• 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 (05/25/25)
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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 (05/18/25)
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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 (05/06/25)
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  • Senior Clinical Strategy Consultant

    Highmark Health (Columbus, OH)
    …+ Deep Clincal Expertise -extensive knowledge of clinical , quality, care, utilization , high-cost claim, and population health management . Must be a ... Description :** **JOB SUMMARY** This job serves as the sales team's clinical expert, providing high-level support and insights for strategic clients, aligning… more
    Highmark Health (05/10/25)
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  • Sr. Consultant , Territory…

    Cardinal Health (Columbus, OH)
    **_What Specialty Networks (UroGPO) contributes to Cardinal Health_** _UroGPO_ creates clinical , operational & economic value for independent Community based Urology ... Networks in creating value to the members in their clinical , operational, and economical goals. This individual will be...Research, SONAR, PSMA Pet/CT, RLT' s and Chronic Care Management . This individual will lead these initiatives within their… more
    Cardinal Health (05/14/25)
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  • Consultant , Nurse Disability

    Lincoln Financial (Columbus, OH)
    …a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for ... industry experience preferred * Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or… more
    Lincoln Financial (05/22/25)
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  • Consultant , Medical Economics

    Molina Healthcare (Cleveland, OH)
    …the results to senior leadership. Responsible for consulting with network and clinical management on opportunities to improve our company's discount position ... analysis of markets and network initiatives. The Medical Economics Consultant manages conflicting priorities and multiple projects concurrently. Responsible for… more
    Molina Healthcare (05/21/25)
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  • Clinical Pharmacist, Population Health…

    ChenMed (Columbus, OH)
    …rapidly expanding and we need great people to join our team. The Clinical Pharmacist specializing in Population Health is a skilled and proactive professional who ... needed. **ESSENTIAL JOB DUTIES/RESPONSIBILITIES:** + Acts as a national pharmacy consultant for our physicians regarding patient case inquiries, drug interactions,… more
    ChenMed (03/11/25)
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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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  • 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 (05/08/25)
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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 (03/07/25)
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  • SQPE Specialist I

    Cleveland Clinic (Canton, OH)
    …development. + Act as a consultant in educating and evaluating clinical and support department staff regarding quality management regulations and standards ... improvement initiatives using the Cleveland Clinic Improvement Model. + Partner with clinical leadership to set objectives and key results. + Model Cleveland Clinic… more
    Cleveland Clinic (05/14/25)
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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 (05/21/25)
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  • Reimbursement Solutions Analyst

    Cardinal Health (Columbus, OH)
    …payers, pharmacists and manufacturers for integrated care coordination and better patient management . Backed by nearly 100 years of experience, with more than 40,000 ... currently have a career opening for a Reimbursement Solutions Analyst. **What Clinical Operations contributes to Cardinal Health** Clinical Operations is… more
    Cardinal Health (05/22/25)
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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 Patient Experience Specialist I

    Cleveland Clinic (Dover, 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 (05/08/25)
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  • Nursing Practice Specialist - Toledo Hospital…

    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 (04/17/25)
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  • PRN House Supervisor - Mercy Perrysburg - Nights

    Bon Secours Mercy Health (Perrysburg, OH)
    …effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. Job Description **Summary:** The Supervisor ... Clinical Nurse functions in an administrative role on off-shifts,...nursing standards activity on their shift. Works collaboratively with management for change, evaluation of practice standards and problem… more
    Bon Secours Mercy Health (05/19/25)
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  • Beef Monitoring Customer Success Representative…

    Merck (Columbus, OH)
    …Skills:** Adaptability, Adaptability, Animal Science, Animal Welfare, Beef Cattle Management , Business, Case Study Research, Clinical Experience, Conflicts ... Livestock Management , Multi- Management , Newsletter Writing, Project Management , Resource Utilization , RFID Technology, Sales Goal Achievement {+… more
    Merck (05/15/25)
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