Experience with utilization management systems
or clinical decision-making tools such as: Medical Coverage Guidelines (MCG), CMS guidelines, and/or InterQual.
2+ Years of clinical medical
or behavioral
health experience. This position is eligible for a CVS
Health bonus, commission
or short-term incentive program in…
High School degree
or GED equivalent required. Successful completion of a coding license
or certificates; Credentialed Coder Certificate/License (CPC, CRC, CPMA…
Active and unrestricted
RN license required; Kentucky
or compact license preferred. Experience in prior authorization reviews utilizing InterQual
or Milliman…
Black belt
or equivalent experience in attention to details. A genuinely cheerful spirit of collaboration in general, but especially when receiving feedback…
To achieve excellence in
nursing care, TriHealth encourages: pursuit of improved knowledge through continuing education classes, formal education leading to…
High school
or equivalent (Preferred). * Schedule: Part-time
or contract. United States: Reliably commute
or planning to relocate before starting work …
Completion of an approved coding
orhealth information technology program with current certification(s), such as RHIA, RHIT, CCS, CCS-P
or CPC, CPMA, CRC, with…