- Molina Healthcare (OH)
- …RN or Clinical Social Worker/Counseling License. + Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified Professional ... or state board licensing mandate. + At least 2 years in case , disease or utilization management ; managed care; or medical/behavioral health settings. + One… more
- Elevance Health (Columbus, OH)
- …Alternate locations may be considered. The **Medical Director** will be responsible for utilization review case management for North Carolina Medicaid. May ... ** Utilization Management Medical Director- NC Medicaid**...and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers… more
- Molina Healthcare (Dayton, OH)
- …the pharmacy benefit changes for the upcoming year. + Works with the Case Management department as part of a member-centered interdisciplinary care team. ... (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management ), clinical pharmacy… more
- Select Medical (Dublin, OH)
- …**OhioHealth Rehabilitation Hospital Dublin** A joint venture with Select Medical & OhioHealth ** Case Manager (RN or MSW)** **Benefits of becoming a Case ... and long term disability, and tuition assistance) **Responsibilities** **Position Summary** The Case Manager is responsible for the coordination of health care… more
- Select Medical (Dublin, OH)
- …**OhioHealth-** **Neuro Transitional Center** **Joint venture with Select Medical** **Position:** Case Manager PRN **Location: Dublin, Ohio** **Schedule:** Per ... Diem + We are seeking a Case Manager with rehabilitation experience for an...allotted time frame; assuring payments of services meeting patient-related utilization management criteria, and implementation of safe… more
- Select Medical (Beachwood, OH)
- **Overview** **Hospital Name:** **Cleveland Clinic with Select Medical** **Position:** Case Manager **Location:** Beachwood, OH **Schedule:** PRN, Per Diem Our ... team of over 44,000 committed to providing exceptional patient care **Responsibilities** The Case Manager is responsible for the coordination of health care… more
- CVS Health (Columbus, OH)
- …skills preferred. + Managed care/ utilization review experience preferred. + Case management and discharge planning experience preferred + Experience working ... and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and regulatory standards… more
- OhioHealth (Columbus, OH)
- …- in our careers and in our communities. **Job Description Summary:** The Case Manager extender works collaboratively with all interdisciplinary staff internal ... correcting inpatient room and bed charges and performing charge reconciliation. The case manager extender is well organized, highly motivated, customer service… more
- Elevance Health (Toledo, OH)
- **LTSS Service Coordinator - RN Clinician ( Case Manager )** **Hiring statewide across Ohio** **Location** : This field-based role enables associates to primarily ... individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management , or similar role; or any combination of… more
- Elevance Health (Worthington, OH)
- **LTSS Service Coordinator ( Case Manager )** **Hiring statewide across Ohio** **Location** : This field-based role enables associates to primarily operate in the ... associates, and may be involved in process improvement initiatives. + Submits utilization /authorization requests to utilization management with documentation… more