• Utilization Management

    Humana (Columbus, OH)
    …a part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
    Humana (01/10/26)
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  • Medical Director, Behavioral Health

    Molina Healthcare (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 (01/06/26)
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  • Manager, Healthcare Services - Remote in Ohio

    Molina Healthcare (Columbus, OH)
    …professionals in some or all of the following functions: care management , utilization management , behavioral health , care transitions, long-term ... or more of the following areas: utilization management , care management , care transitions, behavioral health , long-term services and supports (LTSS),… more
    Molina Healthcare (01/04/26)
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  • Senior Medical Director, Behavioral

    Molina Healthcare (OH)
    …while contributing to enterprise-wide strategies for integrated behavioral health programs, utilization management standardization, and cost-effective ... psychiatric leadership and clinical expertise for utilization management , case management , and integrated behavioral health /chemical dependency… more
    Molina Healthcare (01/01/26)
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  • Supervisor, Healthcare Services

    Molina Healthcare (Dayton, OH)
    …professionals in some or all of the following functions: care management , utilization management , behavioral health , care transitions, long-term ... Job Duties * Assists in implementing health management , care management , utilization management , behavioral health and other program… more
    Molina Healthcare (01/07/26)
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  • Behavioral Health Care Manager I

    Elevance Health (Columbus, OH)
    …abuse cases preferred. ​ **Preferred Skills, Capabilities and Experiences:** + Experience in behavioral health utilization management is highly ... Behavioral Health Care Manager I- ... Behavioral Health Care Manager I- Behavioral ...there is licensed staff supervision. Previous experience in case management / utilization management with a broad… more
    Elevance Health (01/10/26)
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  • Coordinator, Intake Utilization

    Evolent (Columbus, OH)
    …the mission. Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for ... and client contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, … more
    Evolent (01/06/26)
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  • Pharmacist - Utilization Management

    Highmark Health (Columbus, OH)
    …coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by ... prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
    Highmark Health (12/30/25)
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  • Behavioral Health Care Manager II

    Elevance Health (Cincinnati, OH)
    ** Behavioral Health Care Manager II -...is licensed staff supervision. + Previous experience in case management / utilization management with a broad ... the Elevance Health family of companies, Carelon Behavioral Health , formerly Beacon Health ...Beacon Health Options, offers superior clinical mental health and substance use disorder management , a… more
    Elevance Health (01/08/26)
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  • Behavioral Health Medical Director…

    Elevance Health (Mason, OH)
    ** Behavioral Health Medical Director-Psychiatrist Appeals** **Location:** This role enables associates to work virtually full-time, with the exception of ... Monday - Friday. Half day Saturday rotation, once a month.** The ** Behavioral Health Medical Director-Psychiatrist Appeals** is responsible for the… more
    Elevance Health (01/09/26)
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