- CVS Health (Columbus, OH)
- …promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team **Position Summary** The ... a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective...projects. Acting as the first point of contact for clinical issues, the Team Lead provides guidance… more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...to work independently under general instructions and with a team + Must be passionate about contributing to an… more
- CVS Health (Columbus, OH)
- …phone, computer, etc. and clinical documentation systems. + 1+ Year of Utilization Review Management and/or Medical Management experience. + Commitment ... promote high-quality healthcare for members. **Position Summary** Join a team that's making a difference in the lives of...lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in… more
- CenterWell (Columbus, OH)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... and who is interested in being part of a team that focuses on excellent service to others. **Use...DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous… more
- Elevance Health (Columbus, OH)
- …The ** Clinical Pharmacist** is responsible for managing the selection and utilization of pharmaceuticals and supports core clinical programs such as DUR, ... **Be Part of an Extraordinary Team ** CarelonRx is a proud member of the...By leveraging the power of new technologies, our strong, clinical -first lens and deep pharmacy expertise, we are actively… more
- Prime Therapeutics (Columbus, OH)
- … clinical programs and drug strategy recommendations including drug formulary, Utilization Management programs, and other drug therapy related products and ... **Job Posting Title** Clinical Account Director - Remote **Job Description** The Clinical Account Director is responsible for the management of all client… more
- Trinity Health (Columbus, OH)
- …Minimum of 5 years acute care medical or surgical experience required;** ** Utilization /Case Management , managed care, or Clinical Documentation and ... Through extensive interaction with physicians and other members of the healthcare team , achieves appropriate clinical documentation to support code assignment,… more
- Hologic (Columbus, OH)
- …analyze, track activity, and provide accurate forecasts. + Leverage internal resource team across Clinical , Sales, Service, Technology and National Accounts to ... Radiology Clinical Account Manager - Columbus, OH Columbus, OH,...this role, you will also build strong relationships with team members and customers - working to uncover and… more
- Prime Therapeutics (Columbus, OH)
- …and timely fashion. + Demonstrates the value of pharmacy solutions (unit cost, utilization management & patient care enhancement). + Identifies opportunities for ... visa or residency sponsorship **Additional Qualifications** + 3-5 years' experience in clinical operations, quality, network, pharmacy or project management OR a… more
- Centene Corporation (Columbus, OH)
- … and operational groups, including but not limited to: + Care Coordination + Utilization Management + Population Health + Quality + Medical Affairs + Health ... supports the CMO of the Buckeye Community Health Plan and clinical leadership teams by coordinating, organizing, and driving cross-functional initiatives that… more