- 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
- Intermountain Health (Columbus, OH)
- …specialty care settings or previous appeals experience. + Demonstrated experience in utilization review and/or case management , hospital insurance billing, third ... **Job Description:** The RCO Audit & Appeals RN Consultant is responsible for consulting on clinical Appeals and Audits for Intermountain Health. The Audit/Appeals… more
- 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 (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
- Cleveland Clinic (Cleveland, 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 (Garfield Heights, 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