Utilization Management RN jobs in Ohio

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Case Manager - $7500 Sign-On Bonus
Meeting patient related utilization management criteria. The Case Manager assumes responsibility for utilization reviews and resource management, discharge...
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Behavioral Health Field Care Advocate - Lake County OH
Optum is offering an innovative new standard for care management. Independent, active and unrestricted Mental Health License to include PsyD, LP, LPCC, LISW,...
Registered Nurse (Case Manager)
Tracks number of Case Management visits insuring optimal utilization of resources. This RN conducts Bio-psychosocial assessments, directs medication management,...

Registered Nurse (RN) - Utilization Management (UM) Nurse Co...

Aetna - 1,999 reviews - New Albany, OH
The UM Nurse Consultant performs medical necessity review in response to requests for prior authorization of inpatient and outpatient services. The UM Nurse

Nurse Navigator – Case Management – Mount Carmel New Albany

Trinity Health - 105 reviews - New Albany, OH 43054
Minimum 2 years of clinical nursing experience with 1 year experience in utilization review, discharge planning, case management, disease management or medical....

Behavioral Health Field Care Advocate

UnitedHealth Group - 4,852 reviews - Mentor, OH 44060  +4 locations
Optum is offering an innovative new standard for care management. Independent, active and unrestricted Mental Health License to include PsyD, LP, LPCC, LISW,...

Nurse Care Coordinator

Quantum Health - 25 reviews - Columbus, OH 43235 (Northwest area)
Utilization Management Nurse (RN or LPN)*. This nurse is responsible for providing utilization management services for Quantum Health members in an inpatient...
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Utilization Coordinator - Case Management - Part-time - Days

Fairfield Medical Center - 55 reviews - Lancaster, OH
Prioritizing and time management; Works under the supervisor of Case Management to provide utilization coordination for all admissions of every age group and...

Registered Nurse, RN Disease Manager, Wright-Patterson AFB,...

Platinum Business Corporation - 4 reviews - Dayton, OH
Educates/trains team/facility staff on policies and procedures for utilization of guidelines, protocols and other disease management activities....
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RN Care Manager - CPC+ - Green Township

The Christ Hospital Health Network - 10 reviews - Cincinnati, OH 45219 (CUF area)
RN Care Manager. The RN Care Manager promotes excellence in healthcare delivery to the patient and/or patient family by developing and monitoring health...

Concurrent Review Nurse I

Buckeye Community Health Plan - 16 reviews - Columbus, OH 43215 (Downtown area)
Educate providers on utilization and medical management processes. Current State's LPN/LVN or RN License. Enter and maintain pertinent clinical information in...

Utilization Management Nurse (RN) - Dublin OH

Humana Inc. - 2,356 reviews - Dublin, OH
Utilization Management Nurse, RN. Previous experience in utilization management discharge planning and/or home health or rehab....

Registered Nurse Care Review Clinician, Inpatient Review

Molina Healthcare - 351 reviews - Columbus, OH
Utilization Management Certification (CPHM). Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess,...
Registered Nurse – Case Manager / Utilization Review
Participate in Quality Assurance and Utilization review activities, as directed. Maxim Staffing Solutions is currently seeking ER RN's for both full time and...
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Case Manager (RN or MSW) - Inpatient Rehab
OhioHealth Rehabilitation Hospital - Columbus, OH 43201
And Payer/Referral Management. Pre-Admissions, Admissions, Patient Accounts, Utilization Review, PPS Coordinator, etc., to assure positive fiscal management...
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