• Utilization Management

    Humana (Columbus, OH)
    …us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional who utilizes ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
    Humana (10/17/25)
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  • Medical Director II, Behavioral

    Molina Healthcare (Columbus, OH)
    …chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and ... and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and… more
    Molina Healthcare (10/18/25)
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  • Medical Director, Behavioral Health

    Molina Healthcare (Dayton, OH)
    …chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and ... and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and… more
    Molina Healthcare (10/03/25)
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  • Clinical Learning Facilitator - Utilization

    Molina Healthcare (OH)
    …licensing mandate. + At least 2 years in case, disease or utilization management ; managed care; or medical/ behavioral health settings. + One year of ... Social Worker/Counseling License. + Certified Case Manager (CCM), Utilization Management Certification (CPHM), Certified Professional in Health Care Quality,… more
    Molina Healthcare (09/17/25)
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  • Clinical Information Systems Specialist…

    Molina Healthcare (Cincinnati, OH)
    …implementation and training delivery for utilization management , care management , long-term services (LTSS), behavioral health , and other applicable ... systems analysis, and 1 year experience in a care management , utilization management , behavioral health , medical, or managed care setting, or… more
    Molina Healthcare (10/16/25)
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  • Healthcare Services Operations Support Auditor

    Molina Healthcare (Columbus, OH)
    …program(s) proficiency. Preferred Qualifications * Utilization management , care management , behavioral health and/or long-term services and supports ... * At least 2 years health care experience, preferably in utilization management , care management , and/or managed care, or equivalent combination of… more
    Molina Healthcare (09/28/25)
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  • Utilization Management Clinical…

    CVS Health (Columbus, OH)
    utilization /benefit management function **Required Qualifications** + Licensed independent Behavioral Health clinician (LISW, LPCC, LMFT) or a Registered ... with heart, each and every day. **Position Summary** The Behavioral Health UM Clinician position is designed...to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking… more
    CVS Health (10/15/25)
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  • Behavioral Health Care Manager II

    Elevance Health (Columbus, OH)
    ** Behavioral Health Care Manager II** A proud member of the Elevance Health family of companies, **Carelon Behavioral Health ** , offers superior ... (EST) business hours with** **some weekends based upon organizational/business needs.** The ** Behavioral Health Care Manager II** is responsible for managing… more
    Elevance Health (10/07/25)
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  • Clinical Case Manager Behavioral

    CVS Health (Columbus, OH)
    …+ Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate ... care issues through established channels + Ability to speak to medical and behavioral health professionals to influence appropriate member care. + Utilizes… more
    CVS Health (09/05/25)
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  • Registered Nurse (RN) - Behavioral

    Bon Secours Mercy Health (Youngstown, OH)
    …**_* PRN position_** **Summary of Primary Function/General Purpose of Position** The Behavioral Health Registered Nurse (RN) functions as a care provider ... Collects and records nursing assessment of the physical and behavioral health status of the patient. *...patient outcomes are met. * Participates in the safe management of the milieu, intervening effectively with patients who… more
    Bon Secours Mercy Health (10/11/25)
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