Utilization Management Nurse jobs in Ohio

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Awesome Outstanding RN Needed Under New Management
Logan Care and Rehabilitation - Logan, OH 43138
Must hold and maintain a current license to practice as a Registered Nurse (RN) in practicing state. Assure that effective quality nursing care is delivered...
Registered Nurse
Actively participates in Utilization Management or Interdisciplinary Care Management Meeting to facilitate appropriate discharge planning;...

Utilization Management Manager

The Corporate Genius - Cleveland, OH
Skilled & knowledgeable in utilization management, Medicare& insurance regulations. Minimum 3 years of utilization review or case management experience....

Clinical Documentation Specialist

Mount Carmel Health - 51 reviews - Westerville, OH
Current license to practice as registered nurse in the State of Ohio. Utilization/Case Management, managed care, or Clinical Documentation and experience in ICD...

Specialist, Medical Necessity Claims Reviewer

Molina Healthcare - 424 reviews - Columbus, OH
Completion of an accredited Registered Nurse (RN), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program....

Utlization Management Nurse Associate (RN or LPN)

Aetna - 2,218 reviews - New Albany, OH
The Utilization Nurse Associate performs medical necessity review in response to requests for prior authorization of outpatient services....

Clinical Care Manager

Aetna - 2,218 reviews - New Albany, OH  +1 location
Case management and discharge planning experience preferred. Nursing/Registered Nurse and / or Mental Health/Licensed Social Worker (LSW) is required....

Utilization Management Nurse Reviewer-Care Authorizations

Medical Mutual of Ohio - 72 reviews - Cleveland, OH
Performs utilization management activities to ensure the provision of safe, timely, appropriate, and necessary covered healthcare services to members;...

Business Manager

Veterans Affairs, Veterans Health Administration - 2,744 reviews - Columbus, OH
$62,005 - $80,603 a year
Develops, analyzes, evaluates, advises on, or improves the effectiveness of work methods and procedures, manpower utilization, distribution of work assignments,...


TriHealth - 85 reviews - Cincinnati, OH
UTILIZATION AND APPEALS COORDINATOR:. Registered Nurse Current Ohio licensure. This position may perform utilization management functions on a prospective,...

Personal Care Guide, Nurse Care Coordinator

Quantum Health - 26 reviews - Columbus, OH 43235 (Northwest area)
Identify members for specific case management and/or chronic condition management activities by utilizing established screening criteria....


Crystal Clinic Orthopaedic Center - 11 reviews - Akron, OH
Case Management Certification preferred. Current license to practice as registered nurse in the State of Ohio....
Case Manager (RN or MSW) *New Inpatient Rehab Hospital
Cleveland Clinic Rehabilitation Hospital - Beachwood - Beachwood, OH
And Payer/Referral Management. Pre-Admissions, Admissions, Patient Accounts, Utilization Review, PPS Coordinator, etc., to assure positive fiscal management...
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Assistant Director of Nursing
HCR ManorCare - 2,529 reviews - Portsmouth, OH 45662
The position conducts the nursing process, assessment, planning, implementation, and evaluation under the scope of the State's Nurse Practice Act of Registered...
Lead Case Manager - $3000 Sign on Bonus!
Meeting patient related utilization management criteria. Hospital case management:. Using discretion and independent judgment, the Lead Case Manager assumes...
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