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Utilization Review Specialist-PRN
Acadia External
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Franklin Township, OH, 43223
... Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified ... Facilitate peer review calls between facility and external organizations. Initiate and complete the formal appeal process ... - Jun 14
Clinical Authorization Review Nurse (Medicaid Health Systems
ohio.gov
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Franklin County, OH
... Title: Clinical Authorization Review Nurse Classification: Medicaid Health Systems Specialist RN (PN 20102136) Office: ... in prior authorization and service authorization oversight and utilization activities Reviewing both physical and behavioral ... - Jun 12
Clinical Authorization Review Nurse (Medicaid Health Systems
Ohio Department of Commerce
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Clinton Township, OH, 43224
... Title: Clinical Authorization Review Nurse Classification : Medicaid Health Systems Specialist RN (PN 20102136 ) Office : ... in prior authorization and service authorization oversight and utilization activities Reviewing both physical and behavioral ... - Jun 17
Clinical Review Clinician - Appeals
Spectraforce Technologies
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Clinton Township, OH, 43224
... * Preferred: RN-Not required * Nice to have: - Direct patient care experience - Longevity at positions - Writing appeal or authorization outcome letters. - experience with Trucare and/or Amisys systems is greatly valued. - Utilization review nurse, ... - Jun 24
Clinical Review Nurse - Prior Authorization
Spectraforce Technologies
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Clinton Township, OH, 43224
... Authorization Nurse, Medical Review Nurse, Appeals Nurse, Utilization Management or Quality Assurance Nurse experience; ... with positive attitude Top 4 must-have hard skills (stack-ranked): RN/LPN licensed professional Comfortable toggling between ... - Jun 24
Clinical Review Nurse - Prior Authorization
Centene Corporation
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Clinton Township, OH, 43224
... healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive ... utilization management processes preferred. License/Certification: LPN - Licensed Practical Nurse - State Licensure required RN ... - Jun 26
Clinical Authorization Review Nurse (Medicaid Health Systems
Medicaid
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Columbus, OH, 43215
... Title: Clinical Authorization Review Nurse Classification\: Medicaid Health Systems Specialist RN (PN 20102136) Office\: ... in prior authorization and service authorization oversight and utilization activities Reviewing both physical and behavioral ... - Jun 25
Clinical Review Nurse - Prior Authorization
Actalent
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Clinton Township, OH, 43224
... The role involves collaboration with healthcare providers and the authorization team to ensure timely review and approval of ... Knowledge of utilization management processes preferred LPN - Licensed Practical Nurse - State Licensure required OR RN - ... - Jun 24
Physician Advisor, Utilization Review/Management
Sutter Health
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Clinton Township, OH, 43224
... Comprehensive knowledge of Utilization Review, levels of care, and observation status. Some awareness of healthcare reimbursement systems: Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Patient Processing Service (PPS) ... - Jun 24
Model Risk Review Specialist I
Huntington
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Columbus, OH
... Summary: The primary responsibility of the Model Risk Review Specialist will be to independently and collaboratively review and validate models/ quantitative frameworks spanning credit, interest rate, market risk, economic capital or capital market ... - Jun 04