- Novo Nordisk Inc. (Lima, OH)
- …in order to influence formulary status, as applicable May analyze impact of managed care in the territory and its effect on prescribing decisions, ... Novo Nordisk, we are the world leader in diabetes care and a major player in defeating other serious...Internally, the DCS I report to the District Business Manager of the specific sales territory. The DCS I… more
- HealthCare Support (New Albany, OH)
- …hospital setting, alternative care setting such as home health or ambulatory care required. Healthcare and/or managed care industry experience. Case ... RN Field Case Manager HealthCare Support is actively seeking a RN Field Case Manager to fill an opening in New Albany, OH. Daily Responsibilities for RN Field… more
- PharmaCord (Cincinnati, OH)
- …reside in the state of Ohio. When you join the team as an Executive Case Manager , you'll have the opportunity to make a difference in the lives of our patients each ... prescriptions or cases are handled in a timely manner. An Executive Case Manager has the ability to translate knowledge into patient friendly language and education.… more
- Sprenger Wellspring Silver Maple (Massillon, OH)
- …policies and procedures and Quality Assurance Plan, State Licensing standards, and managed care regulations. Certificates and Licenses: Current CPR and First ... (LPN) - NIGHT SHIFT Department: Nursing Reports To : Subacute Detox Nurse Manager FLSA Status: Hourly Duties and Responsibilities include the following. Other duties… more
- Cardinal Health (Columbus, OH)
- …companies (ex. Blue Cross, Blue Shield, IPA, etc). Reporting to the Director of Managed Care , the Manager of Contracting is responsible for managing ... **_What Managed Care contributes to Cardinal Health_**...other activity as it relates to payer interaction. The Manager of Payor Contracting is responsible for reviewing, auditing… more
- Molina Healthcare (Columbus, OH)
- …integrity and other cost recovery processes + Direct PM experience in Managed Care Operations (claims, system configuration, provider data management preferred) ... and appreciates the member environments we serve + Exposure to all Managed Care industry functional departments **JOB QUALIFICATIONS** **Required Education** +… more
- Molina Healthcare (Dayton, OH)
- …QUALIFICATIONS:** + At least 6 years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, ... integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape… more
- Molina Healthcare (Cincinnati, OH)
- …years of experience in a pharmacy, Medication Therapy Management (MTM), Pharmacy Benefit Manager (PBM), and/or managed care setting, or equivalent combination ... Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care . **Essential Job… more
- Indeed (Columbus, OH)
- …policy, and many region-specific benefits. **Benefits - Health, Work/Life Harmony, & Wellbeing** We care about what you care about. We have a multitude of ... benefits to support Indeedians, as well as their pets, kids, and partners including medical, dental, vision, disability and life insurance. Indeedians are able to enroll in our company's 401k plan, as well as an equity-based incentive program. Indeedians will… more
- Molina Healthcare (Dayton, OH)
- …* At least 8 years clinical systems experience, preferably as a product owner / manager within a managed care , nursing informatics or health care ... implementation, and oversight of technology that drives core utilization management, care management, long-term services and supports (LTSS), clinical operations and… more
- Molina Healthcare (Cleveland, OH)
- …Qualifications** * At least 3 years of experience in a pharmacy, Pharmacy Benefit Manager (PBM), formulary, and/or managed care setting, and 1-2 years ... team (ICT). * Works with the Pharmacy Benefit Manager (PBM) to manage formulary changes and update marketing...Qualifications** * Medicare Part D and/or Medicaid experience. * Managed care experience. To all current Molina… more
- Molina Healthcare (OH)
- …or related **REQUIRED EXPERIENCE:** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **REQUIRED LICENSE, ... REQUIREMENTS:** **PREFERRED EXPERIENCE:** 3-5 years in case management, disease management, managed care or medical or behavioral health settings. **PREFERRED… more
- Molina Healthcare (Columbus, OH)
- …Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **Required ... unrestricted RN license in the state of OH Case Manager RN will work in remote and field setting...**Preferred Experience** 3-5 years in case management, disease management, managed care or medical or behavioral health… more
- Elevance Health (Columbus, OH)
- **Behavioral Health Care Manager II** A proud member of the Elevance Health family of companies, **Carelon Behavioral Health** , offers superior clinical mental ... hours with** **some weekends based upon organizational/business needs.** The **Behavioral Health Care Manager II** is responsible for managing psychiatric and… more
- Molina Healthcare (OH)
- …Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **Required ... in Nursing **Preferred Experience** 3-5 years in case management, disease management, managed care or medical or behavioral health settings. Preferred License,… more
- Molina Healthcare (Cleveland, OH)
- …Long Term Services & Supports. + 1-3 years in case management, disease management, managed care or medical or behavioral health settings. + Required License, ... Degree in Nursing **Preferred Experience** + 3-5 years in case management, disease management, managed care or medical or behavioral health settings. + 1 year… more
- Molina Healthcare (OH)
- …Term Services & Supports. + 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **PREFERRED EXPERIENCE:** + ... 3-5 years in case management, disease management, managed care or medical or behavioral health settings. + 1 year experience working with population who receive… more
- Humana (Columbus, OH)
- …+ BSN or MSN degree + Knowledge of Milliman or Interqual + Managed care experience + Certified Case Manager (CCM) + Bilingual in English and Spanish (see ... part of our caring community and help us put health first** The Care Manager , Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members'… more
- Premier Health (Dayton, OH)
- **Clinical Excellence** **FT/ 80 hours per pay** **Summary of Position** The RN Care Manager will provide a systematic organization of care with the ... care team members and/or settings. The RN Care Manager will provide high quality, patient...+ Provide ongoing assessment, monitoring, and tracking in EHR Care will be managed by the use… more
- Molina Healthcare (Cleveland, OH)
- …(LPN) Program **REQUIRED EXPERIENCE:** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **REQUIRED ... in OB HIGH RISK / maternal health case management, disease management, managed care or medical or behavioral health settings. To all current Molina employees:… more
