• Case Manager -Sbhi

    Premier Health (Eaton, OH)
    …standards for administration and reporting of outcome measures and documentation of utilization management of clinical care. . Demonstrate knowledge of other ... Case Manager FACILITY: SAMARITAN BEHAVIORAL HEALTH Case Manager functions as a member of a team to assist in the planning, development, and delivery of… more
    Premier Health (09/04/25)
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  • Manager Software Engineering - AI Platforms…

    Highmark Health (Columbus, OH)
    …Remote Work From Anywhere Role! We are seeking an experienced Software Engineering Manager to lead our AI Platforms and Services Engineering team, a group at ... Join us and build the future of AI! **ESSENTIAL RESPONSIBILITIES** + Perform management responsibilities to include, but are not limited to: involved in hiring and… more
    Highmark Health (08/08/25)
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  • Medical Management Specialist I

    Elevance Health (Columbus, OH)
    …information regarding case and determines appropriate area to refer or assign case ( utilization management , case management , QI, Med Review). + Provides ... reports and documents all actions. + Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical… more
    Elevance Health (09/24/25)
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  • National Accounts Medical Director

    Elevance Health (Cincinnati, OH)
    …to day clinical responsibilities means that the medical director is directly involved in Utilization Management and Case Management . + Daily case reviews for ... clients/ members. The medical director provides clinical expertise in all aspects of utilization review and case management . Provides input on the clinical… more
    Elevance Health (09/23/25)
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  • LTSS Transition Concierge Coordinator

    Elevance Health (Columbus, OH)
    …for in-person visits, as needed, to accommodate business need. + Submits utilization /authorization requests to utilization management with documentation ... **LTSS Concierge Coordinator (Case Manager )** **Hiring statewide across Ohio** **This position is...contractual requirements for member outreach, such as coordination and management of an individual's LTSS waiver, behavioral more
    Elevance Health (09/27/25)
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  • Disease Management Nurse - Remote

    Sharecare (Columbus, OH)
    …change techniques, the nurse helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is ... according to the disease management program intervention guidelines. A Disease Management Nurse is supervised by an Operations Manager (OM). All Sharecare… more
    Sharecare (09/13/25)
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  • Medical Management Clinician

    Elevance Health (Independence, OH)
    …_‐_ _centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs._ **Medical ... Management Clinician** **Location:** This role enables associates to work...a minimum of 4 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted… more
    Elevance Health (09/10/25)
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  • Medical Director- Long Term Support and Service…

    Elevance Health (Toledo, OH)
    …a State agency.*_ **Preferred Skills, Capabilities and Experiences:** + 1-2 years Utilization Management experience strongly preferred. + Strong oral, written, ... person_ _‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs._ The… more
    Elevance Health (09/26/25)
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  • RN Lead, Healthcare Services

    Molina Healthcare (Cleveland, OH)
    …healthcare services team supporting one or more of the following functions: care management , utilization management , care transitions, long-term services and ... at least 2 years of managed care experienced in utilization management * Registered Nurse (RN) ONLY...and unrestricted in state of practice. * Certified Case Manager (CCM), Certified Professional in Health Care Management more
    Molina Healthcare (09/26/25)
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  • Transitions of Care - RN, 100% Virtual, CareBridge

    Elevance Health (OH)
    …patients with IDD and patients with special needs is preferred. + Home Health, Utilization Management or Case Management experience strongly preferred. + ... responsible for participating in delivery of patient education and disease management interventions and for performing health coaching for members, across multiple… more
    Elevance Health (10/01/25)
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