remote on call nurse practitioner or physician assistant certified***prn***multi state licensure**

nurse

preauthorization registered nurse Jobs in Ohio

preauthorization registered nurse

remote on call nurse practitioner or physician assistant certified***prn***multi state licensure** Jobs in Ohio

registered nurse

Humana

<div>
 
 Become a part of our caring community and help us put health first
 
 
 
 Are you a transitioning military service member or a military spouse looking for an internship that supports the goal to put health first?
 
 
 The DOW SkillBridge Internship and Military Spouse Fellowship Programs will provide you with key training to perform your internship. You will partner with your team to support members, projects, and to meet goals impacting business outcomes. The professionals you work with at Humana will depend on the type of internship you select. They may include healthcare professionals, HR, and IT, to name a few. The objective is to support and facilitate care for members.
 
 
 To be eligible for this internship, you must either be a transitioning military service member or a military spouse, and you must obtain eligibility to participate in these DOW sponsored programs.
 
 
 The Prior Authorization, Registered Nurse, RN, Intern will report to a manager of the National Medicaid team. You will utilize training and engage formerly acquired skillsets to complete medical necessity reviews for requested services using clinical judgment and provides referrals to internal stakeholders for further review depending on case findings.
 
 
 
 You will participate in the following assignments in this role:
 
 
 
 
 Clinical Review
 
 
 
 <ul>
 <li>
 Conduct comprehensive clinical reviews of prior authorization requests to determine medical necessity and benefit eligibility.
 </li>
 <li>
 Apply advanced evidence-based clinical guidelines in review decisions.
 </li>
 <li>
 Ensure compliance with accreditation, state, and federal regulations.
 
 
 </li>
 </ul>
 
 Communication And Coordination
 
 
 
 <ul>
 <li>
 Communicate with healthcare providers to obtain necessary clinical information and clarify requests.
 </li>
 <li>
 Coordinate with medical directors and interdisciplinary teams to support decision-making.
 </li>
 <li>
 Serve as a liaison between clinicians, internal departments, and members.
 
 
 </li>
 </ul>
 
 Documentation And Reporting
 
 
 
 <ul>
 <li>
 Document all review findings and decisions in clinical documentation systems.
 </li>
 <li>
 Ensure timely and accurate documentation of prior authorization determinations.
 </li>
 <li>
 Support reporting initiatives and provide data for performance improvement projects.
 
 
 </li>
 </ul>
 
 Quality Assurance
 
 
 
 <ul>
 <li>
 Implement quality assurance measures to ensure accuracy and consistency in prior authorization decisions.
 </li>
 <li>
 Conduct regular audits and reviews to maintain high standards of service.
 </li>
 <li>
 Identify process improvement opportunities and contribute to performance improvement projects.
 
 
 </li>
 </ul>
 
 Education And Training
 
 
 
 <ul>
 <li>
 Educate providers and staff on prior authorization policies, criteria, and review processes.
 </li>
 <li>
 Provide mentorship and feedback to nonclinical staff and peers to enhance workflow efficiency.
 </li>
 <li>
 Stay current with clinical best practices and regulatory changes.
 
 
 </li>
 </ul>
 
 Required Qualifications
 
 
 
 
 Use your skills to make an impact
 
 
 
 <ul>
 <li>
 You must be a transitioning service member eligible to participate in the DOW SkillBridge or a military spouse eligible to participate in the military spouse fellowship&middot;
 </li>
 <li>
 Active Registered Nurse, RN, enhanced Compact, (eNLC) license without restrictions or disciplinary action.
 </li>
 <li>
 Minimum two (2) years clinical nursing experience such as acute care, emergency room, ICU, skilled or rehabilitation setting.
 </li>
 <li>
 Working knowledge of MS Office including Word, Excel, PowerPoint, and Teams in a Windows based environment and an ability to quickly learn new systems and ability to troubleshoot and resolve basic technical difficulties in a remote environment.
 </li>
 <li>
 Possess an interest in working in the managed care industry
 
 
 </li>
 </ul>
 
 Preferred Qualifications
 
 
 
 <ul>
 <li>
 Bachelor's degree
 </li>
 <li>
 Previous Medicare/Medicaid experience.
 </li>
 <li>
 Previous experience in prior authorization, utilization management.
 </li>
 <li>
 Experience working with MCG or Interqual guidelines.
 </li>
 <li>
 Certification in Case Management, (CCM) or Utilization Review, (UR).
 </li>
 <li>
 Knowledge of payer policies, insurance companies and government health programs.
 
 
 </li>
 </ul>
 
 Workstyle:
 
 Remote Work at Home
 
 
 
 Location:
 
 Must reside in a state that participates in the enhanced compact license, (eNLC)
 
 
 
 Work Schedule:
 
 Weekdays 8:00 AM to 4:30 PM Central Time
 
 
 
 Travel:
 
 None
 
 
 
 Additional Information
 
 
 
 
 Work At Home Requirements
 
 
 
 <ul>
 <li>
 WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
 </li>
 <li>
 A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
 </li>
 <li>
 Satellite and Wireless Internet service is NOT allowed for this role.
 </li>
 <li>
 A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
 
 
 </li>
 </ul>
 
 The DOW SkillBridge Internship Program
 
 provides transitioning military service members time to gain civilian work experience while still on active duty with an employer for a period approved by their command and the DOW, with an average timeline of 90 days.
 
 
 
 The Military Spouse Fellowship Program
 
 connects military spouses with employers offering a variety of professional onsite, field, or remote based opportunities for a period up to 12 weeks.
 
 
 <ul>
 <li>
 Networking opportunities will be provided while participating in the Internship or Fellowship.
 </li>
 <li>
 Due to factors such as location, and/or requirements that cannot be modified, full-time employment is not guaranteed upon completion of the Internship or Fellowship.
 
 
 </li>
 </ul>
 
 Interview Format
 
 As part of our hiring process, we will be using a screening and interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring leaders with an enhanced method for decision-making. If you are selected to move forward from your application prescreen, you will receive an email correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview.
 
 (please be sure to check your spam or junk folders often to ensure communication isn't missed)
 
 If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
 
 
 Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
 
 
 
 
 
 Scheduled Weekly Hours
 
 
 
 
 
 1
 
 
 
 About Us
 
 
 
 Humana Inc. (NYSE: HUM) is committed to putting health first &ndash; for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health &ndash; delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
 
 
 
 Equal Opportunity Employer
 
 
 
 It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
</div>

Preauthorization Registered Nurse

DataAnnotation

<div>
 We are looking for a Nurse to join our team to train AI models. You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of each model.
 
 
 
 Physicians &amp; Advanced Practice Clinicians
 
 
 
 In this role you will need to be an expert in healthcare. We are interested in a wide range of expertise, so relevant backgrounds include:
 
 
 Physicians of all specialties (e.g., Internists, Cardiologists, Oncologists), Physician Assistants, Nurse Practitioners, Certified Nurse-Midwives, Certified Registered Nurse Anesthetists, Clinical Nurse Specialists, Registered Nurses.
 
 
 
 Therapists
 
 
 
 Physical Therapists, Occupational Therapists, Speech-Language Pathologists, Respiratory Therapists, Athletic Trainers, Massage/Recreational Therapists.
 
 
 
 Diagnostic &amp; Laboratory Professionals
 
 
 
 Radiologic Technologists, Sonographers, MRI &amp; Nuclear Medicine Technologists, Medical Laboratory Scientists, Phlebotomists, Histology &amp; Genetics Technicians.
 
 
 
 Public Health &amp; Specialized Roles
 
 
 
 Dietitians/Nutritionists, Genetic Counselors, Epidemiologists, Public Health Nurses.
 
 
 
 Benefits
 
 
 
 <ul>
 <li>
 This is a full-time or part-time REMOTE position
 </li>
 <li>
 You&rsquo;ll be able to choose which projects you want to work on
 </li>
 <li>
 You can work on your own schedule
 </li>
 <li>
 Projects are paid hourly starting at $50-$60 USD per hour, with bonuses on high-quality and high-volume work
 
 
 </li>
 </ul>
 
 Responsibilities
 
 
 
 <ul>
 <li>
 Give AI chatbots diverse and complex healthcare related problems and evaluate their outputs
 </li>
 <li>
 Evaluate the quality produced by AI models for correctness and performance
 </li>
 <li>
 Ensure the medical accuracy of model performance
 
 
 </li>
 </ul>
 
 Qualifications
 
 
 
 <ul>
 <li>
 Fluency in English (native or bilingual level)
 </li>
 <li>
 A current or in progress medical degree
 
 
 </li>
 </ul>
 Notes: Payment is made via PayPal. We will never ask for any money from you. PayPal will handle any currency conversions from USD. Only applicants in the United States will be considered for this role. This is an independent contract position.
 
 
 #medicine
</div>

Nurse

<div>
 We are looking for a Pharmacy Technician to join our team to train AI models. You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of each model.
 
 
 
 Physicians &amp; Advanced Practice Clinicians
 
 
 
 In this role you will need to be an expert in healthcare. We are interested in a wide range of expertise, so relevant backgrounds include:
 
 
 Physicians of all specialties (e.g., Internists, Cardiologists, Oncologists), Physician Assistants, Nurse Practitioners, Certified Nurse-Midwives, Certified Registered Nurse Anesthetists, Clinical Nurse Specialists, Registered Nurses.
 
 
 
 Therapists
 
 
 
 Physical Therapists, Occupational Therapists, Speech-Language Pathologists, Respiratory Therapists, Athletic Trainers, Massage/Recreational Therapists.
 
 
 
 Diagnostic &amp; Laboratory Professionals
 
 
 
 Radiologic Technologists, Sonographers, MRI &amp; Nuclear Medicine Technologists, Medical Laboratory Scientists, Phlebotomists, Histology &amp; Genetics Technicians.
 
 
 
 Public Health &amp; Specialized Roles
 
 
 
 Dietitians/Nutritionists, Genetic Counselors, Epidemiologists, Public Health Nurses.
 
 
 
 Benefits
 
 
 
 <ul>
 <li>
 This is a full-time or part-time REMOTE position
 </li>
 <li>
 You&rsquo;ll be able to choose which projects you want to work on
 </li>
 <li>
 You can work on your own schedule
 </li>
 <li>
 Projects are paid hourly starting at $50-$60 USD per hour, with bonuses on high-quality and high-volume work
 
 
 </li>
 </ul>
 
 Responsibilities
 
 
 
 <ul>
 <li>
 Give AI chatbots diverse and complex healthcare related problems and evaluate their outputs
 </li>
 <li>
 Evaluate the quality produced by AI models for correctness and performance
 </li>
 <li>
 Ensure the medical accuracy of model performance
 
 
 </li>
 </ul>
 
 Qualifications
 
 
 
 <ul>
 <li>
 Fluency in English (native or bilingual level)
 </li>
 <li>
 A current or in progress medical degree
 
 
 </li>
 </ul>
 Notes: Payment is made via PayPal. We will never ask for any money from you. PayPal will handle any currency conversions from USD. Only applicants in the United States will be considered for this role. This is an independent contract position.
 
 
 #medicine
</div>

Pharmacy Technician

<div>
 We are looking for a Physical Therapist to join our team to train AI models. You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of each model.
 
 
 
 Physicians &amp; Advanced Practice Clinicians
 
 
 
 In this role you will need to be an expert in healthcare. We are interested in a wide range of expertise, so relevant backgrounds include:
 
 
 Physicians of all specialties (e.g., Internists, Cardiologists, Oncologists), Physician Assistants, Nurse Practitioners, Certified Nurse-Midwives, Certified Registered Nurse Anesthetists, Clinical Nurse Specialists, Registered Nurses.
 
 
 
 Therapists
 
 
 
 Physical Therapists, Occupational Therapists, Speech-Language Pathologists, Respiratory Therapists, Athletic Trainers, Massage/Recreational Therapists.
 
 
 
 Diagnostic &amp; Laboratory Professionals
 
 
 
 Radiologic Technologists, Sonographers, MRI &amp; Nuclear Medicine Technologists, Medical Laboratory Scientists, Phlebotomists, Histology &amp; Genetics Technicians.
 
 
 
 Public Health &amp; Specialized Roles
 
 
 
 Dietitians/Nutritionists, Genetic Counselors, Epidemiologists, Public Health Nurses.
 
 
 
 Benefits
 
 
 
 <ul>
 <li>
 This is a full-time or part-time REMOTE position
 </li>
 <li>
 You&rsquo;ll be able to choose which projects you want to work on
 </li>
 <li>
 You can work on your own schedule
 </li>
 <li>
 Projects are paid hourly starting at $50-$60 USD per hour, with bonuses on high-quality and high-volume work
 
 
 </li>
 </ul>
 
 Responsibilities
 
 
 
 <ul>
 <li>
 Give AI chatbots diverse and complex healthcare related problems and evaluate their outputs
 </li>
 <li>
 Evaluate the quality produced by AI models for correctness and performance
 </li>
 <li>
 Ensure the medical accuracy of model performance
 
 
 </li>
 </ul>
 
 Qualifications
 
 
 
 <ul>
 <li>
 Fluency in English (native or bilingual level)
 </li>
 <li>
 A current or in progress medical degree
 
 
 </li>
 </ul>
 Notes: Payment is made via PayPal. We will never ask for any money from you. PayPal will handle any currency conversions from USD. Only applicants in the United States will be considered for this role. This is an independent contract position.
 
 
 #medicine
</div>

Physical Therapist

Molina Healthcare

JOB DESCRIPTION
 
Job Summary
 
Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.
 
Essential Job Duties
 
<ul>
<li>Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments.</li>
<li>Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.</li>
<li>Conducts telephonic, face-to-face or home visits as required.</li>
<li>Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.</li>
<li>Maintains ongoing member caseload for regular outreach and management.</li>
<li>Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care.</li>
<li>Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration.</li>
<li>Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.</li>
<li>Assesses for barriers to care, provides care coordination and assistance to member to address concerns.</li>
<li>May provide consultation, resources and recommendations to peers as needed.</li>
<li>Care manager RNs may be assigned complex member cases and medication regimens.</li>
<li>Care manager RNs may conduct medication reconciliation as needed.</li>
<li>25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications</li>
<li>At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.</li>
<li>Registered Nurse (RN). License must be active and unrestricted in state of practice.</li>
<li>Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.</li>
<li>Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA).</li>
<li>Demonstrated knowledge of community resources.</li>
<li>Ability to operate proactively and demonstrate detail-oriented work.</li>
<li>Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.</li>
<li>Ability to work independently, with minimal supervision and self-motivation.</li>
<li>Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations.</li>
<li>Ability to develop and maintain professional relationships.</li>
<li>Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.</li>
<li>Excellent problem-solving, and critical-thinking skills.</li>
<li>Strong verbal and written communication skills.</li>
<li>Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.</li>
</ul>
Preferred Qualifications
 
<ul>
<li>Certified Case Manager (CCM).</li>
</ul>
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
 
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
 Pay Range: $26.41 - $51.49 / HOURLY
 <ul>
<li>Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.</li>
</ul>

Care Manager (RN)

Altea Healthcare

Certified Nurse Practitioner (NP) / Physician Assistant (PA-C) &ndash; Post-Acute Care (Weekends)Location: Ohio, Illinois, &amp; IndianaCompensation: $475 - $600 per dayJob Type: Part-Time***An active Nurse Practitioner (NP) or Physician Assistant (PA-C) license in Ohio, Illinois, and Indiana is required prior to the start date. The candidate must also be willing to obtain additional state licenses as needed.******The proposed schedule for this role is on the weekends.***Launch or Grow Your Career in Post-Acute Care!Are you a Certified Nurse Practitioner (NP) or Physician Assistant (PA-C) looking for a rewarding and high-paying career with work-life balance? Whether you're an experienced provider or a recent graduate eager to learn, we provide the training, mentorship, and support you need to succeed in post-acute and skilled nursing care.✅ New Graduates Welcome &ndash; Training &amp; Support Provided! ✅ Flexible Scheduling &ndash; Achieve Work-Life Balance ✅ Competitive Pay At Altea Healthcare, we offer a collaborative team environment, cutting-edge technology, and ongoing education to ensure you thrive in your career.What You&rsquo;ll Do:As a NP or PA-C, you will be taking calls remotely for national level for CCM visits from 7am - 7pm rotating with our other providers. These duties can be performed remotely but you must be available to take the calls when you are scheduled to work. The ideal candidate will be licensed in Ohio, Illinois, and Indianatocomplete CCM visits monthly. Typical schedule may be varied and shall include weekends and holidays.You should have experience in one of the following specialties: acute care, family health or geriatrics. Patience, problem-solving, and good communication skills are important. If you are dedicated to advancing your knowledge and clinical expertise through research and professional discourse, we would like to meet with you to share our mission, vision, values for the post-acute industry.Your daily responsibilities include:<ul><li>Examine patients medical records</li><li>Ordering and interpreting diagnostic tests (labs, imaging, etc.).</li><li>Diagnosing and managing acute and chronic conditions.</li><li>Prescribing medications and creating treatment plans.</li><li>Collaborating with physicians, nurses, and facility staff.</li><li>Educating patients and families on health conditions and preventive care.</li><li>Documenting patient care accurately and efficiently.</li><li>Oversee patients&rsquo; overall health</li><li>Promote good health practices</li><li>Other duties as assigned</li></ul>Who Should Apply?We welcome both experienced providers and motivated new graduates!✅ NP or PA-C License (or eligibility to obtain) ✅ All Experience Levels Welcome &ndash; Training &amp; Mentorship Available! ✅ Passion for geriatrics, internal medicine, or primary care ✅ Strong team player with excellent communication skills ✅ Self-motivated with a patient-first approachWhat We Offer<ul><li>Highly Competitive Pay ($475 - $600 per day)</li><li>Flexible Scheduling &ndash; Achieve the Work-Life Balance You Want</li><li>Career Growth &amp; Leadership Opportunities &ndash; Fast-Track Your Success</li><li>Ongoing Training &amp; Mentorship &ndash; Support for New Grads &amp; Experienced Providers</li></ul>Take the Next Step in Your Career!Don&rsquo;t miss this opportunity to join a top-tier healthcare team, receive excellent pay, and make a lasting impact in post-acute care.Apply Today &amp; Secure Your Spot!Job Type: Part-timePay: $475.00 - $600.00 per dayApplication Question(s):<ul><li>This role requires licensure in Ohio before starting. Do you hold licensure in Ohio?</li><li>Do you have licensures in the following state of IN or IL?</li></ul>License/Certification:<ul><li>PA-C (Preferred)</li><li>Certified Nurse Practitioner (Preferred)</li></ul>Work Location: Remote

Remote On Call Nurse Practitioner or Physician Assistant Certified***PRN***Multi State Licensure**

Explore 6+ Registered nurse in Ohio this March. Find roles across top companies and apply now to boost your career.

6 registered nurse jobs In Ohio

Preauthorization Registered Nurse

Nurse

Pharmacy Technician

Physical Therapist

Care Manager (RN)

Remote On Call Nurse Practitioner or Physician Assistant CertifiedPRNMulti State Licensure**