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Utilization Management Specialist I
SUN Behavioral Columbus
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Columbus, OH, 43229
... Support discharge planning and utilization review when necessary Perform other duties as required Safety (15% of performance review) Strives to create a safe, healing environment for patients and family members Follows all safety rules while on the ... - 2025 Dec 20
Travel RN - Case Management/Utilization Review - Case Management
American Traveler
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Columbus, OH, 43210
... • Minimum of 2 years of RN experience required, • Previous experience using Epic EMR is required, • Case management, utilization review, or precertification experience preferred, Additional Information • First-time travelers are accepted for this ... - Jan 07
Clinical Review Nurse Supervisor (Medicaid Health Systems
State of Ohio
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Columbus, OH, 43215
... Program Integrity Classification: Medicaid Health Systems Administrator 1 RN (PN\: 20092018) Job Overview: The Ohio Department of Medicaid (ODM) is seeking a Registered Nurse (RN) to be a part of our Surveillance/Utilization Review Section (SURS). ... - Jan 07
Medical Review Nurse (RN)
Ohio Staffing
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Clinton Township, OH, 43224
... Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review including diagnosis-related group (DRG) validation, ... - Jan 06
Clinical Review Nurse Supervisor (Medicaid Health Systems
ohio.gov
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Franklin County, OH
... Program Integrity Classification: Medicaid Health Systems Administrator 1 RN (PN: 20092018) Job Overview: The Ohio Department of Medicaid (ODM) is seeking a Registered Nurse (RN) to be a part of our Surveillance/Utilization Review Section (SURS). ... - 2025 Dec 29
Clinical Review Nurse Supervisor (Medicaid Health Systems
Ohio Department of Commerce
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Clinton Township, OH, 43224
... : Program Integrity Classification: Medicaid Health Systems Administrator 1 RN (PN: 20092018 ) Job Overview: The Ohio Department of Medicaid (ODM) is seeking a Registered Nurse (RN) to be a part of our Surveillance/Utilization Review Section (SURS). ... - Jan 06
Transplant Utilization Review Nurse in Dublin, OH
Vivian Health
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Dublin, OH, 43016
Registered Nurse, Transplant Utilization Review Description Location: This position is located at our Dublin, OH campus. Multistate Licensure: Quantum Health nurses must be willing and able to obtain and maintain nursing licensure in multiple states ... - Jan 06
Care Review Clinician (RN)
Columbus Staffing
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Clinton Township, OH, 43224
... Adhere to utilization management (UM) policies and procedures. Required Qualifications At least two years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of ... - Jan 06
Clinical Review Nurse Supervisor (Medicaid Health Systems
State of Ohio
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Columbus, OH, 43216
... Program Integrity Classification: Medicaid Health Systems Administrator 1 RN (PN: 20092018) Job Overview: The Ohio Department of Medicaid (ODM) is seeking a Registered Nurse (RN) to be a part of our Surveillance/Utilization Review Section (SURS). ... - Jan 02
Pre-Certification Review Nurse - Pharmacy
Quantum Health
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Dublin, OH, 43016
... About the role The Pre-Certification Review Nurse - Pharmacy is responsible for reviewing and processing coverage determinations and utilization management reviews for specialty medications, to include site of care assessments, for enrollees of ... - Jan 06