- HealthCare Support (New Albany, OH)
- …hospital setting, alternative care setting such as home health or ambulatory care required. Healthcare and/or managed care industry experience. Case ... RN Field Case Manager HealthCare Support is actively seeking a RN Field Case Manager to fill an opening in New Albany, OH. Daily Responsibilities for RN Field… more
- Cardinal Health (Columbus, OH)
- …companies (ex. Blue Cross, Blue Shield, IPA, etc). Reporting to the Director of Managed Care , the Manager of Contracting is responsible for managing ... **_What Managed Care contributes to Cardinal Health_**...other activity as it relates to payer interaction. The Manager of Payor Contracting is responsible for reviewing, auditing… more
- Molina Healthcare (Columbus, OH)
- …integrity and other cost recovery processes + Direct PM experience in Managed Care Operations (claims, system configuration, provider data management preferred) ... and appreciates the member environments we serve + Exposure to all Managed Care industry functional departments **JOB QUALIFICATIONS** **Required Education** +… more
- Molina Healthcare (Columbus, OH)
- …QUALIFICATIONS:** + At least 6 years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, ... integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape… more
- Molina Healthcare (Columbus, OH)
- …years of experience in a pharmacy, Medication Therapy Management (MTM), Pharmacy Benefit Manager (PBM), and/or managed care setting, or equivalent combination ... Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care . **Essential Job… more
- Indeed (Columbus, OH)
- …policy, and many region-specific benefits. **Benefits - Health, Work/Life Harmony, & Wellbeing** We care about what you care about. We have a multitude of ... benefits to support Indeedians, as well as their pets, kids, and partners including medical, dental, vision, disability and life insurance. Indeedians are able to enroll in our company's 401k plan, as well as an equity-based incentive program. Indeedians will… more
- Molina Healthcare (Columbus, OH)
- …* At least 8 years clinical systems experience, preferably as a product owner / manager within a managed care , nursing informatics or health care ... implementation, and oversight of technology that drives core utilization management, care management, long-term services and supports (LTSS), clinical operations and… more
- Molina Healthcare (Columbus, OH)
- …Qualifications** * At least 3 years of experience in a pharmacy, Pharmacy Benefit Manager (PBM), formulary, and/or managed care setting, and 1-2 years ... team (ICT). * Works with the Pharmacy Benefit Manager (PBM) to manage formulary changes and update marketing...Qualifications** * Medicare Part D and/or Medicaid experience. * Managed care experience. To all current Molina… more
- Molina Healthcare (Columbus, OH)
- …or related **REQUIRED EXPERIENCE:** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **REQUIRED LICENSE, ... REQUIREMENTS:** **PREFERRED EXPERIENCE:** 3-5 years in case management, disease management, managed care or medical or behavioral health settings. **PREFERRED… more
- Molina Healthcare (Columbus, OH)
- …Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **Required ... unrestricted RN license in the state of OH Case Manager RN will work in remote and field setting...**Preferred Experience** 3-5 years in case management, disease management, managed care or medical or behavioral health… more
- Elevance Health (Columbus, OH)
- **Behavioral Health Care Manager II** A proud member of the Elevance Health family of companies, **Carelon Behavioral Health** , offers superior clinical mental ... hours with** **some weekends based upon organizational/business needs.** The **Behavioral Health Care Manager II** is responsible for managing psychiatric and… more
- Humana (Columbus, OH)
- …+ BSN or MSN degree + Knowledge of Milliman or Interqual + Managed care experience + Certified Case Manager (CCM) + Bilingual in English and Spanish (see ... part of our caring community and help us put health first** The Care Manager , Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members'… more
- Molina Healthcare (Columbus, OH)
- …(LPN) Program **REQUIRED EXPERIENCE:** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **REQUIRED ... in OB HIGH RISK / maternal health case management, disease management, managed care or medical or behavioral health settings. To all current Molina employees:… more
- Humana (Columbus, OH)
- …help us put health first** Humana Healthy Horizons in Kentucky is seeking a Field Care Manager , Behavioral Health 2 who will assess and evaluate member's needs ... care and wellbeing of members. The Field Care Manager , Behavioral Health 2 work assignments...Illness (SPMI) and/or Substance Abuse Disorder (SUD) patients + Managed Care Experience + Case Management Certification… more
- AmeriHealth Caritas (Dublin, OH)
- **Role Overview:** The Care Manager supports maternity members through personalized care coordination and case management, helping them achieve optimal ... care setting. + Case management experience, preferably within a managed care organization, is desired. ; **Licensure:** + A current and unrestricted… more
- Elevance Health (Columbus, OH)
- …acute care setting. + Minimum 2 years "telephonic" Case Management experience with a Managed Care Company. + Managed Care experience. For candidates ... Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for care management...Nurse Case Manager II** is responsible for care management within the scope of licensure for members… more
- J&J Family of Companies (Columbus, OH)
- …to address critical access and affordability issues for patients. + Partner with managed care colleagues to understand current policies and potential future ... Solutions (PECS) team is recruiting for a Field Reimbursement Manager which will be a field-based position that will...across multiple payer types and plans (ie, Medicare, Medicaid Managed Care , Commercial). + Execute business in… more
- Molina Healthcare (Columbus, OH)
- …Term Services & Supports. + 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **PREFERRED EXPERIENCE:** + ... 3-5 years in case management, disease management, managed care or medical or behavioral health settings. + 1 year experience working with population who receive… more
- ChenMed (Columbus, OH)
- …Commission for Case Manager Certification (CCMC) or the American Association of Managed Care Nurses (CMCN) desired + This position requires possession and ... expanding and we need great people to join our team. The Intensive Community Care Manager (ICCM) is a Registered Nurse (RN) who works with our highest complexity… more
- CDM Smith (Columbus, OH)
- …CDM Smith currently has a new opportunity for a Senior Project Manager with previous experience managing industrial water and/or wastewater projects to join ... Smith's mission by: * Managing and serving as the lead Project Manager on water/wastewater projects * Providing technical guidance, senior leadership, and mentoring… more
