- Highmark Health (Columbus, OH)
- …consistent with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable ... + Experience in a clinical setting **Preferred** + Experience in UM/CM/QA/Managed Care **LICENSES AND CERTIFICATIONS** **Required** + Current RN state licensure… more
- Sharecare (Columbus, OH)
- …September 8th, 2025** **Salary:** **$85,000 annually, plus comprehensive benefits package** The Care Manager supports the implementation of the Value Based ... telephonic Case or Care Management with CareFirst members. The Care Manager partners with members, caregivers, providers, and the interdisciplinary… more
- CVS Health (Columbus, OH)
- …. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience in ... position consists of working intensely as a telephonic case manager with patients and their care team...a hospital setting. + A Registered Nurse that holds an active, unrestricted… more
- CenterWell (Columbus, OH)
- …or requested. **Use your skills to make an impact** **Required Experience/Skills:** + Registered Nurse or Physical Therapist. + Current state license as a ... Registered Nurse or Physical Therapist. + 5 years of professional experience in Home Care , 2 years of which are in an administrative, supervisory, quality… more
- Highmark Health (Columbus, OH)
- …in case management including but is not limited to: developing a care plan, encouraging behavior changes, identifying and addressing barriers, helping members to ... coordinate care , and identifying various resources to assist members in...in addressing targeted populations **LICENSES AND CERTIFICATIONS** **Required** + RN license in PA or WV or DE or… more
- Centene Corporation (Columbus, OH)
- …Bachelor's degree in Nursing and 2 - 4 years of related experience. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact State ... workplace flexibility. **Position Purpose:** Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide… more
- Humana (Columbus, OH)
- …programs and more! Apply now to begin your future with a Fortune 500 Company! The Field Care Manager Nurse 2 ( Care Manager Plus, Physical Health) ... Humana Healthy Horizons in Ohio is seeking a Field Care Manager to assess and evaluate member's...your skills to make an impact** **Required Qualifications** + Registered Nurse with 2 years of experience… more
- BrightSpring Health Services (Fairfield, OH)
- …management/supervisory experience + Degree from an accredited school of nursing + Licensed Registered Nurse required + Valid driver's license from state of ... Home Health, Hospice, Residential and Private Duty. If your passion is outstanding patient care coupled with a desire to help others live their best life, then come… more
- Molina Healthcare (OH)
- …materials and other related documentations. **JOB QUALIFICATIONS** **Required Education** + Registered Nurse or equivalent combination of Licensed Vocational ... assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term...Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of … more
- Sharecare (Columbus, OH)
- …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... support in an appropriate, efficient and cost-effective manner while ensuring high quality care . The Disease Management Nurse works with participating members to… more
- Medical Mutual of Ohio (OH)
- …Home health care experience is a plus. **Professional Certification(s):** + Registered Nurse with current State of Ohio unrestricted license. Multiple state ... Medicare Supplement, and individual plans. Under limited supervision, the RN Case Manager evaluates and provides support...Board. Bachelor's Degree preferred. + 3 years as a Registered Nurse with a combination of clinical… more
- Insight Global (Mayfield Heights, OH)
- …prior auths (using auto approval or business rules or sending to a RN to review) Managed Care experience with payers like Medicare/Medicaid/Dual ... the preparation and execution of User Acceptance Testing Assist the project manager in developing the requirements phase plan and develop the requirements management… more
- Medical Mutual of Ohio (OH)
- …+ Home health care experience is a plus. **Professional Certification(s):** + Registered Nurse with current State of Ohio or multistate unrestricted license. ... Educates members and families to make informed personal health care decisions and determines the most effective treatment options....Board. Bachelor's Degree preferred. + 3 years as a Registered Nurse with a combination of clinical… more
- AmeriHealth Caritas (Dublin, OH)
- **Role Overview** The Care Manager II is responsible for managing and coordinating care , services, and social determinants of health for Members with acute, ... issues, gaps in care and barriers to care . The Care Manager II...Remote **Responsibilities** + Support Members during transitions of care through assessment, coordination of care , education… more
- AmeriHealth Caritas (Athens, OH)
- …case management services in achieving their optimal level of health through self-management. The Care Manager II ( RN /LSW) is responsible for engaging the ... services. Discover more about us at www.amerihealthcaritas.com . **Responsibilities:** The Care Manager provides support to complex members appropriate for… more
- AmeriHealth Caritas (Dublin, OH)
- **Role Overview:** The Care Manager is responsible for managing and coordinating care , services, and social determinants of health for Members with acute, ... issues, gaps in care and barriers to care . The Care Manager develops... plan, and teaching self-management. **Licensure:** + Requirements for RN : Current, unrestricted Ohio RN license in… more
- CenterWell (Columbus, OH)
- …it will allow for off-days during the week.** The **Clinical Care Coordinator/ Care Manager , Telephonic Nurse ** helps to ensure optimal continuity of ... The Clinical Care Coordinator is under the general supervision of the Manager of Care Coordination and under established performance criteria. This is a… more
- Cardinal Health (Columbus, OH)
- …Rheumatology (Rheum) Customer Success contributes to Cardinal Health_** The Clinical Manager for our Rheumatology (Rheum) Customer Success team is responsible for ... the EVP of Provider Solutions. In this role, the Manager will be held primarily accountable for the overall...that will lead our Rheum program. **Location** - Fully remote with the expectation of 15-20% travel. Travel does… more
- Sedgwick (Cincinnati, OH)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Field Case Manager -Sign On Bonus Eligible **This Field Case Manager will cover our ... have as least 1.5 years of prior Field Case Manager workers compensation experience.** **PRIMARY PURPOSE OF THE ROLE:**...on the health and lives of others, and a remote work environment that allows face to face interaction… more
- Sedgwick (Columbus, OH)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Field Case Manager -Sign On Bonus Eligible **We are growing all across the US and are ... on the health and lives of others, and a remote work environment that allows face to face interaction...more. + Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.… more