- Lumen (Columbus, OH)
- …show value and improvement for technologies and processes. + Create and analyze utilization statistics of systems to identify causes for system degradations as well ... as recommend required system enhancements for business case and budget approval. + Perform upgrading, patching, hardening, user access permissions, and routine… more
- Elevance Health (Columbus, OH)
- …information regarding case and determines appropriate area to refer or assign case ( utilization management, case management, QI, Med Review). + Provides ... and documents all actions. + Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical information.… more
- Molina Healthcare (Cleveland, OH)
- …License must be active and unrestricted in state of practice. * Certified Case Manager (CCM), Certified Professional in Health Care Management certification ... supporting one or more of the following functions: care management, utilization management, care transitions, long-term services and supports (LTSS), behavioral… more
- Elevance Health (Independence, OH)
- …The **Medical Director** will be part of the Central Region team responsible for utilization review case management and appeals for local Commercial business in ... 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
- The Salvation Army (Youngstown, OH)
- …assist the Mahoning County Area Services Coordinator, Operations Director and Program Manager with social service programs, activities and assistance as requested. + ... and assistance. + Work with Operations Director and Program Manager to request volunteers as needed + Assist with...sources + Assist in the identification, recruitment, training and utilization of volunteers for both local and seasonal social… more
- Elevance Health (Norwood, OH)
- **LTSS Service Coordinator - Clinician ( Case Manager )** **Hiring statewide across Ohio** **Location** : This field-based role enables associates to primarily ... of an RN, with overall responsibility for the member's case . As required by applicable state law and contract,...health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will… more
- Elevance Health (Toledo, OH)
- …with providers and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss ... for posting. + Works independently with oversight from immediate manager . + May be responsible for an entire clinical...state or territory of the United States when conducting utilization review or an appeals consideration and cannot be… 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
- Molina Healthcare (Akron, OH)
- …ASSOCIATION:** Certified Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional Healthcare Management, Certified ... of payment decisions. + Serves as a clinical resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. +… more