- CVS Health (OH)
- …No weekends or holidays. + 1+ years of utilization review/ utilization management required. + 3+ years of behavioral health clinical experience in a ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable… more
- Elevance Health (Cincinnati, OH)
- **Medical Management Clinician ** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... long term services and supports, and psychosocial needs._ The **Medical Management Clinician ** responsible for ensuring appropriate, consistent administration of… more
- Elevance Health (Columbus, OH)
- …an accommodation is granted as required by law._ The **LTSS Service Coordinator-RN Clinician ** is responsible for overall management of member's case within the ... and face-to-face functional assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral … more
- Elevance Health (Portsmouth, OH)
- …telephonic or face-to-face assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral ... **LTSS Service Coordinator - Clinician (Case Manager)** **Candidates should live in one...person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial… more
- Molina Healthcare (OH)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At ... of KY and or compact licensure The Care Review Clinician Inpatient Review BH will provide prior authorization for...for outpatient and inpatient services for the KY Medicaid behavioral health population. Strong post-acute level of care experience… more
- Highmark Health (Columbus, OH)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
- Molina Healthcare (Akron, OH)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At ... * Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Behavioral Health nursing experience- inpatient psychiatric, IMD, Residential SUD,… more
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