Incentives Utilization Management | Miamisburg | Part-time | Varied Shift Overview Kettering Health ... Registered professional nurse with education, knowledge and experience. * Role focuses on review of ...
Incentives Utilization Management | Miamisburg | Part-time | Varied Shift Overview Kettering Health ... Registered professional nurse with education, knowledge and experience. * Role focuses on review of ...
Job Details Utilization Management | Miamisburg | Part-time | Varied Shift Responsibilities & Requirements * Registered professional nurse with education, knowledge and experience. * Role focuses on ...
Job Details Utilization Management | Miamisburg | Part-time | Varied Shift Responsibilities & Requirements * Registered professional nurse with education, knowledge and experience. * Role focuses on ...
Job Details Utilization Management | Miamisburg | Part-time | Varied Shift Responsibilities & Requirements * Registered professional nurse with education, knowledge and experience. * Role focuses on ...
Job Details Utilization Management | Miamisburg | Part-time | Varied Shift Responsibilities & Requirements * Registered professional nurse with education, knowledge and experience. * Role focuses on ...
Utilization Management | Miamisburg | Part-time | Varied Shift * Registered professional nurse with education, knowledge and experience. * Role focuses on review of inpatient and observation ...
Utilization Management | Miamisburg | Part-time | Varied Shift * Registered professional nurse with education, knowledge and experience. * Role focuses on review of inpatient and observation ...
Care Management Coord RN
Oxford, OH · On-site
Oxford, OH 45056 Schedule: Part Time Day Incentives & Benefits: We offer competitive shift ... Performs utilization review for patients served. Requires weekend, holiday, and off site commitment ...
Care Management Coord RN
Oxford, OH · On-site
Oxford, OH 45056 Schedule: Part Time Day Incentives & Benefits: We offer competitive shift ... Performs utilization review for patients served. Requires weekend, holiday, and off site commitment ...
Care Management Coord RN
Oxford, OH · On-site
Oxford, OH 45056 Schedule: Part Time Day Incentives & Benefits: We offer competitive shift ... Performs utilization review for patients served. Requires weekend, holiday, and off site commitment ...
Care Management Coord RN
Oxford, OH · On-site
Oxford, OH 45056 Schedule: Part Time Day Incentives & Benefits: We offer competitive shift ... Performs utilization review for patients served. Requires weekend, holiday, and off site commitment ...
Care Management Coord RN
Oxford, OH · On-site
Oxford, OH 45056 Schedule: Part Time Day Incentives & Benefits: We offer competitive shift ... Performs utilization review for patients served. Requires weekend, holiday, and off site commitment ...
Care Management Coord RN
Oxford, OH · On-site
Oxford, OH 45056 Schedule: Part Time Day Incentives & Benefits: We offer competitive shift ... Performs utilization review for patients served. Requires weekend, holiday, and off site commitment ...
Oxford, OH 45056 Schedule: Part Time Day Incentives & Benefits: We offer competitive shift ... Performs utilization review for patients served. Requires weekend, holiday, and off site commitment ...
Oxford, OH 45056 Schedule: Part Time Day Incentives & Benefits: We offer competitive shift ... Performs utilization review for patients served. Requires weekend, holiday, and off site commitment ...
Demonstrates compliance with facility-wide Utilization Management policies and procedures ... We also offer our employee assistance program to part time employees. * Your Impact Matters: Join a ...
Demonstrates compliance with facility-wide Utilization Management policies and procedures ... We also offer our employee assistance program to part time employees. * Your Impact Matters: Join a ...
Demonstrates compliance with facility-wide Utilization Management policies and procedures ... We also offer our employee assistance program to part time employees. * Your Impact Matters: Join a ...
Demonstrates compliance with facility-wide Utilization Management policies and procedures ... We also offer our employee assistance program to part time employees. * Your Impact Matters: Join a ...
Demonstrates compliance with facility-wide Utilization Management policies and procedures ... We also offer our employee assistance program to part time employees. * Your Impact Matters: Join a ...
Demonstrates compliance with facility-wide Utilization Management policies and procedures ... We also offer our employee assistance program to part time employees. * Your Impact Matters: Join a ...
Demonstrates compliance with facility-wide Utilization Management policies and procedures ... We also offer our employee assistance program to part time employees. * Your Impact Matters: Join a ...
Demonstrates compliance with facility-wide Utilization Management policies and procedures ... We also offer our employee assistance program to part time employees. * Your Impact Matters: Join a ...
Licensed Practical Nurse (On Call)
Columbus, OH · On-site
$33.99/hr
Practice basic cost containment and utilization management for patient care and facility operations ... Degree in nursing , current valid nursing license as a Licensed Practical Nurse for the state of ...
Licensed Practical Nurse (On Call)
Columbus, OH · On-site
$33.99/hr
Practice basic cost containment and utilization management for patient care and facility operations ... Degree in nursing , current valid nursing license as a Licensed Practical Nurse for the state of ...
Nurse Practitioner - NP Primary Care - P/T Every Weekend
Kent, OH · On-site
$41.85 - $90.13/hr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... management of health problems, health counseling, and disposition planning for our patients.
Nurse Practitioner - NP Primary Care - P/T Every Weekend
Kent, OH · On-site
$41.85 - $90.13/hr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... management of health problems, health counseling, and disposition planning for our patients.
Nurse Practitioner - NP Primary Care - P/T Every Weekend
Kent, OH · On-site
$41.85 - $90.13/hr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... management of health problems, health counseling, and disposition planning for our patients.
Nurse Practitioner - NP Primary Care - P/T Every Weekend
Kent, OH · On-site
$41.85 - $90.13/hr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... management of health problems, health counseling, and disposition planning for our patients.
Nurse Practitioner - NP Primary Care - P/T Every Weekend
$41.85 - $90.13/hr
At CVS Health , you'll be surrounded by passionate colleagues who care deeply, innovate with ... management of health problems, health counseling, and disposition planning for our patients.
Nurse Practitioner - NP Primary Care - P/T Every Weekend
$41.85 - $90.13/hr
At CVS Health , you'll be surrounded by passionate colleagues who care deeply, innovate with ... management of health problems, health counseling, and disposition planning for our patients.
Nurse Practitioner - NP Primary Care - P/T Every Weekend
Kent, OH · On-site
$41.85 - $90.13/hr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... management of health problems, health counseling, and disposition planning for our patients.
Nurse Practitioner - NP Primary Care - P/T Every Weekend
Kent, OH · On-site
$41.85 - $90.13/hr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... management of health problems, health counseling, and disposition planning for our patients.
RN Case Manager Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
RN Case Manager Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
RN Case Manager Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
RN Case Manager Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
Nurse Practitioner - NP Primary Care - P/T Every Weekend
$41.85 - $90.13/hr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... management of health problems, health counseling, and disposition planning for our patients.
Nurse Practitioner - NP Primary Care - P/T Every Weekend
$41.85 - $90.13/hr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... management of health problems, health counseling, and disposition planning for our patients.
Part Time Cvs Utilization Management Nurse information
What is the difference between Part Time Cvs Utilization Management Nurse vs Part Time Cvs Case Management Nurse?
| Aspect | Part Time Cvs Utilization Management Nurse | Part Time Cvs Case Management Nurse |
|---|---|---|
| Certifications | RN license, Utilization Review Certification (if applicable) | RN license, Case Management Certification (e.g., CCM) |
| Work Environment | Utilization review departments, insurance companies, healthcare facilities | Patient care coordination, hospitals, clinics |
| Employer & Industry Usage | Insurance providers, healthcare organizations | Hospitals, healthcare systems, community clinics |
While both roles require RN licensure and involve patient or healthcare management, the Utilization Management Nurse focuses on reviewing medical necessity and insurance approvals, whereas the Case Management Nurse coordinates patient care and discharge planning. Understanding these differences helps job seekers identify the right role based on their skills and career goals.
What are the most commonly searched types of Cvs Utilization Management Nurse jobs in Ohio?
The most popular types of Cvs Utilization Management Nurse jobs in Ohio are:
Part-time
Re-posted 23 days ago
Kettering Health rating
7.3
Based on 190 frontline employees who took The Breakroom Quiz
303rd of 898 rated healthcare providers
Job description
Incentives
Utilization Management | Miamisburg | Part-time | Varied Shift
OverviewKettering Health is a not-for-profit system of 14 medical centers and more than 120 outpatient facilities serving southwest Ohio. Our mission is to live God's love by promoting and restoring health. Our commitment to our patients is to help individuals be their best. With that context, safety is our top priority. We provide an integrated system of healthcare experts committed to providing exceptional care.
Preferred Qualifications- 5 years clinical experience with 2 years case management
- Case Management certification
- Works independently
- Familiar with MCG Care guidelines
- Ability to adapt quickly to changing priorities and regulations
- Experience with Microsoft applications and EPIC software
! WEEKEND ONLY!
Responsibilities & Requirements- Registered professional nurse with education, knowledge and experience.
- Role focuses on review of inpatient and observation admissions to ensure correct assignment of Admit status.
- Communicates concurrently and resolves medical necessity discrepancies with physicians and other hospital leadership as needed.
- Responsible for completing clinical review on all assigned patients and communicates these reviews to payers.
- Identifies potential or actual denials for admission or ongoing stay both during the patient's hospital stay and post discharge.
- Review and decide the validity of medical necessity payer denials. Submits payer denial appeals.
- Participates in design of work flows and procedure to reduce incidence of denials.
- Current unrestricted Ohio RN licensure, BSN required.
- Experience with computers required.
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