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RN, Registered Nurse- Pre-Certification Pharmacy Review
quantum-health
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Dublin, OH, 43017
... Certification Review Nurse – Pharmacy is responsible for reviewing and processing coverage determinations and utilization ... What you’ll bring Current and Active license as a Registered Nurse (RN) in the state of Ohio. Licensed Practical Nurses ... - Dec 01
Clinical Review Nurse - Prior Authorization
Veterans Staffing
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Clinton Township, OH, 43224
... Assists with providing education to providers and/or interdepartmental teams on utilization processes to promote high quality and cost-effective medical care to members. Provides feedback on opportunities to improve the authorization review process ... - Nov 25
Utilization Management Specialist I
SUN BEHAVIORAL HEALTH GROUP
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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 ... - Nov 16
Utilization Management Nurse Consultant
CVS Health
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Columbus, OH
... and administration of the utilization/benefit management function. **Required Qualifications** - Must be an RN with active, ... **Preferred Qualifications** - 1+ years’ experience Utilization Review experience - 1+ years’ experience Managed Care - ... - Nov 28
RN Quality Peer Review Specialist
Trinity Health
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Columbus, OH, 43201
... The Peer Review Specialist provides leadership and coordination for the provider peer review processes across the facilities and service areas within Mount Carmel Health System and affiliate joint venture businesses as assigned. **Responsibilities** ... - Nov 27
Clinical Registered Nurse - Utilization Management - Remote
Columbus Staffing
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Clinton Township, OH, 43224
... Review clinical denials including but not limited to referral, preauthorization, medical necessity, non-covered services, ... background - Registered Nurse (RN) 2-3 years combined clinical and/or utilization management experience with managed ... - Nov 23
Utilization Management Nurse Consultant
CVS Health
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Clinton Township, OH, 43224
... administration of the utilization/benefit management function. Required Qualifications Must be an RN with active, current ... Preferred Qualifications 1+ years' experience Utilization Review experience 1+ years' experience Managed Care Strong ... - Nov 30
Senior Credit Review Officer
Huntington National Bank
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Columbus, OH, 43201
Description ummary: The Credit Review Officer - Sr. is responsible for evaluating the credit risk embedded in Bank assets. The candidate will possess a detailed working knowledge of the methodologies and techniques for performing credit risk review ... - Nov 25
RN Quality Peer Review Specialist
Mount Carmel Health System
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Columbus, OH, 43216
... Learn more at The Peer Review Specialist provides leadership and coordination for the provider peer review processes across the facilities and service areas within Mount Carmel Health System and affiliate joint venture businesses as assigned. ... - Nov 28
RN Quality Peer Review Specialist
Trinity Health Corporation
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Columbus, OH, 43216
... Learn more at The Peer Review Specialist provides leadership and coordination for the provider peer review processes across the facilities and service areas within Mount Carmel Health System and affiliate joint venture businesses as assigned. ... - Nov 27