• Utilization Management

    Humana (Columbus, OH)
    …PH ,UM Administration Coordinator 2 contributes to administration of PH utilization management . The UM Administration Coordinator 2 provides non-clinical ... appropriate treatment, care or services for members. The UM Administration Coordinator 2 processes requests for authorization of health services, requiring… more
    Humana (08/02/25)
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  • Senior Resource Coordinator

    Cherry Bekaert (Columbus, OH)
    …and continuous professional development. Our team is looking for a Senior Resource Coordinator to support our Tax group. The Senior Resource Coordinator will ... to work remotely from within the United States. The Senior Resource Coordinator will effectively fill resource engagement requests overseeing the utilization more
    Cherry Bekaert (07/16/25)
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  • Registered Nurse - Community Care…

    Veterans Affairs, Veterans Health Administration (Columbus, OH)
    …knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ... Assumes responsibility for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care. The RN… more
    Veterans Affairs, Veterans Health Administration (08/02/25)
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  • Registered Nurse (RN), Mobile MDS…

    CommuniCare Health Services Corporate (Cincinnati, OH)
    Registered Nurse (RN), Mobile MDS Coordinator CommuniCare Health Services is currently looking for a Registered Nurse to fill the key position of RN Mobile MDS ... Coordinator for its skilled nursing facilities throughout our Midwest...experience with Federal Medicare/Medicaid and Managed Care reimbursement system management in working with the MDS and RAI process… more
    CommuniCare Health Services Corporate (07/31/25)
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  • LTSS Service Coordinator (Case Manager)

    Elevance Health (Mason, OH)
    …associates, and may be involved in process improvement initiatives. + Submits utilization /authorization requests to utilization management with documentation ... **LTSS Service Coordinator (Case Manager)** **Hiring statewide across Ohio** **Location**...care plan. Engage the individual's support network and oversee management of their physical health, behavioral health, and long-term… more
    Elevance Health (07/15/25)
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  • LTSS Service Coordinator - RN Clinician…

    Elevance Health (Mason, OH)
    …unless an accommodation is granted as required by law._ The **LTSS Service Coordinator -RN Clinician** is responsible for overall management of member's case ... with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator , Case Management , or similar role; or any combination of… more
    Elevance Health (07/15/25)
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  • Registered Nurse (RN) - Admissions…

    Bon Secours Mercy Health (Lorain, OH)
    …as a clinical resource and consultant for the acute rehab program. The Admissions Coordinator RN cross trains to cover case management as needed, which includes ... smooth transition to acute rehab unit. Maintains expertise in clinical field, utilization review and case management ; communicates to insurance companies/third… more
    Bon Secours Mercy Health (05/19/25)
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  • Registered Nurse (RN) - Admissions…

    Bon Secours Mercy Health (Lorain, OH)
    …as a clinical resource and consultant for the acute rehab program. The Admissions Coordinator RN cross trains to cover case management as needed, which includes ... smooth transition to acute rehab unit. Maintains expertise in clinical field, utilization review and case management ; communicates to insurance companies/third… more
    Bon Secours Mercy Health (07/22/25)
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  • LTSS Service Coordinator - Clinician (Case…

    Elevance Health (Canton, OH)
    **LTSS Service Coordinator - Clinician (Case Manager)** **Hiring statewide across Ohio** **Location** : This field-based role enables associates to primarily operate ... term services and supports, and psychosocial needs. The **LTSS Service Coordinator -Clinician** is responsible for working under the direction/supervision of an RN,… more
    Elevance Health (07/15/25)
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  • Care Coordinator -Care Management

    MetroHealth (Brooklyn Heights, OH)
    …Coordinates the care of selected patients. Integrates and coordinates access and utilization management , proactive patient panel management , care ... of Science in Nursing. Valid Ohio RN licensure. Three to Five years of case management or managed care experience. Ability to work independently and as a member of a… more
    MetroHealth (05/15/25)
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