- KPH Healthcare Services, Inc. (Maumee, OH)
- …to patients, nurses and physicians as required regarding the contents, utilization , therapeutic actions, possible adverse reactions, or interactions of drugs. + ... activities, educational programs, and departmental/branch meetings. + Drives the Primary Case Management Model (PCMM) in daily interactions through the delegation of… more
- Evolent (Columbus, OH)
- …Responsible for coordinating education and findings with matrixed Physician Business Manager . + Provides medical direction to the support services review process. ... Responsible for the quality of utilization review determinations, including appeals. + Provides input into...as needed for new hires and completes new hire case assessment working on any defined areas of opportunity.… more
- Bon Secours Mercy Health (Lorain, OH)
- …include discharge planning and coordination. Leads rehab team meetings when covering for case manager to discuss appropriateness of program and progress of ... to acute rehab unit. Maintains expertise in clinical field, utilization review and case management; communicates to...employees who serve in the admissions coordinator role or case manager role and provide shared coverage… more
- Bon Secours Mercy Health (Fairfield, OH)
- …as a Social Worker in state of practice (required, preferred in VA)Accredited Case Manager Certification (ACM) from American Case Management Association ... or Certified Case Manager (CCM) from Commission for Case Manager Certification (preferred)EducationBachelor of Social Work (required)Master's degree in… more
- Molina Healthcare (Cleveland, OH)
- …unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management + Certified ... Medical Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + Identifies and… more
- Medtronic (Dayton, OH)
- …the Life** The Surgical Onsite Specialist (SOS) is responsible for providing case support and customer support, training and education, and solution implementation ... Surgical Centers of Therapy (COTs). This role ensures seamless product utilization by assisting with on-site procedures, addressing customer inquiries, performing… more
- Elevance Health (Cincinnati, OH)
- …work East Coast time zone hours.** The **Medical Director** will be responsible for utilization review case management for Commercial business in the New England ... with providers and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss… more
- The Salvation Army (Cincinnati, OH)
- …response and emergency supervision, crisis intervention, intake and short-term case management. Responsibilities DUTIES:* Support provision of emergency response and ... Army.o Providing rotating 24 hour emergency response and comprehensive initial case management.o Assessment immediate needs and conduct intakes.o Coordination with… more
- CDM Smith (Columbus, OH)
- …our Specifications Group. We're looking for candidates with experience as a Senior Manager and Senior Specification Writer. At CDM Smith, we are invested in your ... - Coordinating workload within your Technical Services group and utilization goals for the individuals on your team. -...Smith Placement Agreement from the CDM Smith Recruitment Center Manager to receive payment for your placement. Verbal or… more
- Prime Therapeutics (Columbus, OH)
- …an office or home setting for drug services. + Will actively maintain a required case load and the activities to reach overall goals of switching site of service ... is valued with the program. + Maintains an active case load and accurate case records, adhering...Quality oversight for this program is provided by the Manager , Patient Programs. **Education & Experience** + Associates -… more