• Clinical Learning Facilitator - Utilization…

    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
    Molina Healthcare (09/17/25)
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  • Registered Nurse ( RN )…

    Bon Secours Mercy Health (Youngstown, 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
    Bon Secours Mercy Health (10/01/25)
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  • RN Lead, Healthcare Services

    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 (09/26/25)
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  • Care Review Clinician, PA ( RN )

    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
    Molina Healthcare (09/05/25)
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  • LTSS Service Coordinator - RN Clinician…

    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
    Elevance Health (09/12/25)
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  • Transitions of Care - RN , 100% Virtual,…

    Elevance Health (OH)
    …patients with IDD and patients with special needs is preferred. + Home Health, Utilization Management or Case Management experience strongly preferred. + ... **Transitions of Care - RN , 100% Virtual, CareBridge** Location: This role enables...for participating in delivery of patient education and disease management interventions and for performing health coaching for members,… more
    Elevance Health (10/01/25)
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  • Disease Management Nurse - Remote

    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
    Sharecare (09/13/25)
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  • Care Review Clinician, Prior Authorization

    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
    Molina Healthcare (09/18/25)
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  • BHI Charge Nurse

    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
    Bon Secours Mercy Health (09/30/25)
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  • Manager, Healthcare Services

    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
    Molina Healthcare (09/27/25)
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