Top 23 Utilization management nurse Jobs in Richmond, Ky

RN Clinical Manager - Lexington
Optum —Lexington, KY
- $48,816 - $73,224 a year
- Full-time
- Nursing
- RN License
- Pass drug screening
Quick Apply
Case Manager - Emergency Department
Baptist Health System KY & IN —Richmond, KY
- Full-time
- Nursing
- RN License
- 5 years
- Paid parental leave
- Disability insurance
21h
Regional Supervisor of Utilization Review
Appalachian Regional Healthcare, Inc. —Lexington, KY
- Full-time
- Nursing
- RN License
- Customer service
- Paid time off
3d
Nurse Case Manager/UKHC
University of Kentucky —Lexington, KY
- $75,364 - $95,056 a year
- 8 hour shift
- Background check
- Nursing
- RN License
Care Coordination Assistant
Saint Joseph Hospital - Lexington —Lexington, KY
- $17.24 - $24.35 an hour
- Full-time
- Hospital
- Mid-level
- 3 years
9d
Nursing Manager
Pine Meadows Post Acute —Lexington, KY
- Full-time
- Nursing
- LVN
- RN License
Quick Apply
RN - Flexible Weekend Schedule
Optum —Lexington, KY
- $48.97 - $58.76 an hour
- Full-time
- CPR Certification
- Management
- RN License
Quick Apply
Nurse Clinical/UKHC
University of Kentucky —Lexington, KY
- $28.00 - $39.10 an hour
- Full-time
- Background check
- Nursing
- RN License
RN
Optum —Richmond, KY
- $48.97 - $58.76 an hour
- Full-time
- CPR Certification
- RN License
- Writing skills
Quick Apply
13d
Nurse Clinical Senior/Critical Core/UKHC
University of Kentucky —Lexington, KY
- $29.12 - $45.70 an hour
- Full-time
- Background check
- Nursing
- RN License
Nursing Supervisor - Night Shift
Pine Meadows Post Acute —Lexington, KY
- Full-time
- Nursing
- LVN
- RN License
Quick Apply
Utilization Management Reviewer
Amerihealth Caritas —United States
- Full-time
- Hybrid work
- Nursing
- Microsoft Outlook
- RN License
- Paid holidays
- Health insurance
Claims Nurse (Utilization Management / Claims Review) Must have CALIFORNIA license
Dragonfly Global —United States
- $100,000 - $105,000 a year
- Full-time
- Remote
- LVN
- RN License
- Mid-level
- Travel reimbursement
- Health savings account
Quick Apply

Discover related jobs

Based on your search for utilization management nurse jobs.

Inbound Sales Representative (Remote/Eastern Time)
A Place for Mom —Lexington, KY
Success is measured by reaching daily production benchmarks (inbound calls and outbound return calls), which consists of referring families out to communities…
$45,760 a year
Quick Apply
Outside Contractor Sales
Hayes Pipe Supply, Inc. —Lexington, KY
Our product offering consists of pipe, valves, fire hydrants and accessory items necessary for the installation of water lines, sewer lines, storm sewer lines…
Quick Apply
5d

Show more related jobs

Explore jobs in cities nearby

Check out jobs in cities near your current location, Columbus

Case Manager / PRN ( RN / RT / SW / LPN )
Select Specialty Hospital - Columbus Vic Village(Grant) —Columbus, OH
Current licensure in a clinical discipline either as a Nurse (RN /LPN/ LVN)or a Respiratory Therapist OR current license / certified Social Work license per…
Quick Apply
Care Management RN - Outpatient Oncology
The Ohio State University Wexner Medical Center —Columbus, OH
This position maintains awareness of emerging state and national healthcare trends and drives initiatives to enhance care quality and ensure effective resource…
3d

Show more jobs in cities nearby

I want to receive the latest job alert for utilization management nurse in richmond, ky

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

utilization management nurse jobs near richmond, ky

RN Clinical Manager - Lexington

Optum -
Lexington, KY

Quick Apply

Job Details

Full-time
$48,816 - $73,224 a year

Qualifications

RN License
Driver's License
Task prioritization
Home healthcare regulations

Full Job Description

Explore opportunities with Commonwealth Personal Care Services, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together.

As the Clinical Manager, you are responsible for ensuring high-quality, cost-effective patient care. You oversee the daily operations of the agency, managing key functions such as scheduling, staffing, intake, physician communication, billing, and compliance. Your leadership keeps everything running smoothly, ensuring both clinical excellence and operational efficiency.

Primary Responsibilities:

Evaluate patient eligibility and reimbursement criteria for home care services; collaborate with Agency Director on referral acceptance and care planning
Schedule and ensure timely documentation of initial assessments
Coordinate with Case Coordinators to ensure appropriate staffing and coverage
Monitor patient utilization for compliance with physician orders, agency policies, and funding guidelines; investigate and resolve unfilled shifts
Assist with scheduling for Case Managers, nurses, and PRN staff; ensure timely and accurate documentation submission
Approve and update plans of care (POC), including verbal orders, medications, and treatments
Ensure timely completion of recertifications and verify plan of care content and compliance with policies
Conduct routine and supervisory field visits as required by state regulations
Support training and orientation of newly hired nurses, caregivers, and staff

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

Registered Nurse (RN) license in the state of practice
Solid understanding of home care regulations and reimbursement mechanisms

Driver's License and access to a reliable transportation

State Specific Requirements:

KY: Minimum 2 years of RN experience in aging or disabilities

Preferred Qualifications:

Bachelor's degree in nursing, healthcare, healthcare technology, or education
1+ years of home care experience
Supervisory or management experience
Experience in staff training or orientation
Ability to manage schedules, documentation, and compliance processes

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $48,816 to $73,224 annually based on full-time employment. We comply with all minimum wage laws as applicable.

#LHCJobs

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Quick Apply

Refine Your Search

utilization management nurse jobs in richmond, ky

RN Clinical Manager - Lexington

Case Manager - Emergency Department

Regional Supervisor of Utilization Review

Nurse Case Manager/UKHC

Care Coordination Assistant

Nursing Manager

RN - Flexible Weekend Schedule

Nurse Clinical/UKHC

RN

Nurse Clinical Senior/Critical Core/UKHC

Nursing Supervisor - Night Shift

Utilization Management Reviewer

Claims Nurse (Utilization Management / Claims Review) Must have CALIFORNIA license

Discover related jobs

Explore jobs in cities nearby

I want to receive the latest job alert for utilization management nurse in richmond, ky

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected