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Concurrent Review Nurse I (Independence, MO) (Sign-on Bonus...
Home State Health Plan - 3 reviews - Independence, OH
Educate providers on utilization and medical management processes. Enter and maintain pertinent clinical information in various medical management systems....
Sponsored by Centene Corporation
Case Manager (LTACH)
Meeting patient related utilization management criteria. The Case Manager assumes responsibility for utilization reviews and resource management, discharge...
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Care Manager I (RN) - Independence MO
Home State Health Plan - 3 reviews - Independence, OH
Actively participate in integrated team care management rounds. Identify related risk management quality concerns and report these scenarios to the appropriate...
Sponsored by Centene Corporation

RN Utilization Review

UC Health - 65 reviews - Ohio
RN Utilization Review. RN Utilization Review - UC Medical Center - Utilization Review - Third Shift. Utilization Review with ED assignment....

Registered Nurse - Utilization Review Denial/Appeal Manageme...

University Hospitals - 172 reviews - Cleveland, OH
Hospital Case Management Certification. 3+ years experience in managed care or utilization review. Improved communication, awareness and adherence to regulatory...

Care Review Clinician (RN)

Molina Healthcare - 306 reviews - Columbus, OH
Preferably hospital nursing and/or utilization management. Case Management Certification (CCM), Utilization Management Certification (CPHM) or other healthcare...

Concurrent Review Nurse I

Buckeye Community Health Plan - Columbus, OH 43215 (Downtown area)  +2 locations
Educate providers on utilization and medical management processes. Enter and maintain pertinent clinical information in various medical management systems....

Appeals Nurse Consultant

Aetna - 1,860 reviews - New Albany, OH
Managed care or utilization management experience preferred. Nursing/Registered Nurse license is required. Organizational skills, effective time management and...

UM Nurse Consultant-East or Central Time Zone Offices

Aetna - 1,860 reviews - New Albany, OH
We are looking for a Utilization Management Nurse Consultant to join the North Mountain Territory Medicare SRL Team....

Utilization Management RN

Evolent Health - 21 reviews - Dayton, OH
Prior experience with Utilization Management in a managed care organization. They are also responsible for screening enrollees for case management and disease...

LPN/LVN - Utilization Management (UM) Nurse Associate

Aetna - 1,860 reviews - New Albany, OH
As a Utilization Management (UM) Nurse Associate, you will utilize clinical skills to support the coordination, documentation and communication of medical...

Utilization Review (UR) Nurse

Wood County Hospital - 12 reviews - Bowling Green, OH 43402
Knowledge of current trends and standards of care relevent to utilization review and case management. Registered Nurse in the state of Ohio....

Claims Review Management Nurse

IG - Columbus, OH
$68,000 a year
The ability to adapt and guide customization of national coding initiatives and national payer editing systems to DHS guidelines, and a background in...
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RN - Nurse Supervisor - Sign On Bonus
HCR ManorCare - 2,233 reviews - South Point, OH 45680
Long term care and management / leadership experience preferred. Ensures optimal flow and utilization of resources (including, but not limited to staff,...
Sponsored
Case Manager - 950803
OhioHealth - 106 reviews - Marion, OH 43302
RN - Registered Nurse. A hospital-based case manager coordinates and performs comprehensive patient care review, which includes the integration of Utilization...
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