Top 4573 Community nurse Jobs in Ohio

Appeals Nurse Consultant
CVS Health —Ohio
- $60,522 - $129,615 a year
- Full-time
- Remote
- Google Workspace
- Nursing
- Microsoft Excel
- Health insurance
- Dental insurance
5d
RN Registered Nurse
Evergreen Healthcare Center —Montpelier, OH
- 12 hour shift
- RN License
- Long term care
- Entry level
- Health insurance
- Dental insurance
Quick Apply
RN's and LPN's Jenkins Care Community
Jenkins Care Community —Wellston, OH
- Full-time
- Skilled nursing facility
- RN License
- BLS Certification
- Health insurance
- Dental insurance
Quick Apply
Family Nurse Practitioner
Health Partners of Western Ohio —Tiffin, OH
- From $94,500 a year
- 12 hour shift
- Nursing
- BLS Certification
- Mid-level
- Continuing education credits
- 403(b) matching
Quick Apply
Registered Nurse
Coleman Health Services —Lima, OH
- Full-time
- RN License
- Mid-level
- Nursing
- Continuing education credits
- Health insurance
Quick Apply
Traveler RN - ICU Nights - Galion, Ohio
Avita Health System —Galion, OH
- $45 - $60 an hour
- Temporary
- RN License
- BLS Certification
- Mid-level
Quick Apply
HOME CARE - RN CASE MANAGER
Aultman Health Foundation —Canton, OH
- Weekends as needed
- Nursing
- RN License
- Computer literacy
Psychiatric Staff RN
Nationwide Children's Hospital —Columbus, OH
- From $36.90 an hour
- Part-time
- Acute care
- Background check
- CPR Certification
- Health insurance
- Dental insurance
Quick Apply
Registered Nurse (RN) On Call 7 days on and 7 days off Quick Response
Bella Care Hospice —Ashtabula, OH
- $75,000 - $85,000 a year
- Full-time
- Nursing
- RN License
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
RN - Circulator
Avita Health System —Ontario, OH
- Full-time
- Surgery
- RN License
- PALS Certification
- Free parking
- Paid parental leave
Quick Apply
RN Registered Nurse
BridgePort Healthcare Center of Ohio —Portsmouth, OH
- Full-time
- Skilled nursing facility
- RN License
- Entry level
- Health insurance
- Tuition reimbursement
Quick Apply
RN Registered Nurse Part Time
BridgePort Healthcare Center of Ohio —Portsmouth, OH
- Part-time
- RN License
- Entry level
- Health insurance
- Tuition reimbursement
Quick Apply
RN Nursing Supervisor
Crestwood Care Center —Shelby, OH
- Full-time
- Nursing
- RN License
- Mid-level
- Disability insurance
- Health insurance
Quick Apply
Registered Nurse (RN), Up to $40
Crestwood Care Center —Shelby, OH
- Up to $40 an hour
- 12 hour shift
- RN License
- Long term care
- Entry level
- Health insurance
- Dental insurance
Quick Apply
Charge Nurse Nightshift - RN
EnnisCourt Skilled Nursing —Lakewood, OH
- $40 - $42 an hour
- Part-time
- Background check
- CPR Certification
- Skilled nursing facility
- Health insurance
- Dental insurance
Quick Apply
RN Nursing Supervisor, Nights, No Weekends
Crestwood Care Center —Shelby, OH
- Full-time
- Nursing
- RN License
- Mid-level
- Disability insurance
- Health insurance
Quick Apply
Behavioral Health Registered Nurse
Recovery Defined —Dayton, OH
- $26 - $29 an hour
- Part-time
- CPR Certification
- Nursing
- Psychiatry
- Health insurance
- Dental insurance
Quick Apply
RN - ICU
Avita Health System —Ontario, OH
- Part-time
- RN License
- BLS Certification
- Mid-level
- Free parking
- Paid parental leave
RN - MedSurg
Avita Health System —Ontario, OH
- Full-time
- RN License
- PALS Certification
- Hospital
- Free parking
- Paid parental leave
RN - OB
Avita Health System —Galion, OH
- Full-time
- RN License
- Hospital
- BLS Certification
- Free parking
- Paid parental leave
Quick Apply

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community nurse jobs near ohio

Appeals Nurse Consultant

CVS Health -
Ohio

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Job Details

Full-time
$60,522 - $129,615 a year
5 days ago

Benefits

Health insurance
Dental insurance
Paid time off
Work from home
Vision insurance

Qualifications

Google Workspace
Nursing
Microsoft Excel
Microsoft Outlook
Medicare
RN License
Medicare regulations
Video conferencing software
Collaborative technology platforms
Microsoft Teams
Medicaid
Technical troubleshooting support
Video conferences (communication methods)
Insurance claims appeal handling
Nursing
Nurse Licensure Compact (NLC)
VPN

Full Job Description

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 ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary
Administers review and resolution of clinical complaints and appeals. Interprets data obtained from clinical records to apply appropriate
clinical criteria and policies in compliance with regulatory and accreditation requirements for members and providers. Coordinates clinical
resolutions with internal and external support areas.

What you will do

Acts as a top-level specialist to implement best in class policies, plans, and procedures in support of the Appeals area objectives.
Executes review of all clinical and benefit documentation for complaint and appeal requests (for integrated Medicare/Medicaid plans)
Develops strategy for review requirements to assure case reviews are overseen by practitioners with relevant clinical expertise.
Applies advanced knowledge of complex delegation arrangements, coding logic, contracts, clinical criteria, benefit plan structure, and regulatory requirements to support appeals review.
Ensures appeal process compliance with regulatory and accreditation standards.
Counsels with members, representatives, providers, regulators, and participants on the appeals process in compliance with state regulation and benefit plan designs.
Coaches and trains junior colleagues in techniques, processes, and responsibilities.

Required Qualifications

Candidate must have active and unrestricted Registered Nurse (RN) License in their state of residence
Candidate must be willing to obtain a Compact Registered Nurse (RN) License within 3 months of hire
3+ years of Medicare/Medicaid Appeal Processing/Review Experience

Preferred Qualifications

Utilization management or appeals experience

Education

Associate's Degree in Nursing OR Nursing Diploma (REQUIRED)
Bachelor's Degree (PREFERRED)

License

Active and unrestricted Registered Nurse (RN) License in their state of residence

Work from Home Requirements

You must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of your computer and a minimum download speed of 25 mbs download and 3 mbs upload. WiFi and satellite internet are not permitted.
A quiet, secure and private designated home virtual work location, free from distractions, tidy and organized, compliant with CVS Health and HIPAA guidelines, and allowing for uninterrupted work during work hours.
Work-from-Home colleagues are required to work within the state and city where they have confirmed they currently live.
The company will provide equipment (keyboard, monitor, computer, headset, etc.). All new hires should provide their own workspace furniture (desk or standing desk, as this position would require you to be at your desk for extended periods of time).
If hired, you will commit to obtaining required internet speeds and adhere to all Work From Home requirements.

Technical and Logistical Requirements

Device & System Navigation: Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously to streamline tasks and improve efficiency.
Communication Tools: Ability to communicate on digital channels such as via email, calendar invites, Teams messaging, and virtual meetings.
Collaboration & Scheduling: Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) applications or similar (Google Workspace).
Systems Access & Security: Ability to Log in to secure systems (e.g., VPN, EHR portal), lock a computer screen when unattended, manage strong passwords, and recognize suspicious emails or links.
Troubleshooting & Support: Ability to resolve common technical issues independently, such as: restarting an application when frozen, resolving internet connection issues, and contacting IT for unresolved technical issues.
Future Growth: Openness to learning new skills in the future as the workplace environment evolves

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$60,522.00 - $129,615.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 08/31/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Apply Now

Refine Your Search

community nurse jobs in ohio

Appeals Nurse Consultant

RN Registered Nurse

RN's and LPN's Jenkins Care Community

Family Nurse Practitioner

Registered Nurse

Traveler RN - ICU Nights - Galion, Ohio

HOME CARE - RN CASE MANAGER

Psychiatric Staff RN

Registered Nurse (RN) On Call 7 days on and 7 days off Quick Response

RN - Circulator

RN Registered Nurse

RN Registered Nurse Part Time

RN Nursing Supervisor

Registered Nurse (RN), Up to $40

Charge Nurse Nightshift - RN

RN Nursing Supervisor, Nights, No Weekends

Behavioral Health Registered Nurse

RN - ICU

RN - MedSurg

RN - OB

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