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Clinical Review Clinician - Appeals
Centene Corporation
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Columbus, OH, 43201
... and analyzing the basis for the appeal + Ensures timely review, processing, and response to appeal in accordance with ... Knowledge of utilization management processes preferred. **License/Certification:** + LPN - Licensed Practical Nurse - State ... - Nov 24
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
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 22
Long Term Services & Support Reviewer Utilization Management
AmeriHealth Caritas
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Clinton Township, OH, 43224
... Refers cases to the Plan Medical Director for medical necessity review when medical information provided does not support the nurse review process for giving approval of services requested. Documents case activities for Utilization determinations ... - Nov 23
Clinical Review Nurse - Prior Authorization
Centene Corporation
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Columbus, OH, 43201
... 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 for members + Performs other ... - Nov 24
Utilization Management Specialist I
SUN BEHAVIORAL HEALTH GROUP
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Clinton Township, OH, 43224
... 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 22
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, ... - Registered Nurse (RN) 2-3 years combined clinical and/or utilization management experience with managed health care plan 3 ... - Nov 23
Clinical Review Nurse - Prior Authorization
Centene Corporation
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Clinton Township, OH, 43224
... 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 for members Performs other duties ... - Nov 24
Clinical Review Clinician - Appeals
Centene Corporation
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Clinton Township, OH, 43224
... and analyzing the basis for the appeal Ensures timely review, processing, and response to appeal in accordance with ... Knowledge of utilization management processes preferred. License/Certification: LPN - Licensed Practical Nurse - State ... - Nov 24
Client Review Business Analyst - Senior Associate
JPMorgan Chase Bank, N.A.
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Clinton Township, OH, 43224
... As a Client Review Analyst on our Business Banking Chief Administrator Office (CAO) Team, you will assess cases to identify businesses that may fall outside the scope of Business Banking. The team receives case work through a variety of channels, ... - Nov 20