- CDM Smith (Columbus, OH)
- …of your team. - Coordinating workload within your Technical Services group and utilization goals for the individuals on your team. - Coordinating with your TDM ... a deep understanding of the business, including key metrics such as utilization , project profitability, overhead, and staffing. - Advanced knowledge of necessary… more
- CVS Health (Columbus, OH)
- …for members who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current case management and eligibility status. ... timelines. - Utilizes weekly and daily reporting to identify utilization for the purpose of reducing Emergency Department ...the subsequent care continuum until member can return to prior level of functioning in the community. - Facilitates… more
- Veterans Affairs, Veterans Health Administration (Dayton, OH)
- …but not limited to, visits, referrals, patient demographics, equipment utilization and patient satisfaction. Develops, implements and evaluates clinical guidelines ... and protocols to establish appropriate utilization of services. Supervises a group of employees in...qualify for credit toward annual leave accrual, based on prior work experience or military service experience. This credited… more
- CAE USA INC (Wright-Patterson AFB, OH)
- …actions on the project/task order under consideration, and on the overall utilization of resources. + Participates in monthly Independent Project Reviews (IPR) ... possess at least a Master's in Business Administration or Physical Science. + Prior military experience a plus. + Familiarization of Modeling and Simulation systems… more
- L3Harris (Cincinnati, OH)
- …solutions to a wide range of technical production problems involving the utilization of manufacturing and quality engineering techniques. + Manages a quality ... knowledge. Qualifications: + Bachelor's Degree and minimum 6 years prior related experience. Graduate Degree with a minimum of...Graduate Degree with a minimum of 4 years of prior related experience. In lieu of a degree, minimum… more
- CenterWell (Columbus, OH)
- …of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical ... Medical Surgery, Heart, Lung or Critical Care Nursing experience required + Prior clinical experience preferably in an acute care, skilled or rehabilitation clinical… more
- Elevance Health (Mason, OH)
- …be responsible for identifying, monitoring, and analyzing aberrant patterns of utilization and/or fraudulent activities by health care providers through prepayment ... **How you will make an impact:** . Investigates potential fraud and over- utilization by performing medical reviews via prepayment claims review and post payment… more
- Humana (Columbus, OH)
- …and regulations. + Collaborates with the Medical Director, Quality Improvement and Utilization Director, LTSS Director and other Clinical leaders to reduce barriers ... field. + 5+ years of clinical experience, to include a combination of Utilization Management Case Management, and Managed Care. + 2+ years of leadership experience.… more
- ConvaTec (Cleveland, OH)
- …sales goals. Identify, prioritize, pull-through, and close opportunities + Ensure effective utilization of the products by all trained HCPs within assigned territory ... understanding of Advanced Wound Care dressings + Optimize the utilization of educational and KOL events (ie Examples are...formal recruitment process is required for all our opportunities prior to any offer of employment. This will include… more
- Molina Healthcare (Cincinnati, OH)
- …stay for requested treatments and/or procedures. * Works collaboratively with the Utilization and Case Management departments to provide ABA/BHT services to Molina ... members with ASD and other related disorders. * Approves prior authorization requests for BHT treatment by reviewing Behavioral Health Therapy (BHT) assessments and… more