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Description Role Snapshot Our Utilization Management RN (Registered Nurse) evaluates efficiency, appropriateness, and medical necessity for medical services, and procedures for our Health Plan. This role uses...

Performs patient assessments and collaborates with the care team to develop and implement a plan of care. Makes referrals to other disciplines as indicated by the patient's identified needs or documents rationale for not doing so. Promotes patient...

Reynoldsburg OH 43068 G/T Flexible days, 1-2 evening shifts/week AND weekend days Days, evenings Maxim Healthcare Services is seeking a Registered Nurse (RN) to assume responsibility and accountability for the application of the...

Become a part of our caring community and help us put health first Shift/availability details: Full time 40 hours a week. The schedule will be 8 hour...

Clinical Appeals Nurse (RN) The Clinical Appeals Nurse (RN) provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements,...

We are more than a health system. We are a belief system.We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach...

Description Providence Health Plan caregivers are not simply valued – they're invaluable. Join our team at Providence Health Plan Partners and thrive in our culture of patient-focused, whole-person care...

RN Case Manager Mount Carmel Health System Position Purpose Our RN Case Manager in collaboration with other internal and external disciplines directs and coordinates the care of patients from admission to transfer or...

Telephonic Nurse Case Manager II Sign On Bonus: $3000 Location : This role enables associates to work virtually full-time, with the exception of required in-person training sessions,...

Scope of Position: The Ohio State University Medical Centers mission is focused on integrating quality patient care, education, and research; the Nurse Manager leads a team of professional health care providers cultivating collaboration,...

Business (Non-Clinical) General Summary: Under minimal supervision, reviews and screens the appropriateness of services, the utilization of hospital resources and the quality of patient care rendered. Combines clinical, business,...

Details Client Name Compassus - Kobacker House Job Type Travel Offering Nursing Profession RN Specialty...

IDD RN/LPN A Great Opportunity / Monday - Friday 9am - 5pm At ViaQuest Psychiatric & Behavioral Solutions we offer unique and individualized care to children, adolescents, adults, the aging population, those with...

Clinic RN - Swedish Centralized Triage Full Time, Monday to Friday 8 to 5 Location: Hybrid-remote but may require you to work onsite around Seattle, Washington Job description: As a Centralized Triage Nurse, you'll be the...

Clinical Appeals Nurse (RN) The Clinical Appeals Nurse (RN) provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements,...

Employment Type:Full time. Shift:Day Shift. Description:RN Case Manager, Full-time. Why Mount Carmel? With five hospitals, over 60 free-standing outpatient clinics, a college of nursing, a Medicare Advantage plan, and extensive outreach and community...

We are so glad you are interested in joining Sutter Health! Organization: SCAH-Sutter Care at Home - UT Position Overview: The role is to act as the in-office clinical liaison that represents the agency via...

Cynet Health is seeking an experienced Ambulatory Care Registered Nurse for an exciting Travel Nursing job in Columbus, OH. Shift: 5x8 hr days Start Date: 01/05/2026 Duration: 13 weeks Pay: $2137 / Week About Cynet Health: Ranked...

We are hiring a Patient Care Manager and RN Dual role with Home Health experience. At Caretenders Home Health, a part of LHC Group, we embrace a culture of caring, belonging, and trust and...

Join to apply for the RN - Case Manager role at Integrated Resources, Inc (IRI). Job Title: RN - Case Manager Location: Columbus, OH 43215 Duration:...

Clinical Appeals Nurse (RN) The Clinical Appeals Nurse (RN) provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements,...

Become a part of our caring community and help us put health first The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and billing for services rendered is complete,...

Screening and reviewing prospective, concurrent, and retrospective referrals and authorizations for medical necessity and appropriateness of service and care and discussing with Medical Directors. Coordinate health care services with appropriate...

Educates health care professionals, patients, and families about home care services. Develops and maintains relationships with key referral sources, such as hospitals, nursing homes and physician offices to generate leads. Coordinates patient...

*Employment Type:* Full time *Shift:* 12 Hour Night Shift *Description:* Qualified applicants may submit a resume to Senior Talent Acquisition Partner, Tonya Globlek at ...@mchs.com for expedited consideration. *Position Purpose: * The...