- Parexel (Columbus, OH)
- …Senior Clinical Research Associate (Sr. CRA) is responsible for the site management , site monitoring and close-out of assigned clinical trials investigator sites to ... and the Sponsor's standards. The Sr. CRA is accountable for site management and monitoring, managing investigator site relationships to ensure effective delivery of… more
- Elevance Health (Independence, OH)
- …health, behavioral health, long term services and supports, and psychosocial needs._ ** Medical Management Clinician ** **Location:** This role enables ... hours may be necessary based on company needs. The ** Medical Management Clinician ** responsible for ensuring appropriate, consistent administration… more
- Elevance Health (Waverly, OH)
- **LTSS Service Coordinator - Clinician (Case Manager)** **Hiring near Chillicothe, Findlay, Gallipolis, Ironton, Jackson, Lima, Marietta, Portsmouth, Wapakoneta, ... 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 (Marietta, 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 ... **LTSS Service Coordinator - RN Clinician (Case Manager)** **Hiring in the following counties: Athens, Hocking, Meigs, Morgan, Noble, Perry, and Washington.**… more
- Molina Healthcare (Cleveland, OH)
- JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for verifying ... member care. The candidate must have Medicare Appeals and/or Utilization Management knowledge. Work hours are Monday-Friday 8:00am- 5:00pm PST. This position… more
- Highmark Health (Columbus, OH)
- …and retrospective claims review basis. Review process includes a review of medical documentation, itemized bills, and claims data to assure appropriate level of ... or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment and retrospective… more
- Datavant (Columbus, OH)
- …computer skills, Word, Excel, Outlook, experience working in a health plan medical management documentation system a plus. Minimum Education: LVN/LPN + ... utilization of available health services, review of admissions for medical necessity and necessity of continued stay in the...as it relates to job function as delegated by management Ideal candidate should be a Licensed Practical Nurse… more
- Molina Healthcare (Dayton, OH)
- …in Healthcare Management (CPHM). * Recent hospital experience in a medical unit or emergency room. Previous experience in managed care Prior Auth, Utilization ... * Processes requests within required timelines. * Refers appropriate cases to medical directors (MDs) and presents cases in a consistent and efficient manner.… more
- Molina Healthcare (Dayton, OH)
- …Looking for a RN with experience with appeals, claims review, and medical coding. JOB DESCRIPTION Job SummaryProvides support for clinical member services review ... * Processes requests within required timelines. * Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner.… more
- Molina Healthcare (Akron, OH)
- …within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional information from members or providers in ... Nurse (RN). **Required Experience** 1-3 years of hospital or medical clinic experience. **Required License, Certification, Association** Active, unrestricted State… more
- Molina Healthcare (Cleveland, OH)
- …* Processes requests within required timelines. * Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner. ... teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At least 2 years… more
- Oracle (Columbus, OH)
- **Job Description** The Oracle Health Order Management product team is dedicated to transforming order management through the Oracle Health EHR, which is a core ... of product design, user interfaces and experiences in EHR order management . By creating modern, user-centric solutions and thoughtfully incorporating intelligent… more
- CVS Health (Columbus, OH)
- …or at risk for involvement in, multiple child-serving systems. The Case Management Coordinator utilizes critical thinking and judgment to collaborate and inform the ... case management process, in order to facilitate appropriate healthcare outcomes...activities and monitors care plan progress. * Enhancement of Medical Appropriateness and Quality of Care: o Using holistic… more
- ChenMed (Columbus, OH)
- …people to join our team. The Care Promoter 1 is an unlicensed medical professional cross-trained to perform routine administrative and clinical tasks to keep the ... medical centers running smoothly. The duties of Care Promoter...+ Catalogs and communicates patient needs to the PCP, Clinician , Specialist and/or other clinical personnel. + Prepares patients… more
- Prime Therapeutics (Columbus, OH)
- …and drives every decision we make. **Job Posting Title** Medication Therapy Management Specialist **Job Description** The Medication Therapy Management (MTM) ... Receive inbound and make outbound calls to eligible beneficiaries to schedule MTM clinician interventions in a manner that meets the specialized needs of the… more
- OptiMindHealth (Elyria, OH)
- …Work/life balance! Leadership and advancement opportunities! Join a leading clinician -led behavioral health company today! OptiMindHealth (OMH) is expanding and ... to our clinicians. Packages can be customized towards every clinician 's needs. Packages can include some combination of: ....can include some combination of: . Competitive Salary . Medical benefits . Paid malpractice policy . CEU reimbursement… more
- CVS Health (Columbus, OH)
- …departments. + Strong communication skills. + Strong organizational and time management skills. **Education** + Master's-level clinician and/or RN, licensed ... to coordinate, document, and communicate all aspects of the utilization/benefit management program. + Conduct clinical reviews for adult inpatient behavioral health… more
- Oracle (Columbus, OH)
- **Job Description** Oracle Health is standing up a specialized clinical product management team focused on medical device-aligned products. This team bridges ... patient safety, usability, and compliance across our next-generation EHR and AI-enabled medical device platforms. As a Clinical Product Manager ( Medical Device… more
- Oracle (Columbus, OH)
- **Job Description** Oracle Health is standing up a specialized clinical product management team focused on medical device-aligned products. This team bridges ... patient safety, usability, and compliance across our next-generation EHR and AI-enabled medical device platforms. As a Clinical Product Manager ( Medical Device… more
- Cleveland Clinic (Cleveland, OH)
- …orthopedic anesthesia, anesthesia for nonoperating room anesthesia (NORA) and acute pain management . We embrace a staff anesthesiologist led care team model with ... with ongoing professional career advancement opportunities along four career tracks: Master Clinician , Master Educator, Clinician Scholar, and Clinician … more
