- Molina Healthcare (Columbus, OH)
- **JOB DESCRIPTION** **Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs ... and chemical dependency services and assists with implementing integrated Behavioral Health care management programs. **Knowledge/Skills/Abilities** Provides… more
- Centene Corporation (Columbus, OH)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... implementation of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies… more
- Highmark Health (Columbus, OH)
- …Patient care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed ... current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and… more
- Elevance Health (Columbus, OH)
- …culturally competent, person_ _‐_ _centered coordination for all members that addresses physical health , behavioral health , long term services and supports, ... ** Director of LTSS Provider Relations** **Preferred Location: Ohio....live within 50 miles of one of our Elevance Health PulsePoint locations within the state of Ohio. _The… more
- Highmark Health (Columbus, OH)
- …and lines of business. This will require aligning new models to the health plan's strategic objectives based on a deep understanding of innovation and industry ... Advanced Analytics, Contracting and Provider Relations, Actuary, Finance, Highmark Health Solutions, Health Plan Operations. **ESSENTIAL RESPONSIBILITIES** +… more
- NASCO (Columbus, OH)
- …Cross Blue Shield Medical , Dental, and Vision Plans + Telehealthcare - for Medical and Behavioral visits + Generous PTO with buy/sell options + 9 Company ... **Overview** As Executive Director , Compliance you will lead and provide oversight...is designed to support the physical, mental, and financial health of our associates. We offer: **Physical and Mental… more
- CenterWell (Columbus, OH)
- …best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can ... part of our caring community and help us put health first** The IPA Coding Leader manages a diverse...identify and influence enhancements to technology to improve the medical coder experience. + Oversees coding operations by identifying… more
- Advanced Correctional Healthcare (Delaware, OH)
- …SUMMARY: Our associates deliver a higher standard of business services to support medical care and behavioral health care. We maintain professionalism, ... Health Serv Administrator - Exempt Job Details Job...the Assistant Regional Nurse Mangers, Regional Nurse Manager or Director Medical Operations, and prepares reports as… more
- Elevance Health (Columbus, OH)
- …culturally competent, person_ _‐_ _centered coordination for all members that addresses physical health , behavioral health , long term services and supports, ... services and supports (LTSS) needs are assessed for physical health , behavioral health , and social...counsels, and evaluates performance of direct reports. + Supports director with operational process and strategy to ensure the… more
- National Youth Advocate Program (Columbus, OH)
- …and clinical therapists on case consultation with the development and growth of behavioral health and outpatient mental health services. **Responsibilities** ... Repayment assistance** , up to $1,200 per year! + Medical , Dental, and Vision + **22 Days Off** Each...+ Lead the application of evidence-informed service modalities in behavioral health service delivery for the Service… more
- Humana (Columbus, OH)
- …make an impact** **Reporting Relationship:** This position reports directly to the Behavior Health Lead Medical Director . **Requirements:** . BCBA-D with ... community and help us put health first** The Senior Utilization Management Behavioral Health Professional utilizes behavioral health knowledge and… more
- BrightSpring Health Services (Columbus, OH)
- …community living, adult host homes for adults regardless of disability, behavioral /mental health support, in-home pharmacy solutions, telecare and remote ... for cardholders/users. Reconcile receipts to US Bank statements, obtain Executive Director approval and retain for audit. Reallocate Purchase card expenses as… more
- Evolent (Columbus, OH)
- …as required. + Entering data into a proprietary system generating cases for both the medical and behavioral health reviewers. These requests may be submitted ... also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our... reviews: LVNs, LPNs, and RNs along with our behavioral health reviewers: LMSWs, LCSW, and LPCs,… more
- Maxim Healthcare Services (Mount Vernon, OH)
- …+ Technological proficiency, including mobile devices for documentation Maxim Benefits: Health and Wellness Medical /Prescription, Dental, Vision, Health ... Advocacy (company paid if enrolled Medical ) and Health Advocate Employee Assistance Program Retirement and Financial Security: Health Savings Account,… more
- Molina Healthcare (Columbus, OH)
- …but not limited to, Hospitals, Independent Physician Association, and complex Behavioral Health arrangements. **Job Duties** This role negotiates contracts ... Remote and must live in Ohio _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy… more
- Molina Healthcare (Columbus, OH)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... from authorization requests or for additional information as requested by the Medical Director . **Job Qualifications** **Required Education** HS Diploma or GED… more