- CVS Health (Columbus, OH)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... time, talking on the telephone, and typing on the computer. The UM Nurse Consultant utilizes clinical skills to coordinate, document and communicate all aspects… more
- CVS Health (Columbus, OH)
- …Friday, 8:00am to 5:00pm EST with a late shift rotation 10:30am to 7pm EST. Utilization management is a 24/7 operation. Work schedules may include weekends and ... review experience + Medicare experience + Managed Care experience especially Utilization Management + Proficiency with computer skills which includes navigating… more
- 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
- 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
- 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
- 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
- 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
- Elevance Health (Cincinnati, OH)
- …work East Coast time zone hours.** The **Medical Director** will be responsible for utilization review case management for Commercial business in the New England ... programs to improve quality, cost, and outcomes. May provide clinical consultation and serve as clinical /strategic advisor...discuss review determinations. + Serves as a resource and consultant to other areas of the company. + May… more
- 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 (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
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