• Transitions of Care - RN, 100% Virtual, CareBridge

    Elevance Health (OH)
    …patients, patients with IDD and patients with special needs is preferred. + Home Health , Utilization Management or Case Management experience strongly ... care plans by educating members regarding clinical needs and facilitating referrals to health professionals for behavioral health needs. + Uses motivational… more
    Elevance Health (10/01/25)
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  • Network Relations Consultant Senior (Value-Based…

    Elevance Health (Mason, OH)
    …culturally competent, person_ _‐_ _centered coordination for all members that addresses physical health , behavioral health , long term services and supports, ... support the design and modification of Anthem VBP, based on stakeholder feedback and utilization . **How You Will Make an Impact** Primary duties may include, but are… more
    Elevance Health (09/26/25)
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  • Disease Management Nurse - Remote

    Sharecare (Columbus, OH)
    …members to become empowered and active participants in their own healthcare management for their chronic condition. By providing health education and ... **Job Description:** Sharecare is the leading digital health company that helps people - no matter...nurse helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management more
    Sharecare (09/13/25)
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  • Part-Time Weekend Medical Director (Remote)

    Highmark Health (Columbus, OH)
    …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... (DO) **Substitutions** + None **Preferred** + Master's Degree in Business Administration/ Management or Public Health **EXPERIENCE** **Required** + 5 years… more
    Highmark Health (09/11/25)
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  • Manager, Healthcare Services

    Molina Healthcare (OH)
    …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.),… more
    Molina Healthcare (09/27/25)
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  • LTSS Service Coordinator - Clinician (LSW, LCSW,…

    Elevance Health (Norwood, OH)
    …identification, evaluation, coordination and management of member's needs, including physical health , behavioral health , social services and long term ... competent, person‐centered coordination for all members that addresses physical health , behavioral health , long term... care team, to ensure cost effective and efficient utilization of health benefits. + Decision making… more
    Elevance Health (09/12/25)
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  • Care Review Clinician, Prior Authorization

    Molina Healthcare (Akron, OH)
    …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required...in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management more
    Molina Healthcare (09/18/25)
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  • Change Execution Consultant

    Highmark Health (Columbus, OH)
    **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job plays a key role in ensuring projects (ie change initiatives) meet objectives on time ... and minimize risk to implementation. Works to drive faster adoption, higher ultimate utilization and greater proficiency of the changes that impact employees in the… more
    Highmark Health (09/19/25)
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  • Community Relations Consultant - MyCare Ohio…

    Elevance Health (Dayton, OH)
    …informed, culturally competent, person‐centered coordination for all members that addresses physical health , behavioral health , long term services and ... community. + Coordinates volunteer activities by planning, organizing and providing volunteer management for events. + Responds to requests for funding. + Conducts… more
    Elevance Health (09/24/25)
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  • Medical Director-PSCCR

    Elevance Health (Mason, OH)
    …The **Medical Director-PSCCR** is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... develops, directs, and implements clinical and non-clinical activities that impact health care quality cost and outcomes. + Identifies and develops opportunities… more
    Elevance Health (09/10/25)
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