• Utilization Management Nurse

    CVS Health (Columbus, OH)
    …Must have active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in EST zones.… more
    CVS Health (05/18/25)
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  • Utilization Management Nurse

    CVS Health (Columbus, OH)
    …And we do it all with heart, each and every day. Requisition Job Description Utilization Management is a 24/7 operation and work schedule may include weekends ... and external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with… more
    CVS Health (05/16/25)
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  • Consultant , Nurse Disability

    Lincoln Financial (Columbus, OH)
    …Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible ... for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state...Care, , Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's… more
    Lincoln Financial (04/30/25)
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  • Senior Clinical Strategy Consultant

    Highmark Health (Columbus, OH)
    …​ **SKILLS** + Deep Clincal Expertise -extensive knowledge of clinical, quality, care, utilization , high-cost claim, and population health management . Must be a ... in Business or Clinical field **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse (RN) or Pharmacist (Pharm D) or Physician Assistant (PA) **Preferred** +… more
    Highmark Health (05/10/25)
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  • Registered Nurse (RN) - Admissions…

    Bon Secours Mercy Health (Lorain, OH)
    …smooth transition to acute rehab unit. Maintains expertise in clinical field, utilization review and case management ; communicates to insurance companies/third ... excellence. **Primary Function/General Purpose of Position** The Admissions Coordinator Registered Nurse (RN) is responsible for the coordination of all Acute… more
    Bon Secours Mercy Health (02/18/25)
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  • Ambulatory Registered Nurse (RN)…

    Bon Secours Mercy Health (Toledo, OH)
    …area. **KNOWLEDGE, SKILLS AND ABILITIES:** + Must possess current license as a registered nurse in the state where practice setting is located. + BSN from an ... prevent disease and seek early treatment. + Provides nursing case management for assigned patients. Follows guidelines for care according to diagnosis/procedure.… more
    Bon Secours Mercy Health (04/24/25)
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  • Nursing Practice Specialist - Toledo Hospital…

    ProMedica Health System (Toledo, OH)
    …Specialist focuses on the lifelong learning needs of the professional nurse including orientation, continuing education, and ongoing competency development. The ... department, division, hospital or system level. He/she serves as a consultant , researcher, evidence-based practice mentor, performance improvement leader and project… more
    ProMedica Health System (04/17/25)
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  • SQPE Specialist II

    Cleveland Clinic (Warrensville Heights, OH)
    …compliance with all standards and favorable performance on safety, quality, utilization and experience metrics. + Participate in engraining the safety, quality ... data and participate in improvement strategy development. + Act as a consultant in educating and evaluating clinical and support department caregivers regarding… more
    Cleveland Clinic (05/08/25)
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  • SQPE Specialist I

    Cleveland Clinic (Canton, OH)
    …compliance with all standards and favorable performance on safety, quality, utilization and experience metrics. + Participate in engraining the safety, quality ... data and participate in improvement strategy development. + Act as a consultant in educating and evaluating clinical and support department staff regarding quality… more
    Cleveland Clinic (05/14/25)
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  • Safety Quality Patient Experience Specialist I

    Cleveland Clinic (Dover, OH)
    …compliance with all standards and favorable performance on safety, quality, utilization , and experience metrics. + Participate in engraining the safety, quality, ... when a deviation in standard practice has occurred. + Act as a consultant in educating and evaluating clinical and support department staff regarding quality … more
    Cleveland Clinic (05/08/25)
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