Top 692 Rn/clinical Supervisor Jobs in Ohio

RN Supervisor, Appeals, Managed Care, UM
Centene —Ohio
- $75,300 - $135,400 a year
- Full-time
- Nursing
- RN License
- Mid-level
- Paid holidays
- Health insurance
7d
Case Manager, Registered Nurse
CVS Health —Ohio
- $54,095 - $155,538 a year
- Full-time
- Remote
- Spanish
- Nursing
- Addiction Medicine
- Health insurance
- Dental insurance
RN Clinical Coord., Psychiatry - Main Campus
University Hospitals —Cleveland, OH
- $77,522 - $121,243 a year
- Nursing
- Psychiatry
- RN License
Vocational Rehab RN or CRC
Surety HR —Westlake, OH
- $70,000 a year
- Full-time
- Hybrid work
- RN License
- Customer service
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
12d
Registered Nurse -Clinical Services Supervisor
Creative Foundations —Delaware, OH
- Full-time
- Hybrid work
- Nursing
- OSHA
- RN License
Quick Apply
Clinical Director / Director of Nursing (DON)
Pearl's Hope Home Health Care —Columbus, OH
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- RN License
- Health insurance
- Dental insurance
Quick Apply
12d
Part- Time Home Health Care LPN/RN
Community Behavioral Nursing Services —Medina, OH
- $861.40 - $1,019.70 a month
- Part-time
- CPR Certification
- Nursing
- Vital signs
- Health savings account
- Health insurance
Quick Apply
6d
RN FT Day Shift
Ethan Crossing of Cleveland —Cleveland, OH
- $38 - $40 an hour
- Full-time
- Nursing
- Addiction Medicine
- RN License
- Health savings account
- Paid holidays
Quick Apply
Director, Utilization Management & Operational Integrity
Medical Mutual of Ohio —Cleveland, OH
- Hybrid work
- Nursing
- Microsoft Excel
- Microsoft Outlook
- Health savings account
- Disability insurance
Travel Clinical Research Education Trainer
The Clinical Trials Network, LLC —Cleveland, OH
- $80,000 - $100,000 a year
- Full-time
- Background check
- RN License
- 5 years
- Health insurance
- Dental insurance
Quick Apply
PM Unit Manager RN
Brookdale Senior Living Inc. —Westlake, OH
- $72,220 - $92,000 a year
- Nights as needed
- CPR Certification
- Nursing
- RN License
- Health savings account
- Paid holidays
Quick Apply
Registered Nurse
Oak Street Health —Cleveland, OH
- $60,522 - $129,615 a year
- Full-time
- RN License
- BLS Certification
- Clinic experience
- Health insurance
- Dental insurance
Hospice Registered Nurse Case Manager
Affinity Care of Ohio —Solon, OH
- $82,000 - $86,000 a year
- Full-time
- Nursing
- RN License
- No experience needed
Quick Apply
5d
Evening Part- Time Home Health Care LPN/RN
Community Behavioral Nursing Services —Amherst, OH
- $546.85 - $1,137.00 a week
- Part-time
- CPR Certification
- Nursing
- Vital signs
- Health savings account
- Health insurance
Quick Apply
Weekend Nurse Supervisor RN
Majestic Care of Whitehall —Whitehall, OH
- Full-time
- CPR Certification
- Nursing
- RN License
- Paid holidays
- Life insurance
Quick Apply
4d
Hospice Admissions Nurse RN
Affinity Care of Ohio —Dayton, OH
- Full-time
- Nursing
- RN License
- Writing skills
- Mileage reimbursement
- Paid holidays
Quick Apply
1d
Assistant Director of Nursing ADON
Centerville Health and Rehab —Dayton, OH
- Full-time
- CPR Certification
- Nursing
- RN License
- 401(k)
- Paid time off
Quick Apply
RN Assistant Director of Nursing
Canfield Healthcare Center —Youngstown, OH
- Full-time
- CPR Certification
- Nursing
- Skilled nursing facility
- Health insurance
- Dental insurance
Quick Apply
Hospice Registered Nurse Case Manager
Affinity Care of Ohio —Westlake, OH
- $82,000 - $86,000 a year
- Full-time
- Nursing
- RN License
- No experience needed
Quick Apply
5d
Registered Nurse - MS/Tele
Cambay Healthcare —Cleveland, OH
- $2,400 - $2,750 a week
- Travel nursing
- Background check
- RN License
- Hospital
Quick Apply
5d

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RN Supervisor, Appeals, Managed Care, UM

Centene -
Ohio

Apply Now

Job Details

Full-time
$75,300 - $135,400 a year
7 days ago

Benefits

Paid holidays
Health insurance
401(k)
Tuition reimbursement
Paid time off

Qualifications

Nursing
RN License
Nursing

Full Job Description

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

NOTE: REMOTE RN candidates may reside in any state but a current and active RN license from the state of California is strongly preferred

Position Purpose: Supervises Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team.

Monitors and tracks UM resources to ensure adherence to performance, compliance, quality, and efficiency standards
Collaborates with utilization management team to resolve complex care member issues
Maintains knowledge of regulations, accreditation standards, and industry best practices related to utilization management
Works with utilization management team and senior management to identify opportunities for process and quality improvements within utilization management
Educates and provides resources for utilization management team on key initiatives and to facilitate on-going communication between utilization management team, members, and providers
Monitors prior authorization, concurrent review, and/or retrospective clinical review nurses and ensures compliance with applicable guidelines, policies, and procedures
Works with the senior management to develop and implement UM policies, procedures, and guidelines that ensure appropriate and effective utilization of healthcare services
Evaluates utilization management team performance and provides feedback regarding performance, goals, and career milestones
Provides coaching and guidance to utilization management team to ensure adherence to quality and performance standards
Assists with onboarding, hiring, and training utilization management team members
Leads and champions change within scope of responsibility
Performs other duties as assigned
Complies with all policies and standards

Education/Experience:

Requires Graduate of an Accredited School Nursing or Bachelor's degree and 4+ years of related experience.
Strong knowledge of appeals and utilization management principles preferred.

Preferred Experience:

3 - 5 years of direct work experience and knowledge of the appeals process and utilization management principles in managed care/MCO environments is preferred.

License/Certification:

RN - Registered Nurse - State Licensure and/or Compact State Licensure required
For Health Net Federal Services: Must have current and active licensure or certification that permits independent assessment required
For Health Net Federal Services (Medical Management): Certified Managed Care Nurse (CMCN) within 1-1/2 Yrs required
For Health Net Federal Services: US citizenship and current National Agency Check government security clearance required

NOTE: REMOTE RN candidates may reside in any state but a current and active RN license from the state of California is strongly preferred

Pay Range: $75,300.00 - $135,400.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Apply Now

Refine Your Search

Rn/clinical Supervisor jobs in Ohio

RN Supervisor, Appeals, Managed Care, UM

Case Manager, Registered Nurse

RN Clinical Coord., Psychiatry - Main Campus

Vocational Rehab RN or CRC

Registered Nurse -Clinical Services Supervisor

Clinical Director / Director of Nursing (DON)

Part- Time Home Health Care LPN/RN

RN FT Day Shift

Director, Utilization Management & Operational Integrity

Travel Clinical Research Education Trainer

PM Unit Manager RN

Registered Nurse

Hospice Registered Nurse Case Manager

Evening Part- Time Home Health Care LPN/RN

Weekend Nurse Supervisor RN

Hospice Admissions Nurse RN

Assistant Director of Nursing ADON

RN Assistant Director of Nursing

Hospice Registered Nurse Case Manager

Registered Nurse - MS/Tele

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