• Utilization Management

    CVS Health (Columbus, OH)
    …**Position Summary** This Clinical Consultant position is with Aetna's Utilization Management (UM) team and is a field-based/Remote position out of the ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable in… more
    CVS Health (07/02/25)
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  • Utilization Management

    CVS Health (Columbus, OH)
    … skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is knowledgeable ... external constituents in the coordination and administration of the utilization /benefit management function **Required Qualifications** + Licensed independent… more
    CVS Health (07/03/25)
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  • Utilization Management Nurse…

    CVS Health (Columbus, OH)
    clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Utilizes clinical experience and skills ... constituents in the coordination and administration of the utilization /benefit management function Function in a clinical telephone queue working with… more
    CVS Health (07/01/25)
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  • Utilization Management Nurse…

    CVS Health (Columbus, OH)
    …Must have active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in EST zones.… more
    CVS Health (06/26/25)
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  • RN Clinical Consultant

    Guardian Life (Columbus, OH)
    **Position Summary** The RN Clinical Consultant serves as a clinical resource for the investigation and assessment of medical information regarding ... medical reviews and analysis of long-term disability claims. The RN Clinical Consultant identifies restrictions, limitations and duration impacting functional… more
    Guardian Life (07/02/25)
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  • Workfront Configuration Consultant

    Eliassen Group (Columbus, OH)
    … to support the implementation of Workfront as an Enterprise Portfolio and Project Management tool. As the Senior Consultant , you will work closely with our ... **Workfront Configuration Consultant ** **Anywhere** **Type:** Contract **Category:** Development **Industry:** Insurance **Workplace Type:** Remote **Reference ID:**… more
    Eliassen Group (07/01/25)
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  • Advanced Analytics Consultant - Behavioral…

    Elevance Health (Cincinnati, OH)
    …of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management , a ... **Advanced Analytics Consultant ** **- Behavioral Health Data** **Location:** Seven Fields,...target the right members. + Develops methodology to measure clinical , utilization , and financial outcomes of a… more
    Elevance Health (06/18/25)
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  • Manager, Clinical Engineering

    OhioHealth (Columbus, OH)
    … to other OhioHealth Hospitals. The Manager ensures efficient, cost-effective management of the organization's clinical equipment. **Responsibilities And ... to other OhioHealth Hospitals. The Manager ensures efficient, cost-effective management of the organization's clinical equipment. **MINIMUM QUALIFICATIONS**… more
    OhioHealth (06/07/25)
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  • Clinical Education Specialist - Toledo…

    ProMedica Health System (Toledo, OH)
    …department, division, hospital or system level. He/she serves as a consultant , researcher, evidence-based practice mentor, performance improvement leader and project ... nursing in the growth and development of nursing practice through utilization of evidence-based practice concepts and process, the ProMedica Nursing Professional… more
    ProMedica Health System (06/01/25)
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  • Registered Nurse (RN) - Admissions Coordinator…

    Bon Secours Mercy Health (Lorain, OH)
    …to acute rehab unit. Maintains expertise in clinical field, utilization review and case management ; communicates to insurance companies/third party ... discharge planners, and physicians. This role serves as a clinical resource and consultant for the acute...The Admissions Coordinator RN cross trains to cover case management as needed, which includes initiating and directing the… more
    Bon Secours Mercy Health (05/19/25)
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  • Laboratory Coordinator II - Automated Chemistry

    Cleveland Clinic (Cleveland, OH)
    …healthcare organizations. Cleveland Clinic's Department of Laboratory Medicine has a Clinical Biochemistry section that maintains a comprehensive menu of routine, ... high-volume automated clinical chemistry tests. This section also operates a regional...machine learning to optimize operational workflows and improve staff utilization . As Laboratory Coordinator, you will provide administrative and… more
    Cleveland Clinic (06/25/25)
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  • SQPE Specialist II

    Cleveland Clinic (Warrensville Heights, OH)
    …development. + Act as a consultant in educating and evaluating clinical and support department caregivers regarding quality management regulations and ... the way. Putting patients first requires more than world-class clinical care - we go above and beyond by...with all standards and favorable performance on safety, quality, utilization and experience metrics. + Participate in engraining the… more
    Cleveland Clinic (06/25/25)
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  • Case Manager-Sbhi

    Premier Health (Eaton, OH)
    …standards for administration and reporting of outcome measures and documentation of utilization management of clinical care. . Demonstrate knowledge ... for identified clients. Case Manager acts as a resource consultant to other team members and collects resource materials...and productivity expectations. . Provide CPST services to coordinate clinical care in the form of face to face,… more
    Premier Health (06/05/25)
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  • Ambulatory Registered Nurse (RN) - Pediatric…

    Bon Secours Mercy Health (Toledo, OH)
    …effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. **St. Vincent Medical Center** **Full Time Days** ... Duties and Responsibilities:** + Will be a clerical and clinical position and will perform both room and check...disease and seek early treatment. + Provides nursing case management for assigned patients. Follows guidelines for care according… more
    Bon Secours Mercy Health (07/02/25)
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  • Physician (Radiation Oncologist)

    Veterans Affairs, Veterans Health Administration (Dayton, OH)
    …delivering health care by participating in programs and following policies, improving utilization of resources, suggesting needed process changes for the clinical ... Total Rewards. Major duties include, but are not limited to: Provides clinical instructions for physics, dosimetry, radiation therapists and other clinical more
    Veterans Affairs, Veterans Health Administration (05/03/25)
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  • Safety, Quality and Patient Experience (SQPE)…

    Cleveland Clinic (Mayfield Heights, OH)
    …has occurred. + Act as a consultant in educating and evaluating clinical and support department staff regarding quality management regulations and standards ... compliance with all standards and favorable performance on safety, quality, utilization , and experience metrics. + Participate in engraining the safety, quality,… more
    Cleveland Clinic (07/01/25)
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