- CVS Health (Columbus, OH)
- …Quality of Care: -Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and ... Master's degree in Behavioral /Mental Health or related field** -Unencumbered Independent Behavioral Health clinical license in the state where they work:… more
- Highmark Health (Columbus, OH)
- …Nursing **EXPERIENCE** **Required** + 7 years of any combination of clinical , case management and/or disease/condition management experience, provider operations ... panel of members that range in health status/severity and clinical needs. The incumbent assesses health management needs of...interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are… more
- National Youth Advocate Program (Columbus, OH)
- …Tuition Assistance, and **Work Anniversary Trips** ! **Position Overview** **Summary** The Clinical Services Manager assists the Director of Service Reception to ... vision, and values while providing leadership to the clinical supervisor and clinical therapists on case consultation with the development and growth of … more
- Molina Healthcare (Columbus, OH)
- … health settings. Preferred License, Certification, Association Active, unrestricted Certified Case Manager (CCM) To all current Molina employees: If ... an integrated delivery of care across the continuum, including behavioral health and long term care, for members with...per regulated timelines and determines who may qualify for case management based on clinical judgment, changes… more
- Molina Healthcare (Columbus, OH)
- …health settings. Preferred License, Certification, Association Active, unrestricted Certified Case Manager (CCM) **Bilingual (Spanish)** **WORK SCHEDULE:** ... an integrated delivery of care across the continuum, including behavioral health and long term care, for members with...per regulated timelines and determines who may qualify for case management based on clinical judgment, changes… more
- Humana (Columbus, OH)
- …the Director, Case Management and supports the strategic priorities for Clinical Operations, Medical & Behavioral Health and Humana Government Business ... Puerto Rico. + Current valid and unrestricted Registered Nurse license + Certified Case Manager (CCM) + 5 years of healthcare supervisory/management experience,… more
- AmeriHealth Caritas (Dublin, OH)
- …the hospital or community health setting. + A minimum of 3 years of case management experience **preferred in behavioral health.** + Proficiency in utilizing MS ... care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about… more
- AmeriHealth Caritas (Dublin, OH)
- **Role Overview:** The Care Manager is responsible for managing and coordinating care, services, and social determinants of health for Members with acute, chronic, ... medically complex and/or behavioral health conditions and other health needs. Serves as...Utilizes strong assessment and communication skills, critical thinking, and clinical knowledge to identify issues, gaps in care and… more
- AmeriHealth Caritas (Dublin, OH)
- **Role Overview** The Care Manager II is responsible for managing and coordinating care, services, and social determinants of health for Members with acute, chronic, ... medically complex and/or behavioral health conditions and other health needs. Serves as...Utilizes strong assessment and communication skills, critical thinking, and clinical knowledge to identify issues, gaps in care and… more
- CVS Health (Columbus, OH)
- …we do it all with heart, each and every day. **Job Summary** The Care Manager -Registered Nurse is a key member of our Special Needs Plan (SNP) care team, responsible ... for coordinating care for members who often face multiple chronic medical and behavioral health conditions, as well as various social determinants of health (SDoH)… more
- Highmark Health (Columbus, OH)
- …resource utilization, identification of opportunities for referral to a Health Coach/ case management, and identification and resolution of quality issues. Monitors ... with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable state, federal… more
- AmeriHealth Caritas (Dublin, OH)
- …and clinical management for pregnant and postpartum members. Works with the Clinical Program Manager to develop policies and procedures. Oversees the call ... care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about… more
- Elevance Health (Columbus, OH)
- …office visits with providers and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering ... The **Medical Director** will have program management responsibilities including clinical policy development, program development/implementation, and overseeing clinical… more
- Elevance Health (Dublin, OH)
- …competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs. ... the direction/supervision of an RN, with overall responsibility for the member's case . As required by applicable state law and contract, the Clinician contributes… more
- Elevance Health (Dublin, OH)
- …competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs. ... the individual's support network and oversee management of their physical health, behavioral health, and long-term services and supports, adhering to state and… more
- OhioHealth (Columbus, OH)
- …for individuals from at-risk populations from interdisciplinary team members (including physicians, Case Managers, staff nurses and other members of the care team). ... responsibilities for scheduling staff, daily assigning of cases, and assisting the manager with direct supervision of the social work staff and masters level… more
- Maxim Healthcare (Marion, OH)
- …changes in patient/client status to the Director of Clinical Services and/or Clinical Supervisor / Case Manager or licensed designee + Documents all ... medical record and + communicates this information as needed + Attends case conferences, team meetings, education in-services as required + Supports professional… more