• Supervisor, Payor Contracting

    Cardinal Health (Columbus, OH)
    …companies (ex. Blue Cross, Blue Shield, IPA, etc). Reporting to the Director of Managed Care , the Manager of Contracting is responsible for managing ... **_What Managed Care contributes to Cardinal Health_**...any other activity as it relates to payer interaction. Manager of Payor Contracting is responsible for reviewing, auditing… more
    Cardinal Health (06/11/25)
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  • Director, Managed Care Contracting…

    Bon Secours Mercy Health (Cincinnati, OH)
    … sites and clinicians are recognized for clinical and operational excellence. **DIRECTOR MANAGED CARE CONTRACTING - LARGE ACCOUNTS** **| REMOTE** This position ... is responsible for developing, managing, and leading the day-to-day activities associated with managed care contracting for both fee for service and risk… more
    Bon Secours Mercy Health (08/19/25)
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  • Health Plan Operations, Payment Integrity Program…

    Molina Healthcare (Akron, OH)
    …QUALIFICATIONS:** + At least 7 years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, ... integrity issues, and process gaps. + Apply understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape… more
    Molina Healthcare (08/14/25)
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  • RN Care Manager Remote with field…

    Molina Healthcare (OH)
    …Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **Required ... and familiarity with claims is highly preferred. The Case Manager must be able to work in a high-volume...**Preferred Experience** 3-5 years in case management, disease management, managed care or medical or behavioral health… more
    Molina Healthcare (09/05/25)
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  • Care Manager (Ohio LSW/LISW)

    Molina Healthcare (OH)
    …or related **REQUIRED EXPERIENCE:** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **REQUIRED LICENSE, ... REQUIREMENTS:** **PREFERRED EXPERIENCE:** 3-5 years in case management, disease management, managed care or medical or behavioral health settings. **PREFERRED… more
    Molina Healthcare (07/20/25)
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  • Behavioral Health Care Manager II

    Elevance Health (Independence, OH)
    **Behavioral Health Care Manager II** Carelon Behavioral Health **_Virtual_** **_: _** _ _ This role enables associates to work virtually full-time, with the ... programs for autism and depression, and insightful analytics to improve the delivery of care . The **Behavioral Health Care Manager II** responsible for… more
    Elevance Health (09/06/25)
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  • Care Manager (RN)- Ohio- Central/WC

    Molina Healthcare (Cleveland, OH)
    …Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **Required ... in Nursing **Preferred Experience** 3-5 years in case management, disease management, managed care or medical or behavioral health settings. Preferred License,… more
    Molina Healthcare (08/29/25)
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  • Care Manager , Ltss (RN)-Toledo,…

    Molina Healthcare (Cleveland, OH)
    …Long Term Services & Supports. + 1-3 years in case management, disease management, managed care or medical or behavioral health settings. + Required License, ... Degree in Nursing **Preferred Experience** + 3-5 years in case management, disease management, managed care or medical or behavioral health settings. + 1 year… more
    Molina Healthcare (08/29/25)
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  • Licensed Care Manager - Substance…

    Molina Healthcare (Akron, OH)
    …or LMFT * 3+ years in behavioral health case management, disease management, managed care settings. * Field-based case management or home health experience. ... in the state of OH (LMSW or LCSW) Case Manager will work remotely supporting Medicaid SUD population, this...assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long… more
    Molina Healthcare (08/10/25)
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  • Credentialing Program Manager

    OhioHealth (Marion, OH)
    …**Additional Job Description:** **degree and two years' experience in the healthcare, managed care , credentialing or medical staff services field or equivalent ... combination of education and 7+ years' experience in healthcare, managed care , credentialing or medical staff services field** **SPECIALIZED KNOWLEDGE**… more
    OhioHealth (07/02/25)
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