- Molina Healthcare (OH)
- …or state board licensing mandate. + At least 2 years in case, disease or utilization management ; managed care; or medical/ behavioral health settings. + One ... or Clinical Social Worker/Counseling License. + Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified Professional in Health Care… more
- Bon Secours Mercy Health (Springfield, OH)
- …* Nursing judgment and skill based on principles of the biological, physical, behavioral , and social sciences * Application of the nursing process in patient care ... partnership * Interprofessional collaboration and leadership * Understanding and utilization of office and clinical technologies * Compassionate, relationship-based… more
- CVS Health (Columbus, OH)
- …+ Licensed independent Behavioral Health clinician (LISW, LPCC, LMFT) or a Registered Nurse ( RN ) with unrestricted Ohio state license with psychiatric ... to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking... Health licensure (LISW, LMFT, LPCC) or if a Registered Nurse Associates degree required and BSN… more
- Molina Healthcare (Cleveland, OH)
- …least 2 years of managed care experienced in utilization management * Registered Nurse ( RN ) ONLY if required by state contract, regulation or state ... skills. * Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Registered Nurse ( RN ). License must be active and… more
- Molina Healthcare (Akron, OH)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
- Elevance Health (Toledo, OH)
- …unless an accommodation is granted as required by law._ The **LTSS Service Coordinator- RN Clinician** is responsible for overall management of member's case ... and face-to-face functional assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral … more
- Sharecare (Columbus, OH)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the… more
- Molina Healthcare (Akron, OH)
- …**JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse ( RN ), Licensed Vocational Nurse (LVN) ... medical clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ), Licensed Vocational Nurse … more
- Bon Secours Mercy Health (Oregon, OH)
- …excellence. **Summary of Primary Function/General Purpose of Position** The Behavioral Health Registered Nurse ( RN ) functions as a care provider of a ... procedures, guidelines of the organization, and within the State's Nurse Practice Act. The RN provides a...of Science Nursing (preferred) **Work Experience** 1 year of RN experience (required) Recent Behavioral Health experience… more
- Molina Healthcare (OH)
- …performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), ... identifying opportunities for improvement. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational… more