• Utilization Management

    CVS Health (Columbus, OH)
    … skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is knowledgeable ... external constituents in the coordination and administration of the utilization /benefit management function **Required Qualifications** + Licensed independent… more
    CVS Health (07/03/25)
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  • Utilization Management Nurse…

    CVS Health (Columbus, OH)
    …Must be willing and able to work Monday through Friday, 8:00am to 5:00pm. Utilization management is a 24/7 operation. Work schedules will include weekend/holiday ... Qualifications** + Managed Care experience + Discharge planning experience + Utilization Management experience **Education** Associates Degree or Nursing Diploma… more
    CVS Health (07/16/25)
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  • Utilization Management Nurse…

    CVS Health (Columbus, OH)
    …Must have active current and unrestricted RN licensure in state of residence + Utilization Management is a 24/7 operation and work schedules will include ... required in med surg or specialty area + Managed Care experience preferred, especially Utilization Management + Preference for those residing in EST or CST zones… more
    CVS Health (07/11/25)
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  • Network Management Consultant

    Prime Therapeutics (Columbus, OH)
    …fuels our passion and drives every decision we make. **Job Posting Title** Network Management Consultant - Remote **Job Description** The Network Management ... Consultant is responsible for development, performance and management of Prime's retail, mail, specialty, and quality-based networks aligning with Prime's Supply… more
    Prime Therapeutics (07/15/25)
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  • Workfront Configuration Consultant

    Eliassen Group (Columbus, OH)
    … to support the implementation of Workfront as an Enterprise Portfolio and Project Management tool. As the Senior Consultant , you will work closely with our ... **Workfront Configuration Consultant ** **Anywhere** **Type:** Contract **Category:** Development **Industry:** Insurance **Workplace Type:** Remote **Reference ID:**… more
    Eliassen Group (07/01/25)
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  • Provider Contract/Cost of Care Consultant

    Elevance Health (Mason, OH)
    **Provider Contract/Cost of Care Consultant ** **Location:** This role requires associates to be in-office 1 day per week, fostering collaboration and connectivity, ... as required by law. The **Provider Contract/Cost of Care Consultant ** provides analytical support to the Cost of Care...advice, analytic and consultative support to Medical Directors and management on cost of care issues. Works on large… more
    Elevance Health (07/16/25)
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  • Manager, Clinical Engineering

    OhioHealth (Columbus, OH)
    … to other OhioHealth Hospitals. The Manager ensures efficient, cost-effective management of the organization's clinical equipment. **Responsibilities And ... to other OhioHealth Hospitals. The Manager ensures efficient, cost-effective management of the organization's clinical equipment. **MINIMUM QUALIFICATIONS**… more
    OhioHealth (06/07/25)
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  • Senior Clinical Pharmacist

    CenterWell (Columbus, OH)
    Clinical Pharmacist develops, maintains, and/or operationalizes strategies related to utilization management edits and/or clinical coverage policies for ... caring community and help us put health first** The Clinical Drug Evaluation and Policy Strategies Senior Clinical...policy development and recommends drug coverage and potential drug utilization tools to mitigate Humana's cost and trend while… more
    CenterWell (07/12/25)
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  • Clinical Education Specialist - Toledo…

    ProMedica Health System (Toledo, OH)
    …department, division, hospital or system level. He/she serves as a consultant , researcher, evidence-based practice mentor, performance improvement leader and project ... nursing in the growth and development of nursing practice through utilization of evidence-based practice concepts and process, the ProMedica Nursing Professional… more
    ProMedica Health System (06/01/25)
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  • Registered Nurse (RN) - Admissions Coordinator…

    Bon Secours Mercy Health (Lorain, OH)
    …to acute rehab unit. Maintains expertise in clinical field, utilization review and case management ; communicates to insurance companies/third party ... discharge planners, and physicians. This role serves as a clinical resource and consultant for the acute...The Admissions Coordinator RN cross trains to cover case management as needed, which includes initiating and directing the… more
    Bon Secours Mercy Health (05/19/25)
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