- Elevance Health (Columbus, OH)
- …criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Location: Virtual: This role...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- Elevance Health (Mason, OH)
- …with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires ... ** Nurse Case Manager II** **Location:** This role enables... Case Manager II** will be responsible for care management within the scope of licensure for members with… more
- Molina Healthcare (OH)
- …Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital or medical… more
- Molina Healthcare (OH)
- …including 3 or more years in one or more of the following areas: utilization management , case management , care transition and/or disease management ... work of external vendors. + Focuses on process improvement, organizational change management , program management and other processes relative to the business.… more
- MTC (Marion, OH)
- …clean; utilize appropriate sanitation methods. 7. Practice basic cost containment and utilization management for patient care and facility operations. 8. ... + Civic duty and military leave Impact lives with Management & Training Corporation (MTC)! At the **North Central...+ **Degree in nursing ** , current valid nursing license as a **Licensed Practical Nurse **… more
- Trinity Health (Canal Winchester, OH)
- …by the service line. + Knowledge of basic functional operations of utilization management , discharge planning, care coordination and transitions of care, ... other system service lines. Collaborates with others in Diley Ridge Medical Center management to assure effective and quality services. Work in collaboration with … more
- Select Medical (Beachwood, OH)
- …allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and ... of the discharge planning process. + The primary job functions in Case Management include: + Clinical Interventions/Discharge Planning + Care Planning Management … more
- Select Medical (Dublin, OH)
- …within the allotted time frame; assuring payments of services meeting patient-related utilization management criteria, and implementation of safe and appropriate ... of the discharge planning process. + The primary job functions in Case Management include: + Clinical Interventions/Discharge Planning + Care Planning Management … more
- Elevance Health (OH)
- …patients with IDD and patients with special needs is preferred. + Home Health, Utilization Management or Case Management experience strongly preferred. + ... agencies and appropriate provider/network. + Refers member to catastrophic case management . **Minimum Requirements:** Requires AS in nursing and minimum… more
- Bon Secours Mercy Health (Lorain, OH)
- …__ Works closely and collaboratively with social worker, care coordinators, therapists, and nursing . Collaborates with PM&R physician, and nurse manager on all ... smooth transition to acute rehab unit. Maintains expertise in clinical field, utilization review and case management ; communicates to insurance companies/third… more