Behavioral Health UM Nurse: Policy & Care Review
Ohio Department of Medicaid
The Ohio Department of Medicaid seeks an Utilization Management Behavioral Health Nurse in the Health Innovation & Quality area, based in Columbus. You will review CCPs, validate decisions, and collaborate with medical directors and policy teams to ensure UM consistency. This full-time role requires an active RN license and 24 months in nursing plus 24 months in Behavioral Health nursing; working hours 8-5 at Lazarus 5. #J-18808-Ljbffr Ohio Department of Medicaid
- ...Clinical Member Services Reviewer Provides support for... ...guidelines, insurance policies, and regulations -... ...integrated delivery of care across the continuum. Contributes... ...management (UM) policies and procedures... ...experience. Registered Nurse (RN). License must be active...PolicyWork at office
$26.41 - $51.49 per hour
...complact license. The Care Review Clinician will provide... ...authorization for behavioral health services for the OH Medicaid... ...guidelines, insurance policies, and regulations -... ...utilization management (UM) policies and... ...experience. Registered Nurse (RN). License must be...PolicyHourly payWork experience placementWork at officeRemote workHome officeMonday to Friday$36.01 per hour
...Utilization Management Behavioral Health Nurse (Medicaid Health Systems Specialist... ...will include: Review Clinical Coverage Policies (CCPs) to ensure service... ...submissions in alignment with UM policy requirements.... ...alignment with statewide managed care requirements. Support...PolicyFull timeWork at office- ...that our members get the care they need, when they... ...role The Utilization Review Nurse is responsible for reviewing... ...members of Quantum Health’s employer groups in... ...transfer of cases for behavioral health management when... ...company ethics and policies Additional Requirements...PolicyWork at office
$550 per month
...Licensed Practical Nurse, Behavioral Health - 2nd Shift Organization: Behavioral... ..., Direct Support/Direct Care, Mental Health Professional... ..., and recovery-informed policies that reflect our mission to... ...eligible applications shall be reviewed considering the following...PolicyHourly payFull timeContract workPart timeWork experience placementWork at officeAfternoon shift- Molina Healthcare in Columbus, OH is seeking a Care Review Clinician to provide prior authorization for behavioral health services for the OH Medicaid population. The role requires strong BH care experience across inpatient, substance use, and outpatient services, plus...Remote job
- ...demonstrate accountable behavior and share our... ...inclusion, leadership and care. The Clinical... ...the residents' health and wellness through... ...related questions. Review all resident... ...required by residence policy and state regulation... ...practice as a Registered Nurse (RN) or Licensed...PolicyFull timePart timeWork at officeLocal areaNight shiftDay shift
$107.76k
...Expected to support all Behavioral Health nursing units as needed at the direction... ...administrative and patient care services nursing... ...Patient Care Services division policies and procedures. Models the... ...Participates in departmental peer review processes. Communicates/...PolicyPart timeOverseasShift workNight shiftWeekend workAfternoon shift- ...LOCAL OK/1st TIMER - Behavioral Health- 12HR Nights Weekend Coverage: Every other weekend Certs Required: BLS Epic is required Required to... ...with frequent shuttle service; best value. Please note: Parking costs and options are subject to change per CampusParc policies....PolicyHourly payLocal areaNight shiftWeekend work
$64k - $70k
...high-quality, proactive care to residents of skilled nursing and long-term care facilities... ...the unique medical and behavioral health needs of residents.... ...facilities through medical record review, behavioral health... ...licensure, organizational policy, and established clinical...PolicyFull timeWork at officeRemote work- ...We are more than a health system. We are a belief system... ...guide. We work hard, care deeply and reach... ...differential Provides general nursing care to patients and... ...to department policies and nursing care standards... ...: 24 Department Behavioral Health Unit 1 Join...PolicyPart timeLocal areaShift workNight shiftWeekend work
$43 per hour
...for the Registered Nurse (RN) role at... ...Flexible spending and health savings accounts 7... ...part of Lifepoint Behavioral Health, nationally... ...stabilization, inpatient care, and outpatient... ...according to policies. Will oversee and... ...communication with external review organizations or...PolicyFull timeRemote workRelocation packageFlexible hoursShift workDay shift- ...Charge Nurse - LPN It's fun to work in... ...demonstrate accountable behavior and share our... ...stewardship, leadership and care. The Charge... ...with the facility policies and procedures.... ...been provided for review and approval.... ...or other related health care facility preferred...PolicyLocal areaNight shiftWeekend workAfternoon shift
- SUN Behavioral Columbus LLC is seeking a dedicated RN for a full... ..., OH. You will perform nursing assessments, administer... ...medications, and coordinate care for patients with behavioral health needs, while educating... ...strict adherence to SUN policies and procedures to support...PolicyFull timeNight shift
$39.9 - $53 per hour
Position: Procedures Nurse (RN) Location:... ...living our cultural behaviors - celebrating... ...life balance Your Health Matters: Comprehensive... ...patient care Using independent... ...invasive procedure policies, standards, and relevant... ...documentation procedures and reviews physician...PolicyHourly payFull timeTemporary work- ...Nurse- Residential Services Program Position... ...trauma informed care training. Excellent... ...home's medical-related policies and procedures are... ...to meet the physical health needs of all... ...needed changes. Review and monitor IS{s and Behavior Intervention Plans (...PolicyLocal areaFlexible hoursShift work
$37.25 - $54.12 per hour
...Registered Nurse (RN) We are seeking a... ...patient-centered care through a combination... ...patient histories Reviewing medications and... ...Identifying and addressing health concerns observed... ..., social workers, behavioral health specialists... ...organizational policies. Perform...PolicyPart timeWork at officeLocal areaRemote workRelocation package- ...demonstrate accountable behavior and share our... ...inclusion, leadership and care. The Clinical... ...the residents’ health and wellness through... ...related questions. • Review all resident... ...required by residence policy and state regulation... ...as a Registered Nurse (RN) or Licensed Practical...PolicyFull timePart timeWork at officeLocal areaNight shiftDay shift
$78.4k - $107.8k
...Become a part of our caring community The Nurse Auditor 2 performs clinical... ...coding experience to conduct reviews of provider codes and... ...PACU, L&D, mother-baby, behavioral health, SNF, care manager/discharge... ...Opportunity Employer It is the policy of Humana not to...PolicyBi-weekly payFull timeTemporary workApprenticeshipRemote workWork from homeHome officeMonday to Friday$76.75k
...on relevant exp. Benefits Eligible. *Behavioral Health experience preferred* Expected to support all Behavioral Health nursing units as needed at the direction of leadership... ...unit; facilitates communication of policy changes and system educational opportunities...PolicyFull timeMonday to FridayFlexible hoursShift work$2,320.48 per week
...Behavioral Health Registered Nurse in Columbus, OH LeaderStat is currently seeking a Behavioral Health Registered... ...you focus on providing top-notch care to your patients, we’ll handle the rest... ...$2403.64 gross weekly Utilization Review Nurse – RN or LVN - Full Remote MICU...Weekly payFull timeContract workRemote workRelocation packageShift workDay shift- Mount Carmel Behavioral Health is hiring a Nurse Educator! Shift Day Schedule Full Time... ...of acute inpatient care for adult men and women, age... ...Nursing Director /Educator to review outcomes data to evaluate... ...facility and/or organization policies and procedures Implement...PolicyFull timeLocal areaImmediate startShift work
- ...Healthcare in Columbus, OH is seeking a Behavioral Health Nurse Manager to provide clinical leadership... ...therapists, case managers, and primary care providers to ensure coordinated, comprehensive care, while guiding staffing, policy development, #J-18808-Ljbffr Southeast...Policy
$44.38 per hour
...At ODM Office Health Innovation & Quality... ..., and tracking UM clinical... ...Manage two teams of nurses and oversee UM... ...and managed care entities. Develop... ...maintaining written policies and procedures... ...application of review criteria across... ..., social or behavioral science or...PolicyFull timeContract workWork at office$36.01 - $50.37 per hour
...Behavioral Health/Psychiatric Nurse (RN) Organization: Behavioral Health - Central Ohio Behavioral Healthcare... ...hiring, and recovery-informed policies that reflect our mission to serve Ohioans... ...comprehensive, person-centered care that addresses the full range of behavioral...PolicyHourly payFull timeContract workPart timeWork experience placementWork at officeMonday to FridayShift workNight shiftWeekend workAfternoon shift- ...5Join our team and help lead the nursing care that supports individuals on their journey toward better mental health and wellness! We are seeking a Behavioral Health Nurse Manager to provide clinical... ..., and evaluation of nursing policies, procedures, and clinical...Policy
- ...department's needs. Shift assignments are reviewed every 4-week scheduling period, but... ...Special procedures/unit details: 17 James cares for all solid tumor cancers throughout the... ...lots. Please note: Parking costs and options are subject to change per CampusParc policies....PolicyPermanent employmentContract workShift workNight shiftWeekend work
- ...Medical Oncology with progressive care beds/pediatric patients. High... ...needs. Shift assignments are reviewed every 4-week scheduling... ...Overall 2 years of acute care nursing exp, with at least 1 year of... ...costs and options are subject to change per CampusParc policies....PolicyHourly payPermanent employmentContract workShift workNight shiftWeekend work
- ...ages 12 to 17, with mental health and behavioral disorders. We have a 20-bed... ...requiring intensive crisis care and treatment intervention.Position... ...opening for Registered Nurses 7a – 7pm and 7pm – 7am for our... ...compliance according to the policies and procedures.Maintains...PolicyImmediate startRelocation package
$32 - $38 per hour
...Description PRN Registered Nurse Coordinator US -... ...Federal Occupational Health Clinics in Columbus, OH... ...state license and FOH policy and SOP which may include... ...Provide non-emergency care to FOH clients according... ...office. Provides and reviews destination specific...PolicyPermanent employmentContract workReliefWork at officeFlexible hours
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