- MetroHealth (Cleveland, OH)
- ** Utilization Review Specialist - Utilization Management** **Location:** **METROHEALTH MEDICAL CENTER** **Biweekly Hours:** **80.00** **Shift:** ... **Responsible for communicating information to internal and external customers of the Utilization Review and Care Management Department. Follows up on inquiries… more
- Elevance Health (Columbus, OH)
- …regarding case and determines appropriate area to refer or assign case ( utilization management, case management, QI, Med Review ). + Provides information ... reports and documents all actions. + Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical… more
- Cardinal Health (Cincinnati, OH)
- Job Description **Senior Consultant, Product Sales Specialist - NPHS** **The territory covers Indiana, Michigan, Ohio, Kentucky, Missouri** The Product Sales ... Specialist is responsible for developing opportunities, selling, growing and...responsible for developing opportunities, selling, growing and maintaining product utilization among targeted healthcare providers and administrators. The incumbent… more
- Datavant (Columbus, OH)
- …tools. The specialist serves as a key liaison between coding, billing, utilization review , case management, and payer relations to reduce denials and improve ... and life experiences to realize our bold vision for healthcare. The Specialist is responsible for identifying, analyzing, and resolving claim denials across the… more
- EMCOR Group (Cincinnati, OH)
- …pharmaceutical, transportation, and government sectors. **Job Title:** Operations Specialist **Job Summary:** This role provides tactical and operational ... order management and procedural compliance. **Essential Duties and Responsibilities:** Daily review of waiting material and waiting quote work orders, onsite status… more
- Cognizant (Columbus, OH)
- …and retro-authorization as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral, preauthorization, medical ... necessity determinations to the Health Plan/Medical Director based on the review of clinical documentation in accordance with Medicare, Medicaid, and third-party… more
- KeyBank (Brooklyn, OH)
- …mortgage loan processes. **ABOUT THE JOB** This position is responsible for the review of loan documentation for complex commercial loan clients and the booking of ... queues to ensure timely processing of tasks. + Effective utilization of "dual monitor" environment. + Ability to work...Act as team champion to assist team members. + Review and book the most complex loans, which include… more
- Cardinal Health (Columbus, OH)
- **_Senior Specialist - Injunctive Relief Compliance_** **_What Quality Compliance contributes to Cardinal Health_** Quality develops and implements quality policies, ... all applicable Open Source and Law Enforcement searches as required + Review any disciplinary documentation associated with any individual/entity to determine if any… more
- Cleveland Clinic (Cleveland, OH)
- …organizations in the world. As a Safety, Quality and Patient Experience (SQPE) Specialist II at Lutheran Hospital, you will help drive excellence across a diverse ... ensure compliance with standards and improve performance across safety, quality, utilization and experience metrics. This is an exciting opportunity to advance… more
- Battelle Memorial Institute (Columbus, OH)
- …individuals to apply. **Job Summary** The Travel and Protection Program Specialist is primarily responsible for conducting high-level threat analysis and the ... mitigate risks and vulnerabilities to executives; develop, implement, and periodically review executive protection plans, procedures, and programs to support safety,… more
- CVS Health (OH)
- …We have an exciting opportunity available for highly motivated individuals as Medicare Sales Specialist . The position will be a part of a specialized team who will ... all sales presentations. + Servicing of existing members and inquiries related to utilization of their product, benefits, etc. + Cross selling applicable products to… more
- Battelle Memorial Institute (Columbus, OH)
- …make informed recommendations to the Maintenance Manager and Building Controls Specialist for reducing operational costs. + Ensure all environmental conditions meet ... by working with Controls Specialists and Maintenance Teams to review the building automation system for alarm conditions. +...programs for equal treatment of all staff and full utilization of all qualified employees at all levels within… more
- Schaeffler (Wooster, OH)
- Specialist - Project Management - Tooling Location: Wooster, OH, US, 44691 Job Requisition ID: 36134 Schaeffler is a dynamic global technology company and its ... resourcing. + Monitor project progress and continuously check availability and utilization of capacities, resources, services and materials. + Coordinate and prepare… more
- Evolent (Columbus, OH)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a… more
- Amergis (Dublin, OH)
- …and referrals for psychosocial needs + Participates in Quality Assurance and Utilization Review activities, as directed + Empowers patients in decision-making ... continuum of care activities for assigned patients and ensuring optimum utilization of resources, service delivery, and compliance with medical regime. Essential… more
- Premier Health (Centerville, OH)
- …cost-effective medication therapy; optimize medication use through drug order review , therapeutic drug monitoring, participation in high-risk emergencies including ... and drug therapy research activities as applicable. The clinical pharmacy specialist provides for staff development activities and the coordination of staff… more
- EMCOR Group (Cincinnati, OH)
- …cost. Develop an auditing process and establish QBR schedule with account Procurement Specialist for our key vendors to hold them accountable to meeting our ... procedures. Own the centralized Fire Extinguisher/system software and insure proper utilization and training across all sites. Investigate, develop and implement… more
- Ryder System (Columbus, OH)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The ... (Tier 1 Call Center Representatives and Tier 2 Functional Specialist ). Ensure contact center staff have the training and...to get things done regardless of obstacles + Optimized utilization of resources to provide a delightful and consistent… more
- Cleveland Clinic (Warrensville Heights, OH)
- …safety, quality and experience. As a Safety, Quality and Patient Experience (SQPE) Specialist - Sepsis Coordinator, you will play a critical role in advancing our ... compliance with all standards and favorable performance on safety, quality, utilization , and experience metrics. + Participate in engraining the safety, quality,… more
- ChenMed (Columbus, OH)
- …and explain nurse practitioner role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... detailed care of the patient regardless of involvement of an internal or external specialist . + Once mastery of the Core Model is established, plays an active role… more