- Holzer Health System (Gallipolis, OH)
- …organizational and financial outcomes. Serves as a clinical expert and resource in Utilization Review and Case Management. Partners with Social Workers ... field will be taken into consideration. . Professional experience with case management, utilization review , or discharge planning highly desirable. .… more
- Molina Healthcare (Columbus, OH)
- …(such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services ... (such as, therapeutic drug monitoring, drug regimen review , patient education, and medical staff interaction), and oversight (establishing and measuring performance… more
- OhioHealth (Mansfield, OH)
- …high risk clients from newborn to elderly. A hospital-based case manager coordinates and performs comprehensive patient care review , which includes the ... quality client care within fiscally expedient time frames. The case manager works with acutely ill and/or...integration of Utilization Review , Quality Assurance, Risk Management, Infections Control and Discharge… more
- CVS Health (Columbus, OH)
- …members. **Key Responsibilities** + This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or ... Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management....lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- Cleveland Clinic (Cleveland, OH)
- …or AHA Certification by an approved entity + Two years of recent experience in utilization review , quality or care management + Knowledge of acute care and ... personal protective equipment as required for procedures Keywords: : RN, Registered Nurse, Case Management, Case Manager , RN Case Manager , Registered… more
- Premier Health (Eaton, OH)
- Case Manager FACILITY: SAMARITAN BEHAVIORAL HEALTH Case Manager functions as a member of a team to assist in the planning, development, and delivery of ... clients and uses that knowledge to coordinate services and advocate for identified clients. Case Manager acts as a resource consultant to other team members and… more
- CVS Health (Columbus, OH)
- …Care Management Programs to change lives in new markets across the country. The Case Manager , Licensed Practical Nurse is responsible for care coordination of ... who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current... prior claims to address potential impact on current case management and eligibility status. Focus assessments and/or questionnaires… more
- Cleveland Clinic (Cleveland, OH)
- …care at one of the top healthcare organizations in the nation. As an RN Case Manager , you will collaborate with inter-professional teams across the continuum of ... by an approved entity + Two years of recent experience in utilization review , quality or care management + Knowledge of acute care and accreditation… more
- Highmark Health (Columbus, OH)
- …Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/ case … more
- Highmark Health (Columbus, OH)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/ case … more
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