RN Care Specialist
MARYHAVEN, INC.
Job Description
Job Description Utilization Review Specialist Job Description
Unique opportunity to join Maryhaven, Central Ohio’s largest and most comprehensive behavioral services provider specializing in addiction recovery. We are looking for skilled, talented, and compassionate people to join our team! Maryhaven was founded on the principles of Diversity, Equity, and Inclusion in 1953, opening our doors to serve an overlooked segment of our population, women in need of substance abuse recovery services. We remain driven by our value of excellence in quality care for all and fostering a culture that embraces dignity of all. The Utilization Review Specialist coordinates the design, development, implementation, and monitoring of the organization’s Benefits and utilization review functions. The Utilization Review Specialist manages daily operations, which include supervising the staff performing benefit enrollments and utilization management activities. The Utilization Review Specialist review functions as the internal resource on issues related to the appropriate utilization of resources & services, coordination of care across agency and utilization review and management. The Manager of Utilization review participates in department development and unit performance improvement.
Utilization Review Specialist Benefits
Knowledge and skills at a level normally acquired through the completion of a Bachelor's Degree in human service or behavioral health with two (2) years experience in the field of chemical dependency, or adolescent treatment or equivalent experience and training in behavioral health field.
Knowledge of Electronic Health Records.
Must have LPCC, LSW, LCDC III or RN.
Utilization Review Specialist Requirements
- Salary commensurate with experience
- Medical, Vision, & Dental
- Paid time off
- 11 paid holidays
- 403 (b) Retirement savings plan
- Continuing education and tuition reimbursement options
- A well-funded and managed non-profit organization driven not by the bottom line, but by helping its customers
- Equal Employment Opportunity (EEO)
- ...after a 90 day in-office training period.Job Description Summary:Reviews behavioral health cases to determine medical necessity and... ...certifications, pre-authorizations, re-authorization, concurrent utilization reviews, retrospective reviews, and denial management....SuggestedWork at officeWork from homeMonday to FridayFlexible hours
- Nationwide Children's Hospital is seeking a utilization review professional to evaluate behavioral health cases, ensuring medical necessity and guideline alignment. You will engage with hospital teams and third-party payors to secure quality care and proper payment. The...SuggestedRemote jobWork at officeWork from home
- Maryhaven, Inc. in Columbus, OH is seeking an experienced Utilization Review Specialist to coordinate the design, development, implementation, and monitoring of the organization’s benefits and utilization review functions. You will supervise staff performing benefit enrollments...Suggested
- ...including mental, physical, and financial wellness Professional development and growth opportunities How you’ll contribute Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient records to determine...SuggestedFull timeTemporary workLocal areaFlexible hours
- Maryhaven, Inc. in Columbus, Ohio, is seeking a Counselor III (LSW, LPC, LCDC II or III) to provide chemical dependency and mental health counseling, case management, and treatment planning for clients referred to Maryhaven for treatment. The role requires a bachelor's...Suggested
- ...Campus Columbus, OH Full Time RN or LPN First Community Village... ...significant change updates, annual reviews, CAAs, and electronic submission for... ...thorough working knowledge of RUGS III/IV scoring process to best utilize for accurate scoring of residents. Sets...Full timePart timeWork at officeImmediate startFlexible hours
- ...Utilization Management Specialist At St. Vincent Family Services, it's our job to help families build bright futures. Make it your job, too!... ...all MCO prior authorization activities. Monitors and reviews MCO portals to track authorization status, pending requests...Work at officeAfternoon shift
- A healthcare navigation organization is seeking a Utilization Review Nurse in Dublin, OH. The role involves reviewing inpatient medical service... ...discharge planning for patients. Candidates should have a current RN license in Ohio, with a minimum of 2 years of clinical...Work at office
- ...experience doesn’t match every requirement. About the role The Utilization Review Nurse is responsible for reviewing and processing medical... ...Licensure: Current and active license as a Registered Nurse (RN) in the state of Ohio. Licensed Practical Nurses (LPNs) currently...Work at office
- ...often (in days) to receive an alert: Title: International Trip Review Specialist, Senior (NJUS) Company: NetJets Aviation, Inc. Area of... ...flight test plans and reviewing aircraft performance limitations. Utilize test flight plans to update Owner reservation trip times, identify...All shiftsFlexible hoursNight shiftDay shiftAfternoon shift
- Nationwide Children’s Hospital is seeking a Behavioral Health Utilization Review Specialist to review cases, determine medical necessity, and ensure compliance with guidelines. The role conducts pre-certifications, pre-authorizations, and retrospective reviews, collaborating...Remote jobWork at officeWork from home
- ...We are looking to fill a Scientist II or III - Metrology Specialist position working as a full-time employee of Parexel FSP on long... ...operating procedures (SOPs) Responsibilities Prepare, review, and approve instrument/equipment documentation such as master...Full time
- ...time Senior Violence Prevention Specialist to support our government... ...consultation, supporting literature reviews and manuscript development,... ...policy, medicine, nursing, or a related field. At least 5... ...treatment of all staff and full utilization of all qualified employees at...Full timeContract workWork at officeLocal areaRemote workFlexible hours
$54.68k - $63.73k
...25%Job Shift: Day The Health Specialist coordinates and monitors health... ...Performance Standards by reviewing health records, coordinating... ...exclusion procedures. Identifies and utilizes state and local resources for... ...Associate Degree in Nursing or related field with a valid...Temporary workLocal areaShift work- ...Triage Specialist The Triage Specialist conducts a thorough telephonic nursing triage for acute and chronic medical complaints and uses... ...to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor. Central...Full timeWork at officeMonday to FridayFlexible hoursShift workWeekend workDay shift
- ...resulted in policy outlined time frame. Review all patient checkouts, enter recalls,... ...of personal and financial information by utilizing HIPAA guidelines and regulations As time... ...miscellaneous duties as assigned by nurse manager (or designee), practice manager, or human...Work at officeFlexible hours
- RN Addiction Specialist Meaningful Nursing. Exceptional Benefits. Work-Life Balance. Looking for a nursing career where you can make a difference... ...results, nursing assessments, and patient goals. Review laboratory and toxicology results with patients. Provide education...Flexible hoursAfternoon shift
- Job Title Capacity Management Specialist RN Department University Hospital | Center for Emergency Services Scope of Position The Capacity... ...base of processes and systems by attending meetings and reviewing training materials and identifies, addresses, and works to resolve...Shift workNight shift
- ...people’s lives. Position Summary We are seeking a Pharmacovigilance Specialist I. Reporting to the Adverse Events & Product Complaints (AEPC)... ...knowledge of call center or intake workflows supporting AE/PC review Knowledge of FDA AE/PC reporting requirements; 21 CFR Part 314....Full timeWork at officeAll shiftsMonday to FridayShift work
- ...Health Information Management Specialist Established in 1984,... ...communication; relationship building; utilizing a computer for typing and... ...need a signed notary, have been reviewed, signed and dated. Handle... ..., Business or related field OR two years of Medical Records...Temporary workWork at officeAfternoon shift
- ...Expand Access. Lead Markets. Transform Care. We are seeking a RN Executive Director Specialist - Hospice to join our leadership team. This role acts as... ...Experience (Not Required): Bachelor’s degree in nursing or related field preferred; equivalent experience accepted...Daily paidFull timePart timeLocal area
$36.01 per hour
...Description - Rehabilitation Program Specialist 2 (20036229) (2600064H)... ...but not limited to: Reviewing assessments and/request to make... ...if approval criteria are met utilizing federal & state regulations.... ...able to secure a Driver License OR supply your own transportation...Hourly payFull timePart timeWork at officeLocal areaWork from homeNight shift- St. Vincent Family Services in Columbus, OH is seeking an Utilization Management Specialist to coordinate prior authorizations for clinical services across multiple MCOs. You will serve as the main liaison between the agency and payors, ensuring timely submissions, accurate...
- Assessment Specialist (LSW) 7pm-7am Columbus Springs Dublin , part of Lifepoint Behavioral Health, nationally known healthcare organization... ...Social Work or counseling and relevant licensure (LSW, LISW, LPC, LPCC, MFT, IMFT) Valid driver’s license and a favorable Motor...Full timeFlexible hours
- NetJets Aviation, Inc. is seeking an International Trip Review Specialist, Senior to manage owner inquiries from booking through flight execution, identifying issues and proposing customized options to ensure on-time, high-quality experiences. The role requires 4+ years...Flexible hours
- ...Counseling Centers (NCCC) is a nonprofit mental health agency providing behavioral healthcare since 1968. We’re seeking an Assessment Specialist (LSW/LPC/MFT) to handle intakes, diagnostic assessments and individual service plans. Travel to Twin Valley Behavioral Health and...Local area
- ...forecasts resourcing requirements (optimal machine/equipment utilization) Performs complex modeling to develop operational capacity Attends... ...timing concerns and recommends possible solutions Compiles, reviews and submits detailed production information to internal and...Full timeFlexible hoursShift work
- Respiratory Services Clinician (RT, RN, or LPN) The Respiratory Services Clinician supports the clinical teams in completing daily tasks... ...member, and completing Sleep Glad or Telehealth appointments. Reviews insurance compliance requirements with patients for NIV, PAP,...
- ...If you have questions while submitting an application, please review these frequently asked questions. Current Employees and Students... ...it will transfer to your application. Job Title: Staff Nurse (RN) - Main OR - Level 1 Trauma - Varying Shifts Department: University...Interim roleShift workRotating shift
- Berger Health System in Columbus, Ohio is seeking a Surgical Tech to assist in surgical procedures, ensuring optimal patient care and maintaining a sterile environment. This role emphasizes the ability to anticipate surgeon needs, participate in team operations, and comply...Relocation package
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to RN Care Specialist. Be the first to apply!

