CareFirst BlueCross BlueShield
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Columbus,OH
Resp & Qualifications PURPOSE: The Clinical Medical Review Nurse handles day-to-day review of professional and institutional claims and provider appeals that require medical review to determine if the claim...
Providence Service
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Columbus,OH
Description Utilization Review RN - Remote 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...
AccessNurse
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Columbus,OH
Requirements Qualifications / Experience Current multi-state RN license with no restrictions; nurses currently holding a single-state RN license must obtain a multi-state license prior to being made a job...
NorTek Medical Staffing
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Columbus,OH
Nortek Medical Staffing, Inc. is seeking a Registered Nurse (RN) Clinic Behavioral Health for a nursing job in Columbus, Ohio. Job Description & RequirementsSpecialty:...
Molina Healthcare
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Columbus,OH
**Job Description** **Job Summary** Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate...
TeamHealth
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Columbus,OH
Evenings, Weekend Only, Full-time & Part-time opportunities available (20hrs +) Hiring for evenings and weekends (*weekends and holidays are required) Incentives for Bilingual Spanish Telephone Triage RNs! Are you looking for an...
Valley Health
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Columbus,OH
Department WMH FRIMA-RHC - 259441Worker Sub Type RegularWork Shift First Shift (United States of America) Pay Grade Job Description Job...
CVS Health
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Columbus,OH
We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold...
ThedaCare
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Columbus,OH
Why ThedaCare? Living A Life Inspired! Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion to provide outstanding care. We are inspired to reinvent health care by becoming a proactive partner in...
Corewell Health
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Columbus,OH
About Outpatient Clinics Corewell Health operates over 300 outpatient clinics across Michigan, bringing a multitude of care options to the communities that we serve. There are over 40 different types of primary care and specialty...
OhioHealth
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Columbus,OH
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 further to help people uncover their...
Baptist Health
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Columbus,OH
Shift: Night Working Hours: 6:30p-7a Summary: The Admission/Discharge Registered Nurse (RN) is a member of the Nursing Care Team and is responsible for collaboration, communication & facilitation of optimal provision of...
315 health
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Columbus,OH
We believe everyone should have confidence in navigating their healthcare. We are looking for a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention and management of their health through continuous care...
American Recruiting and Consulting Group
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Columbus,OH
CLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are direct hire FTE positions with salary, benefits, etc. This is a fantastic opportunity to...
Acadia Healthcare
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Columbus,OH
Overview Mount Carmel Behavioral Health is hiring Admissions RN's! Available Shift: Full Time Day (7a-7p) Full Time Night (7p-7a) Sign...
UnitedHealth Group
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Columbus,OH
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data...
Marshall Health Network
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Columbus,OH
Cabell Huntington Hospital is seeking a full-time Virtual Integrated Care Coordinator (RN) for our CHH Virtual Integrated Care Department. This job is responsible for supporting and driving...
Amergis
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Columbus,OH
" The Utilization Review Specialist is responsible for the assessment and review of the healthcare delivery system with a concentration on tasks that promote cost-effective quality care and cost containment in accordance with various federal...
CareSource
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Columbus,OH
Job Summary: The Intake Nurse - RN is responsible for assessing potential new members for eligibility for the program and for explaining the program to them and their families. Responsible for knowing required outreach activities...
InnovAge
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Columbus,OH
Responsibilities The Phone Triage Registered Nurse provides skilled nursing telephone triage for participants experiencing medical concerns during nights, holiday and weekends in accordance with InnovAge...
Sutter Health
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Columbus,OH
We are so glad you are interested in joining Sutter Health! Organization: SHSO-Population Health Services-Utah Position Overview: Aids patients in obtaining the correct level of care with...
Lifespark Holdings
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Columbus,OH
The Admissions Nurse is responsible for the overall direction and coordination of activities related to admission of residents to the facility while providing superior customer service. Position: Admissions Nurse - Remote...
Actalent
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Columbus,OH
Clinical Review Nurse Job Description Join a dynamic team in a brand new 2026 program dedicated to managing the Duals line of business, combining Medicare and Medicaid benefits into a single comprehensive service. This program operates...
Guidehealth
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Columbus,OH
Company Description WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable,...
Mount Carmel Health System
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Dublin,OH
*Employment Type:* Full time *Shift:* Day Shift *Description:* *Position Purpose:* The Preop/PACU/PAT/PHASE 2 departments at Mount Carmel Dublin are unique. The Registered Nurse would expect to see pre-surgical and post-surgical care cases...
