …And we do it all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedules will include weekends, ... communication skills, both verbal and written **Required Qualifications** - 2 + years of experience as a Registered Nurse...and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and… more
    CVS Health (01/16/26)
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  • Utilization Management Nurse

    CenterWell (Columbus, OH)
    …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... and/or dependable transportation necessary + Travel for offsite Orientation 2 to 8 weeks + Travel to offsite meetings...procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous… more
    CenterWell (01/16/26)
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  • Registered Nurse -Assistant Nurse…

    Veterans Affairs, Veterans Health Administration (Cleveland, OH)
    …as the Assistant Nurse Manager within Long-term Care in Cares Tower 2 . Responsibilities The Registered Nurse -Assistant Nurse Manager duties include but ... nursing experience in which one year is equivalent to Nurse I, Level 2 ; OR a BSN...are not creditable as related degrees. Preferred Experience: BSN, 1- 2 years management experience, and 2… more
    Veterans Affairs, Veterans Health Administration (01/15/26)
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  • Medical Review Nurse (RN)- Remote

    Molina Healthcare (OH)
    …ensure appropriate reimbursement to providers. + Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) ... modification of payment decisions. + Serves as a clinical resource for utilization management , CMOs, physicians and member/provider inquiries/appeals. + Provides… more
    Molina Healthcare (01/09/26)
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  • Telephonic Nurse Case Manager II

    Elevance Health (Cincinnati, OH)
    …criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Location: This role enables...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
    Elevance Health (01/07/26)
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  • Registered Nurse (RN) Case Manager…

    Trinity Health (Columbus, OH)
    …of clinical nursing experience with at least 2 years experience in utilization review, discharge planning, case management , or disease management ... respond to common symptoms they might experience. + Coordinates with the utilization review, case management , discharge planning staff within network facilities.… more
    Trinity Health (01/07/26)
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  • Registered Nurse (RN) - Obstetrics (OB)…

    Bon Secours Mercy Health (Warren, OH)
    …an environment where associates want to work and help communities thrive. **Registered Nurse (RN) - Obstetrics (OB) - St. Joseph Warren Hospital** **Summary of ... Primary Function** The Obstetrics (OB) Registered Nurse (RN) addresses the care provided to healthcare consumers in the context of women-, newborn-, and… more
    Bon Secours Mercy Health (01/08/26)
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