- Dayton Children's Hospital (Dayton, OH)
- Facility:Dayton Children's - Main CampusDepartment: Utilization Review TeamSchedule: Full timeHours:40Job Details:Under the supervision of the Manager of ... Utilization Management, the Utilization Review ...Requirements: Bachelors: Nursing (Required) Certification/License Requirements: [Lic] RN: Registered Nurse (RN) - Ohio Board of Nursing At Dayton… more
- CVS Health (OH)
- …solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. **Position ... practice experience in medical healthcare. + 3+ years Medical Review or Utilization Management experience. + 2+...required, BSN preferred. **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for… more
- CVS Health (Columbus, OH)
- …with heart, each and every day. **Position Summary** This is a fulltime remote Utilization Review opportunity. Working hours are four 10hr days **including every ... UMNC participating in non-traditional, weekend shift rotation **Preferred Qualifications** + Utilization review experience + Experience with LTAC, skilled rehab,… more
- Centene Corporation (Columbus, OH)
- …perspective on workplace flexibility. **Position Purpose:** Supervises Prior Authorization, Concurrent Review , and/or Retrospective Review Clinical Review ... team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources to ensure adherence… more
- Humana (Columbus, OH)
- …Coordinator or discharge planner in an acute care setting + Previous experience in utilization management/ utilization review for a health plan or acute care ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...a good faith estimate of starting base pay for full time (40 hours per week) employment at the… more
- CVS Health (OH)
- …including occasional rotating weekend and holiday schedules **Preferred Qualifications** + Utilization review experience strongly preferred + Behavioral health ... every day. **Position Summary** This Clinical Consultant position is with Aetna's Utilization Management (UM) team and is a field-based/Remote position out of the… more
- Humana (Columbus, OH)
- … Nurse (RN) license in the state of Michigan. + Previous experience in utilization management and/or utilization review . + Minimum of two (2) years ... community and help us put health first** The Manager, Utilization Management Nursing (LTSS Utilization Management Leader)...a good faith estimate of starting base pay for full time (40 hours per week) employment at the… more
- Elevance Health (Mason, OH)
- …Finder and follows up with provider on referrals given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. + ... ** Utilization Management Representative II** **Schedule: Monday-Friday 8am-5pm Eastern...**Virtual** : This role enables associates to work virtually full -time, with the exception of required in-person training sessions,… more
- Premier Health (Dayton, OH)
- …job related experience Prior job title or occupational experience: Case management, utilization review , clinical nurse Prior specific functional ... Full -Time The CSI Clinical Analyst is a registered professional nurse with knowledge and expertise in process analysis, clinical outcome data analysis, … more
- Elevance Health (Mason, OH)
- …fraud and over- utilization by performing medical reviews via prepayment claims review and post payment auditing. + Correlates review findings with ... ** Nurse Audit Senior (Operating Room)** **Virtual:** This role...Room)** **Virtual:** This role enables associates to work virtually full -time, with the exception of required in-person training sessions,… more