- 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 (Columbus, OH)
- …resolving clinical complaints and appeals by reviewing medical records and applying clinical guidelines for Utilization Management group. This RN must be ... high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our...3+ years Utilization Management or Utilization Review experience. + 3+ years clinical … more
- CVS Health (Columbus, OH)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set productivity and ... it all with heart, each and every day. **Position Summary** + Utilizes clinical experience and skills in a collaborative process to assess, plan, implement,… more
- Molina Healthcare (Cleveland, OH)
- …the results to senior leadership. Responsible for consulting with network and clinical management on opportunities to improve our company's discount position ... analysis of markets and network initiatives. The Medical Economics Consultant manages conflicting priorities and multiple projects concurrently. Responsible for… more
- CVS Health (Columbus, OH)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... quality care for members. Administers review and resolution of clinical complaints and appeals. Interprets data obtained from ...care/medical experience. + 1+ years of Appeals experience in Utilization Management + 3+ years utilization… more
- Lincoln Financial (Columbus, OH)
- …a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for ... industry experience preferred * Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or… more
- Cardinal Health (Cincinnati, OH)
- …a highly regulated industry + Previous sales experience selling to physicians, clinical end-users, materials management , and C-suite desired + Strong preference ... Job Description **Senior Consultant , Product Sales Specialist - NPHS** **The territory covers Indiana, Michigan, Ohio, Kentucky, Missouri** The Product Sales… more
- Highmark Health (Columbus, OH)
- …**Job Description :** **JOB SUMMARY** Dynamic and results-oriented Pharmacy Benefit Consultant , serving as the client-facing expert, driving growth and retention of ... Consultation: Provide in-depth pharmacy benefit expertise, offering strategic guidance, clinical recommendations, and solutions tailored to individual client needs.… more
- Veterans Affairs, Veterans Health Administration (Chillicothe, OH)
- …for patients Provides emergency eye care services Adheres to hospital clinical privileges, optometric accrediting agencies, medical staff by-laws, rules, policies ... when eye disease is concurrent with systemic disease Responsible for diagnosis, management and treatment of visual and ocular problems through externa and internal… more
- Cleveland Clinic (Cleveland, OH)
- …development. + Act as a consultant in educating and evaluating clinical and support department staff regarding quality management regulations and standards ... using the Cleveland Clinic Improvement Model. You will collaborate with clinical and operational leaders to establish key objectives, ensure compliance with… more