Utilization Management RN jobs in Ohio

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Behavioral Health Clinical Care Manager
Performs discharge planning and utilization management activities to ensure the provision of safe, timely, appropriate, and necessary covered healthcare...
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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Clinical Manager/Educator - RN Required
Black Stone - 12 reviews - Columbus, OH
Management experience preferred. Access to utilization of public or private transportation system. Excellent Clinical Manager Opportunity with a Leader in Home...

Clinical Nurse Liaison

Medical Mutual of Ohio - 60 reviews - Cleveland, OH
Interprets data/reports to trend clients medical utilization, clinical outcomes. Specific to clinical issues and issues pertaining to care management....

Behavioral Health Nurse Auditor

CGI - 792 reviews - Cleveland, OH 44143
Audit performance review, inter-rater reliability (IRR) and quality assurance (QA) are performed through a well-defined review and quality management program....

Director of Case Management (Traveler)

Thomson Alliance, Inc. - Columbus, OH
RN. Knowledgeable of utilization management as it relates to RAC preparedness and third-party payers; Current CA RN license....
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RN Case Mgr - My Care OH

CareSource - 79 reviews - Cleveland, OH  +1 location
Collaborate with the utilization management department for service authorizations. Works collaboratively with the utilization management department in...

Divisional Director of Case Management

Consulate Health Care - 382 reviews - Columbus, OH
Managed care, Medicare, utilization management practices, insurance benefits, and cost management strategies....

Utilization Management Nurse (RN) - Dublin OH

Humana Inc. - 2,275 reviews - Dublin, OH
Utilization Management Nurse, RN. Previous experience in utilization management discharge planning and/or home health or rehab....

Registered Nurse Utilization Review Case Manager– Case Manag...

Mount Carmel - 20 reviews - Columbus, OH  +1 location
Our RN Utilization Review Case Manager performs utilization review with payors, assists the physician with level of care determinations using screening criteria...

RN Care Management Specialist - Mercy Health West Hospital

Mercy Health - 207 reviews - Township of Green, OH
Initiates referrals for financial counseling which assists in discharge plan development and resource utilization....

RN, Care Coordination - Women's (weekends)

University Hospitals - 184 reviews - Cleveland, OH
Founded in 1866, University Hospitals serves the needs of patients through an integrated network of 18 hospitals, more than 40 outpatient health centers and

RN Registered Nurse / Staff Development / Education

CommuniCare Health Services - 70 reviews - Portsmouth, OH 45662
Prior supervisory experience and management training required. Must possess a current license as an RN. RN Staff Development Coordinator / Educator / Long Term...
Registered Nurse – Case Manager / Utilization Review
Participate in Quality Assurance and Utilization review activities, as directed. Maxim Staffing Solutions is currently seeking Case Manager RN's for both full...
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UM Nurse Consultant - RN
Aetna - 1,934 reviews - New Albany, OH 43054
Utilization Management experience required. An active, unrestricted RN license required. This has enabled American Health to remain an industry frontrunner in...
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