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Clinical Authorization Review Nurse (Medicaid Health Systems
Ohio Department of Commerce
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Clinton Township, OH, 43224
What You Will Do At ODM: Working Title: Clinical Authorization Review Nurse Classification : Medicaid Health Systems ... in prior authorization and service authorization oversight and utilization activities Reviewing both physical and behavioral ... - Jun 17
Clinical Authorization Review Nurse (Medicaid Health Systems
ohio.gov
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Franklin County, OH
... ODM: Working Title: Clinical Authorization Review Nurse Classification: Medicaid Health Systems Specialist RN (PN 20102136) ... in prior authorization and service authorization oversight and utilization activities Reviewing both physical and behavioral ... - Jun 12
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
Medicaid
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Columbus, OH, 43215
What You Will Do At ODM: Working Title: Clinical Authorization Review Nurse Classification\: Medicaid Health Systems ... in prior authorization and service authorization oversight and utilization activities Reviewing both physical and behavioral ... - Jun 25
Physician Advisor, Utilization Review/Management
Sutter Health
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Clinton Township, OH, 43224
... A broad knowledge base of health care delivery and case management within a managed care environment. Comprehensive knowledge of Utilization Review, levels of care, and observation status. Some awareness of healthcare reimbursement systems: Health ... - Jun 24
Clinical Review Nurse - Prior Authorization
Centene Corporation
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Clinton Township, OH, 43224
... all member’s clinical information in health management systems to ensure compliance with regulatory guidelines Assists with providing education to providers and/or interdepartmental teams on utilization processes to promote high quality and ... - Jun 26
Clinical Review Nurse - Prior Authorization
Actalent
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Clinton Township, OH, 43224
... in health management systems to ensure compliance. Educate providers and internal teams on utilization processes to promote high-quality, cost-effective care. Identify and share opportunities for process improvement in the authorization review ... - Jun 24
Clinical Review Clinician - Appeals
Spectraforce Technologies
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Clinton Township, OH, 43224
... - Utilization review nurse, appeal review nurse and direct patient care experience. * Performance indicators: (Metrics: 10 to 15 appeals a day after training. Not letting any items in work queues go over compliance Turn Around Time.) * Best vs. ... - Jun 24
Clinical Review Nurse - Prior Authorization
Spectraforce Technologies
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Clinton Township, OH, 43224
... Care manager or clinical nursing experience, Word, Excel, Virtual meeting skills, MS outlook and EMR systems Nice to haves: Prior Authorization Nurse, Medical Review Nurse, Appeals Nurse, Utilization Management or Quality Assurance Nurse experience; ... - 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 ... In addition, Huntington provides a variety of benefits to colleagues, including health insurance coverage, wellness program, ... - Jun 04