• Utilization Management

    CVS Health (Columbus, OH)
    …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years post… more
    CVS Health (10/21/25)
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  • Medical Management Clinician

    Elevance Health (Cincinnati, OH)
    … health, long term services and supports, and psychosocial needs._ **Medical Management Clinician ** **Location:** This role enables associates to work virtually ... Additional hours may be necessary based on company needs. The **Medical Management Clinician ** responsible for ensuring appropriate, consistent administration of… more
    Elevance Health (10/22/25)
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  • LTSS Service Coordinator - RN Clinician (RN…

    Elevance Health (Zanesville, 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 ... and face-to-face functional assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral more
    Elevance Health (10/17/25)
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  • LTSS Service Coordinator - Clinician (LSW,…

    Elevance Health (Cambridge, OH)
    …telephonic or face-to-face assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral ... **LTSS Service Coordinator - Clinician (Case Manager)** **Hiring near Akron, Cambridge, Canton,...person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial… more
    Elevance Health (10/17/25)
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  • Care Review Clinician , PA (RN)

    Molina Healthcare (Cincinnati, OH)
    …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... / MCG guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). **MULTI STATE / COMPACT… more
    Molina Healthcare (10/18/25)
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  • Utilization Management Clinical…

    CVS Health (Columbus, OH)
    …in the coordination and administration of the utilization /benefit management function **Required Qualifications** + Licensed independent Behavioral Health ... with heart, each and every day. **Position Summary** The Behavioral Health UM Clinician position is designed...to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking… more
    CVS Health (10/15/25)
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