- Somatus (Columbus, OH)
- …Collaborate with local leadership and/or provider engagement to build relationships with case management teams at strategic facilities in assigned area as identified ... by the Operations Manager , provide information and education on Somatus program benefits...discharge. The Hospital Liaison will work with the RNCM, case management and care givers to identify barriers in… more
- Molina Healthcare (Columbus, 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
- Elevance Health (Mason, OH)
- …- Monday. The **Transplant Nurse II** will be responsible for providing case and/or medical management for members receiving transplant services. Continue to learn ... preparation for advancement to the senior level. Within the case management role will within the scope of licensure...claims or service issues. + Assists with development of utilization /care management policies and procedures. + Within the medical… more
- Elevance Health (OH)
- …with IDD and patients with special needs is preferred. + Home Health, Utilization Management or Case Management experience strongly preferred. + Previous ... community agencies and appropriate provider/network. + Refers member to catastrophic case management. **Minimum Requirements:** Requires AS in nursing and minimum of… more
- Elevance Health (Cincinnati, OH)
- …Director** **Carelon Medical Benefits Management** **Post Acute Care Benefit Utilization Management** **Schedule: 10:00-7:00 Central Time** **** **Virtual:** This ... make an impact:** + Ensures timely completion of clinical case reviews for their board certified specialty. + Makes...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- UPMC (Wintersville, OH)
- …including daily, weekly, monthly, or other duties assigned by the Base Site Manager -Aviation. + Maintains fitness for duty by adhering to all employee health ... to conduct of flight ie, GOM, Op Specs, checklist utilization , etc.; operates without violation by regulatory authorities or...than 2,000 hours may be given consideration on a case -by- case basis based upon prior experience and… more
- Deloitte (Cleveland, OH)
- …as general health and group benefits skills. Key Responsibilities + Lead project manager for specific projects or key workstream lead on larger projects. + Evaluate ... Pharmacy Benefit Manager (PBM) contracts, deal terms, and financial proposals. +...services, contracts, performance guarantees, and renewals. + Analyze claims utilization data and assess health plan performance against strategy.… more
- ChenMed (Cleveland, OH)
- …of the nursing plan of care, health education, physician referrals, case management referrals, follow-up and clear documentation according to ChenMed standards ... and in collaboration with other health care professionals. Consults with the manager , physician, and medical director to ensure compliance with guidelines. This… more
- J&J Family of Companies (Toledo, OH)
- …a level of expertise and competence to present, demonstrate, and ensure proper utilization of DePuy Synthes' products. This person must be able to continually ... geography, the F&A Sales Consultant actively collaborates with the Regional Sales Manager to create the business plan, targeting and overall market strategy relative… more
- Kerry (Byesville, OH)
- …and improvements based upon analysis, knowledge, and experience. + Assist Quality Manager with special projects, reports, and training needs. + Inspection of ... records to support daily shift activity. + Perform random case audits for quality, package, and coding compliance. +...+ Prior training in HACCP, SQF, CGMP's helpful. + Utilization of SAP, MS, Excel and general manufacturing software.… more