• Senior Architect - Cloud

    Highmark Health (Columbus, OH)
    **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This role is responsible for designing, developing, implementing, supporting, and optimizing ... solutions, networks, and infrastructure. Ensure optimal technology selection, resource utilization , and seamless integration. + Utilize modeling tools to develop… more
    Highmark Health (07/22/25)
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  • Therapist LISW/PCC

    Premier Health (Dayton, OH)
    Facility: Samaritan Behavioral Health , Inc The therapist plans and delivers outcome-effective clinical, case coordination, intervention, prevention, and/or ... consultation mental health services to pediatrics and their parents, and the...administration and reporting of outcome measures and documentation of utilization management of clinical care. . Demonstrate… more
    Premier Health (10/02/25)
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  • Pharmacy Coordinator

    Highmark Health (Columbus, OH)
    …Wholecare's pharmacy programs with a focus on medication adherence and optimizing member health outcomes. This role involves a high volume of daily contacts with ... address medication-related issues, promote adherence, and ensure appropriate medication utilization . **ESSENTIAL RESPONSIBILITIES** + Communicate effectively with physicians and… more
    Highmark Health (09/19/25)
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  • Case Manager-Sbhi

    Premier Health (Eaton, OH)
    Case Manager FACILITY: SAMARITAN BEHAVIORAL HEALTH Case Manager functions as a member of a team to assist in the planning, development, and delivery of ... administration and reporting of outcome measures and documentation of utilization management of clinical care. . Demonstrate...Minimum of two (2) years' experience in the mental health and/or drug and alcohol field. . Working knowledge… more
    Premier Health (09/04/25)
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  • Pharmacy Benefit Consultant

    Highmark Health (Columbus, OH)
    …**Preferred** + 5 years of experience with communications + 3 years of experience in Utilization Review + 3 years of experience in Account Support + 1 year of ... + In-depth knowledge of the pharmacy industry, including benefit design, formulary management , and pharmacy best practices. + Proven ability to interpret and analyze… more
    Highmark Health (08/26/25)
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  • Care Manager

    AmeriHealth Caritas (Dublin, OH)
    …determinants of health for members with acute, chronic, medically complex, and/or behavioral health conditions and other health needs. Serves as the ... Establishes points of contact to collaborate with identified community, medical, and/or behavioral health teams. + Maintain timely, complete, and accurate… more
    AmeriHealth Caritas (10/02/25)
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  • Care Review Clinician, PA (RN)

    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. ... Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines.… more
    Molina Healthcare (09/05/25)
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  • Clinical UM Nurse 2

    CenterWell (Columbus, OH)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... volume and fast paced environment + Previous experience in utilization management + Education: BSN or Bachelor's...and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral … more
    CenterWell (09/26/25)
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  • Senior Product Owner - EMR

    CenterWell (Columbus, OH)
    …that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... part of our caring community and help us put health first** The Senior Product Owner is responsible for...Owner to lead strategy and execution for our referral management and specialist network solutions, including prior authorization and… more
    CenterWell (09/13/25)
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  • Senior Program Director for Human Performance…

    Battelle Memorial Institute (Columbus, OH)
    …a culture of safety and risk management across all domains, particularly in behavioral health and data privacy. + Direct resource management and staffing ... a **Senior Program Director for Human Performance Optimization (HPO)** within our Health Business to lead the execution of large-scale, globally distributed military… more
    Battelle Memorial Institute (07/31/25)
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