- Humana (Columbus, OH)
- … or discharge planner in an acute care setting + Previous experience in utilization management / utilization review for a health plan or acute care ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing...procedures to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with… more
- MetroHealth (Brooklyn Heights, OH)
- … of selected patients. Integrates and coordinates access and utilization management , proactive patient panel management , care facilitation, and treatment ... in Nursing. Valid Ohio RN licensure. Three to Five years of case management or managed care experience. Ability to work independently and as a member of a… more
- Elevance Health (Columbus, OH)
- …+ Engages the primary service coordinator and other clinical healthcare management and interdisciplinary teams to provide care coordination support. + ... **LTSS Concierge Coordinator (Case Manager)** **Hiring statewide across Ohio** **This...visits, as needed, to accommodate business need. + Submits utilization /authorization requests to utilization management … more
- Elevance Health (Toledo, OH)
- …with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on the development of care management of person-centered care plans. May also ... unless an accommodation is granted as required by law._ The **LTSS Service Coordinator -RN Clinician** is responsible for overall management of member's case… more
- Elevance Health (Worthington, OH)
- …associates, and may be involved in process improvement initiatives. + Submits utilization /authorization requests to utilization management with documentation ... **LTSS Service Coordinator (Case Manager)** **Hiring statewide across Ohio** **Location**...management and interdisciplinary team in order to provide care coordination support. + Manages non-clinical needs of members… more
- Intermountain Health (Columbus, OH)
- …health outcomes for patients. + **Preferred Requirements:** + **LPN License** + Primary Care office experience + Care Management + Social Determinates ... team to provide care coordination for preventative care and utilization mitigation.Identifies appropriate resources, including transportation, housing,… more
- Elevance Health (Norwood, OH)
- …member and the health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will be based upon the current ... **LTSS Service Coordinator - Clinician (Case Manager)** **Hiring statewide across...law and contract, the Clinician contributes to the LTSS care coordination process by performing activities within the scope… more
- MetroHealth (Valley View, OH)
- … care for selected Specialty Pharmacy patients. Integrates/coordinates access, utilization management , and proactive patient management . Communicates ... **10:30a-7p, Rotating Weekends & Holidays** **The MetroHealth System is redefining health care by going beyond medical treatment to improve the foundations of… more
- Cleveland Clinic (Garfield Heights, OH)
- …in educating and evaluating clinical and support department staff regarding quality management regulations and standards of care . + Support medical staff ... and the Southeast communities of Cuyahoga County, Marymount Hospital is an acute care , faith-based hospital. Here, caregivers are guided by the Christian values of… more
- Elevance Health (Mason, OH)
- …and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care . **Title:** Pharmacy Services Coordinator **Location:** Mason, OH - ... is granted as required by law. The **Pharmacy Services Coordinator ** is responsible for being the primary contact and...this includes claim processing, customer service, & medical account management . + Oversees benefit set up process to ensure… more