• Senior Special Investigations Coding Manager…

    CVS Health (Columbus, OH)
    …strategic initiatives, along with a team of medical coders/nurses supporting Aetna 's Special Investigations Unit. Key Responsibilities: + Leadership: Leads a team ... of coding/ nursing professionals who conduct reviews of medical records and...prioritization. + Quality Control and Compliance: Maintains oversight of coder/ nurse reviews, ensuring compliance with ICD-10, CPT and HCPCS… more
    CVS Health (05/24/25)
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  • Case Manager, Licensed Practical Nurse

    CVS Health (Columbus, OH)
    …needs and support safe transitions. **Required Experience** - 2 years Licensed Practical Nurse (LPN) nursing experience - Active and unrestricted LPN/LVN Compact ... member care to a whole new level! Join our Aetna Team as an industry leader in serving dual...markets across the country. The Case Manager, Licensed Practical Nurse is responsible for care coordination of our members… more
    CVS Health (05/22/25)
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  • Case Manager RN - Registered Nurse…

    CVS Health (Columbus, OH)
    …plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. + Applies clinical judgment to the incorporation of ... (CCM) certification + Experience with ATV/ASD **Education** + Associates Degree in Nursing required + BSN preferred **Anticipated Weekly Hours** 40 **Time Type**… more
    CVS Health (05/31/25)
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  • A1A Service Advocate

    CVS Health (Columbus, OH)
    …completion of the training program, pay will be increased to $18.50 per hour. Our Aetna One Advocacy program is Aetna 's premier service and clinical offering for ... Aetna members nationwide and creates industry-leading solutions for our customers. Our Aetna One Advocate is not the typical customer service role. Our focus is… more
    CVS Health (05/29/25)
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  • Care Management Associate-OhioRISE - Must reside…

    CVS Health (Columbus, OH)
    …accordance with the benefit plan. + Identifies triggers for referral into Aetna 's Case Management, Disease Management, Mixed Services, and other Specialty Programs. ... + Utilizes Aetna systems to build, research and enter member information,...for health care service delivery under the direction of nurse or medical director in the most appropriate setting… more
    CVS Health (05/31/25)
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  • Utilization Management Clinical Consultant (Must…

    CVS Health (Columbus, OH)
    …and every day. **Position Summary** This Clinical Consultant position is with Aetna 's Utilization Management (UM) team and is a field-based/Remote position out of ... Behavioral Health clinician (LISW, LPCC, LMFT) or a Registered Nurse (RN) with unrestricted state license in Ohio, and...Minimum of a Diploma RN or Associate's degree in Nursing **Anticipated Weekly Hours** 40 **Time Type** Full time… more
    CVS Health (05/25/25)
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